Chestnut Lodge Care Home

People had medicines prescribed as and when they were required 'PRN' however, it was not clear these had been effective. Appropriate recording was not carried out to identify why these medicines were given and if they had the desired effect. PRN protocols were not in place for all medicines.

Lessons were not always learnt when things went wrong. Audits were carried out on accident and incidents that occurred however, patterns and trends were not looked at to try and reduce falls.

The management team were responsive to the concerns highlighted to them on the inspection and acted quickly to rectify shortfalls found.

Staff were recruited safely. Some feedback we received highlighted that at times the service can appear busy especially the sound of the call bells. A dependency tool was used to assess how many staff were required to look after people safely. However, the registered manager identified where some improvements could be made to make the tool more effective.

People and relatives told us they felt safe using the service. Staff knew how to recognise signs of abuse and knew where to report any concerns. The registered manager referred concerns to the local authority safeguarding team.

Infection control procedures were followed in the service. We observed regular cleaning being carried out and relatives felt the home was clean when they visited.

There was a positive culture within the service and people, staff and the relatives spoke highly of the management team. Staff felt the manager was approachable and always had their door open if they had concerns.

Quality assurance audits were being carried out and some improvements have been made since our inspection to ensure a more effective oversight at the service. Actions were taken to make changes to the call bell system after feedback about the noise for people. People, relatives were encouraged to feedback

about the service through questionnaires and meetings. This encouraged the management team to make changes where necessary.

The registered manager was clear about their roles and responsibilities. Notifications were sent into the care quality commission in line with regulations. The service was open and transparent and followed the duty of candour when things went wrong.