About the service:

Chesterholm Lodge is a care home. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Chesterholm Lodge is registered to provide care for up to 15 people, including people living with dementia and mental health needs. At the time of the inspection, there were 15 people living at the service.

People’s experience of using this service:

• Medicines were not always managed safely. People received support to take their oral medicines safely and as prescribed. However, processes in place to manage other medicines were not always robust.

• There were sufficient numbers of staff available to keep people safe and meet their personal care needs. However, staff were not always available to meet people’s social needs.

• People told us they felt that they received safe care.

• The environment was clean and homely.

• Individual and environmental risks were managed appropriately. People had access to appropriate equipment where needed, which meant people were safe from harm.

• Staff had received appropriate training and support to enable them to carry out their role safely. They received regular supervision to help develop their skills and support them in their role.

• People's rights to make their own decisions were respected. Staff recognised people’s individual needs and supported them to make choices in line with legislation.

• People were supported to access health and social care professionals if needed.

• People received enough to eat and drink and were happy with the food provided.

• Staff were kind, patient and responsive to people's needs. People were treated with dignity and staff respected their privacy.

• Staff knew the people they supported well and had a good understanding of their needs which enabled them to provide person centred care.

• People knew how to complain and were confident that if they raised concerns, the registered manager would act promptly to address these.

• People and staff were fully engaged in the running of the service.

• The management team were open and transparent. They understood their regulatory responsibilities.

• The management team had effective quality assurance systems in place and there was an emphasis on continuous improvement.

The service met the characteristics of Good overall. More information is in the full report.

Rating at last inspection:

The service was rated as Good at the last full comprehensive inspection, the report for which was published on 14 September 2018.

Why we inspected:

This inspection was a responsive inspection. We inspected following concerns raised to us by whistle blowers and members of the public.

We undertook an unannounced inspection of Chesterholm Lodge on 30 August 2018. People in nursing homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The service is registered to provide nursing care for up to 15 to older people, many of whom have dementia or mental health issues. On the day of our inspection 15 people were living at the home. This was the services first inspection.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People were safe. There were sufficient staff to meet people's needs and staff had time to spend with people. People’s nutritional needs were met and staff supported people to maintain a healthy diet. Where people had specific dietary needs, these were met.

Risk assessments were carried out and promoted positive risk taking, which enabled people to live their lives as they chose. People received their medicines safely. Records relating to risks and medicines were accurate and up to date.

The service provided support in a caring way. Staff supported people with kindness and compassion and went the extra mile to provide support at a personal level. Staff knew people well, respected them as individuals and treated them with dignity whilst providing emotional support. People and their relatives, were fully involved in decisions about their care needs and the support they required to meet those individual needs.

There was a positive culture at the service that valued people, relatives and staff and promoted a caring ethos that put people at the forefront of everything they did.

People received effective care from staff who had the skills and knowledge to support them and meet their needs. People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible; the procedures in the service supported this practice. People were supported to access health professionals when needed and staff worked closely with people's GPs to ensure their health and well-being was monitored.

People had access to information about their care and staff supported people in their preferred method of communication.

The service continued to be responsive to people's needs and ensured people were supported in a personalised way. People's changing needs were responded to promptly. People had access to a variety of activities that met their individual needs.

The registered manager monitored the quality of the service and looked for continuous improvement. There was a clear vision to deliver high-quality care and support and promote a positive culture that was person-centred, open, inclusive and empowering which achieved good outcomes for people.