Enter and View visit to Chestnut House Extra Care Housing Scheme for older people
What we did
Visiting extra care schemes continues to be a strategic priority of the use of our Enter and View powers, as it is often the case that tenants of such schemes have fewer chances to express their views in comparison to people using other health or social care schemes.
The purpose of Extra Care Schemes is to combine the advantages of independent living with the provision of co-ordinated onsite care to cover a wide range of essential care needs.
Chestnut House Extra Housing Scheme provides care for people with a minimum care need of 10 hours a week.
The care plans are reviewed every 6 months, or earlier if there is significant change. The majority of tenants suffer from age-related cognitive impairment.
The scheme has capacity for 48 tenants.
We aimed to use interviews with tenants and observations of staff and tenant interaction during our visit at Chestnut House on 17th December 2015, and subsequent conversations with tenant relatives to report on:
- The quality of individual care.
- The responsiveness of services to individual tenants’ need.
In total we spoke to 15 tenants, and 4 relatives.
Key Findings
The feedback from tenants was generally positive, particularly regarding personal care. Many tenants felt that care staff respected their dignity, privacy and allowed them to be as independent as they could be, which was also demonstrable in the scheme’s approach to meal arrangements.
For some tenants, this was perceived as a great alternative to living in a residential care home.
However, there was some negative feedback from both tenants and relatives, including:
- Some tenants feeling unable to speak up for themselves on their wishes.
- Limited activity options outside of what was already provided.
- Delay in repairs.
- Inconsistent staff attitudes, with some staff being more caring than others.
- Lack of communication with relatives.
Our recommendations
Overall, tenants were relatively satisfied with the care provided at Chestnut House. However, based on our interviews and observations, there are some areas of improvement and we recommend the following:
- London Care should discuss with Wandsworth Social Service’s commissioners how best to clarify the responsibilities of and expectations from the scheme and the care manager as to when and how tenants’ additional support needs going beyond narrow definitions of personal care should be responded to. This might best be considered in the context of the contract retendering process.
- The Care Manager should consider how best to reassure relatives about the scheme’s continued commitment to working with them and in particular should make arrangements to ensure that the office downstairs is normally staffed at times when visitors might be expected.
- The care providers and commissioners should consider the potential advantages of offering some or all tenants individual key working support.
- The Care Manager should consider how the provision of meals to a number of tenants in the communal dining area, if it is to continue, might be made into a more enjoyable and sociable experience for them.
What happens next
We shared the report with the managers of Chestnut House. They have sent a response to our recommendations, which you can read below.
We also shared the report with Wandsworth Adult Social Services and we will continue to follow how they may develop the Extra Care Scheme model of care based on what tenants have told us.
Download the reports
If you need this report in a different format, please e-mail
enquiries@healthwatchwandsworth.co.uk or call 020 8516 7767
