Membership review for Chesfield House

The membership review is intended to reflect the experiences of the visitor who might be looking for a placement.

The review is subjective, consistent and impartial, representing the impressions of our team member on the day of the visit. It is a snapshot view only. The contents of this review are intended to cover some of the subjects and issues which an individual, their relatives or their placement officer might ask.

This review has been published with the written agreement of the home owner, or an authorised representative of the company.

‘The staff I spoke with were friendly and helpful, had a great knowledge of each individual service user and clearly took pride at each individual’s achievements.’

Summary of findings

Chesfield House is a residential service situated just outside Leominster on one of the main roads going into the town. 

It felt like a very relaxed home which fitted right into town life. On the day of the visit 4 individuals were living at Chesfield House, all of whom had demonstrated an ability to live at least semi independently. Not all the individuals had a diagnosis of autism; however, I felt the service could meet the needs of someone on the autistic spectrum. None of the individuals had demonstrated behaviour that was particularly challenging, physically or verbally, and on the day of the visit I did not see it as the ideal environment for someone with significant needs in this area. Chesfield could act as an excellent stepping stone to a supported living arrangement.

Introduction

Inspiration Care had several residential and supported living and domiciliary care services in Herefordshire. As well as individuals on the autistic spectrum, Inspiration Care were supporting individuals with learning disabilities, acquired brain injury, cerebral palsy, mental health problems, Asperger’s Syndrome, Prader Willi syndrome and a variety of co-morbid conditions such as epilepsy. 

Chesfield House is situated on the outskirts of the market town of Leominster. There were all the amenities that one might expect within close reach - supermarkets, hospital, GP and dental services, sports, leisure and educational facilities, as well as a bus terminal and main-line rail station which connects to Shrewsbury, London Paddington and the Midlands.

Chesfield House is a Georgian town house with two en-suite bedrooms and three self-contained units. There is walkable access to leisure facilities with a gym and swimming pool close by. The home had a multi-purpose vehicle for all transport needs.

First Impressions

I approached Chesfield House on foot after walking through Leominster. The house is within easy walking distance of the town. The property had nothing about it that suggested it was a residential home and it blended in with the properties on the road. I was greeted at the door by Terry Lewis, the Registered Manager, who took me round the property where I met a couple of staff members and one of the individuals who was living at Chesfield House.

The Environment (Internal)

Chesfield House had  5 ensuite rooms, 3 of which have kitchen facilities one of which was on the ground floor There was a large comfortable lounge and dining room and a fully fitted kitchen.  The home had modern bathroom facilities and was seen to be clean and well maintained throughout.       

The Environment (External)

Chesfield House has a really nice, well-designed and proportioned back garden which looked resplendent in the sunshine on the day of the visit. The front of the property opens on to the main road.

The Environment (Wider environment)

Several individuals have done part-time work and voluntary work in the community whilst living at Chesfield House and a couple of young people who lived there attended local colleges. 

Service users were supported to access local services and amenities. Hereford and Worcester are the nearest major cities and various amenities could be accessed in those areas from both an educational (Worcester and Hereford Colleges) and leisure (Cinema and swimming baths) perspective. Although there were two vehicles available for staff to use to transport individuals when necessary, public transport is very easily accessible with a bus stop just a short distance  from the house. 

Terry, the Registered Manager, reported that there were good relationships on the whole with neighbours and I had heard from Directors, Martyn Titcombe and Karen Hall, that the community of Leominster had been very accepting of Inspiration Care and the individuals they have supported.

Understanding Autism

Inspiration Care ensured that staff were trained to respond effectively to the individual needs of service users with autism and staff were supported by a team of professionals, including psychologist, Nick Logan, who is actually on the board of directors, who were brought in regularly by Inspiration Care to support both service users and staff.

All staff members are also trained with the CALM system (Crisis and Aggression Limitation and Management), which has emphasis on the use of diversion and de-escalation skills.  

Before individuals came into the service, an assessment was carried out which looked at mental capacity, health and medication; mobility and transport; personal care, communication, routines, mental health support and behaviour support needs.

Relationships, dietary needs, social activities and day time activities also form part of the initial assessment.

