Archived: Charlton House Residential Care Home

At the last inspection in August 2016 we found a breach of the regulation relating to quality assurance and we issued a requirement action. Overall, we rated the service as Good. Following the inspection, the provider sent us an action plan telling us how they would make the required improvements.

We carried out a comprehensive inspection on 11 July 2018. At this inspection, we found improvements had been made and the legal requirements had been met.

Overall, the service remains Good.

One of the registered providers was also the registered person/manager. The registered providers, who lived on the premises, had registered with the Care Quality Commission to manage the service. Registered persons have a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The registered person worked every day and employed one member of staff. This was sufficient to meet people’s needs at the time of our visit. Staff performance was monitored through supervision and appraisal.

Medicines were safely managed. Actions were taken after the inspection to make sure supporting records were fully maintained.

Staff demonstrated a good understanding of safeguarding and knew how to report concerns.

People were helped to exercise support and control over their lives. People were supported to consent to care and make decisions.

Risk assessments and risk management plans were in place. Actions were taken after the inspection to make sure risks associated with legionella were identified and managed. Incidents and accidents were recorded.

People were provided with choices at mealtimes. Healthy eating was promoted.

Staff were kind and caring. People were being treated with dignity and respect and people’s privacy was maintained.

Systems were in place to monitor the quality of the service provided. People were given the opportunity to provide feedback.

There was a registered manager in post. One of the registered providers was also the registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider. They were available on the day of our inspection.

Although the service was well led and the registered manager provided good leadership and management, the arrangements in place to assess, monitor and improve the quality of the service were unsatisfactory. There had been no consideration given to how people would be looked after if the registered manager was unwell and could not work. Although people were satisfied with the service they received, there were no records of any feedback they had provided about the service they received.

Both the registered manager and the one member of staff were aware of their responsibilities to protect people from coming to harm and knew how to raise and report concerns. The registered manager would benefit from refresher training with the local authority. The registered manager was ‘on duty’ each day and overnight and during weekday mornings there was one other care assistant. The people in residence at the time of the inspection were fairly independent and these staffing levels were sufficient. The registered manager administered people their medicines as prescribed by the GP and arranged for the repeat prescriptions when these were due. Medicines were well managed.

The induction training programme for the care assistant was basic and did not meet the requirements of the Care Certificate that was introduced in April 2015. The Care Certificate is a set of standards that social care and health workers must work to in their daily working life. However, the care assistant worked with the registered manager at all times and had already commenced a diploma in health and social care.

Any risks to people’s health and welfare were assessed as part of the care planning process. People received the care and support that met their specific needs. People were assessed to check they were able to give consent and made decisions about their day to day life. The registered manager was familiar with the principles of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. This is legislation to ensure people were not deprived of their liberty when they could not give consent. Those people in residence at the time of the inspection were able to consent to be looked after at Charlton House.

People were satisfied with the meals and the drinks they were served with. Any preferences and dislikes of food they had were taken in to account. Where there were concerns about how much a person ate or drank they consulted with the person’s GP. Arrangements were made for people to see their GP and other health and social care professionals as and when they needed to.

Both the registered manager and the care assistant had good relationships with the people they looked after. We found both to be kind, caring and friendly. People were encouraged to express their views and opinions but records were not kept of any feedback people provided. They said they were listened to and were involved in making decisions about their care and support.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

People confirmed that staff listened to them and acted appropriately to their requests. One person said "The staff let me decide how I would like to spend my day and watch the television' and 'If I need help the staff are always here to help me'.

We found people had an individual care plan file which explained their needs and had information about the assistance the people needed. Arrangements were in place to deal with unforeseeable emergencies.

People were cared for in a clean, hygienic environment. We found high standards of cleaning. We checked people bedrooms and were found them to be clean and tidy this included en-suite facilities. All communal toilets were found clean and odourless and had anti-bacterial soap and paper towels in place to wash and dry your hands with.

People that we spoke with during our visit told us "The staff are very nice and very caring' and 'Staffing levels are good. It's nice the staff can take their time and haven't got to rush around'.

Records were kept securely and could be located promptly when needed. The home had a designated area in the main lounge that had a locked cabinet that was used to store files of people who used the services. The registered manager told us that they and the staff on duty had access to keys.

We observed that people were assisted and encouraged to eat their meals in an appropriate and dignified manner. The staff were friendly, caring and supportive and we heard them asking people if they had enough to eat and drink.

People were given support by the provider to make a comment or complaint where they needed assistance. People living in the home told us 'I do not have anything but praise for the home but if I was unhappy I would speak up and be heard' and 'I would tell the staff if I was unhappy'.