Chesterton Lodge

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs. This is the first assessment for this service. This key question has been rated good: This meant people’s needs were met through good organisation and delivery.

This service scored 64 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

While the provider made sure people were at the centre of their care, as we have explored in the caring key question, improvements were needed to ensure people were supported holistically with their needs, in relation to meaningful social engagement. However, the provider worked in partnership with people, relatives and other professionals when reviewing changes in people’s needs. Relatives told us they were involved in the care planning process and had access (where appropriate) to people's care plans. Staff told us they could easily access people’s care plans and risk assessments. Staff were knowledgeable about people's support needs without having to refer to documentation. Staff told us there were regular handovers where changes in peoples’ health, incidents or accidents were shared. One staff member told us, "We have handovers for each individual person. We pass on medical issues, distressed behaviour or appointments. We have to read the handheld devices and confirm it has been read." Care plans were person centred and focused on needs and choices of the person. However, where people’s care plans identified people’s previous hobbies, interests and history. It was not clear how these were being met. The provider shared their plans to increase social engagement and activities in the home.

The provider understood the diverse health and care needs of people, so care was joined-up, flexible and supported choice and continuity. However, there was limited information supporting any community engagement. One person told us, “I am not able to get out and about at all or see anyone outside of the home.” The provider told us there were planned activities and outings in the community, although the last planned outing had been cancelled due to an outbreak of sickness in the home. Staff told us people's care was regularly reviewed and visiting professionals told us the provider worked transparently and shared concerns openly. Care records evidenced continued partnership working and referrals to other health professionals were made as and when required. Care plans and risk assessments were regularly reviewed.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs, such as larger print, audio or braille. Relatives told us they were kept updated with people’s health and wellbeing. One relative told us, "The staff are very good, really good at keeping me updated." Staff told us people attended regular meetings where they could express their views and make suggestions into the service. Monthly newsletters were sent out to relatives and copies given to people using the service. We observed aids such as dementia clocks and date and weather information to support people with dementia. A dementia clock is a clock designed to help people with memory loss tell the time and date. The clocks can help people feel more oriented, which can reduce confusion and anxiety.

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. People told us they attended meetings where they could express their wishes. One person told us how they had recommended a change in the menu and how this had been actioned. They said, "Every Wednesday we have a discussion, we talk about the food, what we think, what we want. I will suggest things. The staff listen.” Staff told us they listened to people and respected their choice and decisions. Although, they said they would like more time to spend talking to people. People and relatives were invited to take part in meetings to feedback into the service. Care plans detailed people’s communication ability and recorded communication aids when required.

The provider made sure people could access the care, support and treatment they needed when they needed it. One person told us "I sometimes see the doctor or the nurse. They [staff] look after me." Staff told us they raised concerns with external professionals such as district nurses, physiotherapists and doctors as and when needed. Partners told us the provider raised referrals as and when required. Records detailed people accessed health professionals such as opticians and dentists as required. We reviewed examples where the provider sought advice and guidance from professionals such as occupational therapists and physiotherapists.

People’s care and treatment was tailored to suit their health needs and wellbeing to ensure they could access support when required. However socially, people told us there were limited opportunities to access and engage in stimulating activities and social events. Staff told us they needed more time to spend interacting and engaging with people. One staff member said, “I feel I am rushing. For example, when supporting a person to dress, I haven’t always got time to talk to that person, it’s more like quick bursts of conversations. Sometimes people want to tell you about their dream, but we don’t always have the time." We observed people engaging in some activities, such as bingo during the first site visit and singing and armchair exercises on the second site visit. We observed people using satellite kitchens to access and prepare their own drinks. However, some people sat for long periods without support to engage in activities of daily living. The provider had an equality, diversity and inclusion policy. The provider shared several initiatives to support people's equality and diversity needs, including an internal LGBTQ(+) group made up of people who identified as being LGBTQ(+) to provide support to each other. LGBTQ+ is an initialism that stands for lesbian, gay, bisexual, transgender, queer or questioning. The ‘+’ represents those who are part of the community, but for whom LGBTQ does not accurately capture or reflect their identity.

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life. Relatives told us about people's health care plans and how these were being met by the service. Staff told us about people’s current support requirements and goals. People’s health goals were clearly documented in care plans. Where people were nearing the end of their life, people's care plans contained end of life wishes and choices. We saw how the home used ReSPECT forms to gather peoples wishes for end-of-life treatments. ReSPECT forms record a summary of a patient's wishes for emergency care and treatment.