Health and Wellbeing

All the people living at Chesfield  House were registered with the local General Practitioner. One individual who was resident on the day of the visit was taking a low dose of anti-psychotic medication and medication was seen to be stored appropriately in a robust, lockable cabinet. All health services including GP, dentist and hospital are virtually on the doorstep. 

As mentioned in the introduction, one individual residing at Chesfield House had a diagnosis of Prader Willi Syndrome and staff supported the person to manage the condition through  appropriate menus in a sensitive way  without making it an issue for them. 

Individuals living in the home

There were four individuals residing at Chesfield House on the day of the visit. All communicated verbally and although some had quite complex needs, all had demonstrated a level of independence and rarely offered physically or verbally challenging behaviour. One young man I met on the day had been awarded Student of the Year at Hereford Art College and was due to undertake a course at Hereford Technical College in September 2014. The needs of each individual were quite varied in terms of their conditions and situations which included acquired brain injury, Prader Willi Syndrome and Asperger’s Syndrome.

Staffing

The staff members I spoke with were friendly and helpful, had a great knowledge of each individual service user and clearly took pride at each individual’s achievements.

The induction for new staff took place over three weeks and included attendance at a number of specific  training sessions around working with autistic clients. There was also induction to Chesfield House itself. Time was also allowed for reading  to allow an understanding of care plans and protocols. As well as the induction training, staff also received training in fire safety, food hygiene, first aid, health and safety, infection control, manual handling, protection of vulnerable adults, safeguarding and mental capacity and deprivation of liberty safeguards.

All shift leaders had supervisory and management training and staff received supervision on a six weekly basis. 

Martyn Titcombe (Director) stated that across the company agency staff were rarely used and it was only because a member of staff had left at short notice that minor usage in recent times had been prompted.

Management of the home 

Terry Lewis was the Manager of Chesfield House. Terry had worked with Inspiration Care since its inception and had been working in social care for several years before that. I asked Terry what he felt was Chesfield’s greatest achievement in the last 2 years. He said he was really proud of how the staff and home came together to support a family, the other service users and  each other after a service users death after a long illness.  The family were touched by the involvement of the team, in the final weeks of the individuals life the family requested that staff remain with them and their daughter stating that they were part of the family as well. 

I also asked Terry what makes Chesfield unique. Terry felt the fact that it is homely and “if people visit I generally have the comments that the home feels very homely, not like a care home or institution at all, but coming to a home from home”. The friendly atmosphere is, he said, something they work on whilst at the same time maintaining a high level of professionalism, ensuring that service users and staff have the opportunity to eat together; ensuring that paperwork is completed discretely as examples.

Lastly I asked Terry how he saw Chesfield House developing over the next 2 years. Terry stated that each year he had worked and managed at Chesfield House, they had developed and he felt that in the next two years Chesfield will continue to get better.  Terry felt that they have learnt a lot about how to support individuals and how to really develop a strong plan quickly and how to monitor this better so that the individual has the best chance of improving. Terry looked  towards a future where Chesfield House will have a reputation of being a highly regarded rehabilitation / education home – a home that will support someone towards independence.

The ratio of service users to staff was never more than 2 to1 during daytime hours. There was also at least one waking night staff and a sleep in staff member on duty through the night.

Policies and procedures relating to the running of the home were available for staff to peruse. There was a staff handbook, supplied to each member of staff which covered areas such as conduct and appropriate dress, as well as support mechanisms. The handbook was due to be reviewed in the near future.

Conclusion

Not all the individuals at Chesfield House had a diagnosis of autism; however, I felt the service could almost certainly meet the needs of someone on the autistic spectrum. None of the individuals were demonstrating behaviour that was particularly challenging either physically or verbally and on the day of the visit I felt that it would be an individual of a similar ilk who would fit best into that environment. Chesfield House could act as an excellent stepping stone to a supported living arrangement.

I would definitely see Chesfield House as an excellent home for someone with autism or Asperger’s without major behavioural concerns. Chesfield House is somewhere an individual can integrate into a supportive community where people from the home can go about their business successfully whilst at the same time receiving therapeutic support form a caring and knowledgeable staff team.

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Visiting Officer: Craig Godding, Director of Operations
Living Autism