The Chestnuts

This service was previously rated as good. We carried out this assessment to confirm whether the rating of good remains accurate. This report does not provide detailed information on areas where we found practice continues to meet a good standard. Instead, our findings focus on any areas where the service needs to improve or where we found exceptional practice.

We assessed the service against ‘Right support, right care, right culture’ guidance to make judgements about whether the provider guaranteed autistic people and people with a learning disability respect, equality, dignity, choices, independence and good access to local communities that most people take for granted. The Registered Manager told us, “The people are at the centre of everything we do. We want to empower them to have a choice and promote their independence.”

The provider had not ensured all environmental and food safety risks were effectively managed. We found a cupboard containing chemicals was unsecured and some food was out of date or did not have appropriate labelling. The Registered Manager secured the cupboard immediately and ensure food beyond its storage date was removed. However, equipment and facilities were regularly checked to ensure they remained safe. Records showed actions identified from these checks were monitored and completed promptly.

Care plans contained detailed and personalised information about people’s health needs. Risk assessments reflected people’s individual risks and provided staff with guidance to support people safely, including in relation to nutrition, epilepsy and modified diets. Staff received relevant training to support people safely. Relatives told us that they felt staffing levels were consistent and that people were supported safely with their mobility and using equipment.

Recruitment checks were completed appropriately. Staff received regular supervision and leaders undertook competency assessments. Leaders ensured staff received training to meet people’s needs.

Medicines were managed safely, with systems in place for storing and administering medicines. Care plans contained clear guidance for staff on when ‘as required’ medicines should be administered. Leaders worked closely with professionals to review medicines and support people with complex health care needs.

Leaders demonstrated a positive approach to learning from incidents and safeguarding concerns. These were investigated and actions implemented to reduce recurrence. Staff told us learning was shared through handovers and team meetings. For example, following a fall, referrals were made to relevant professionals and measures introduced to reduce risks. One staff member told us, “If there are lessons to learn, we discuss them in team meetings and take the manager’s advice on how we can do things better in the future.”

Staff consistently described a supportive leadership team and a culture focused on people, choice and independence. Governance systems provided management oversight and ensured action plans were monitored to support service improvement.

Leaders demonstrated a commitment to continuous improvement through action plans and implementing new ideas. This included engaging with professional forums and improving opportunities for people to access their community.

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes, this can be done through a procedure called the Deprivation of Liberty Safeguards (DoLS), which is part of the Mental Capacity Act 2005 (MCA). We found that staff and leaders worked within the MCA. DoLS authorisations were appropriately applied for and overseen.