Archived: Charlton House Community Resource Centre

Updated 30 April 2019

The inspection:

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team:

The inspection was carried out by two adult social care inspectors, a specialist advisor who was a registered nurse, and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service. The expert by experience’s area of expertise was dementia care.

Service and service type:

Charlton House Community Resource Centre is a ‘care home’. People in care homes receive accommodation and nursing or personal care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had recently appointed a new manager who was registering with the Care Quality Commission. This means that they and the provider will be legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection:

The inspection was unannounced.

What we did:

Before the inspection we reviewed the information we held about the service and the service provider. The registered provider had completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

We looked at the notifications we had received for this service. Notifications are information about

important events the service is legally obliged to send us within required timescales. We used all this information to plan our inspection.

During the inspection, we looked at the care records of eight people who use the service and people’s medication records.

We reviewed five staff files. These included information about recruitment, training, induction and supervision.

We looked at records related to the management of the service. These included checks and audits, meeting minutes and health and safety documents. We reviewed policies and procedures including safeguarding, whistleblowing, complaints, mental capacity, recruitment and medicines. We considered this information to help us to make a judgement about the service.

During the inspection we spoke with 10 people who lived at the service. Some people were unable to tell us about their experiences of living at Charlton House because they were living with dementia and unable to communicate these thoughts. We used observation to help us understand the experience of people who could not talk with us.

We spoke with six members of staff, the registered manager and clinical lead. During and after the inspection we spoke with the relatives or friends of six people who lived at the service.

Updated 30 April 2019

About the service:

Charlton House Community Resource Centre is a nursing home. It was providing personal and nursing care to 28 people aged 65 and over at the time of the inspection.

People’s experience of using this service:

• Risks to people and staff had not been consistently assessed. For example, regular checks of some areas of health and safety.

• The provider had failed to notify CQC about some incidents which had taken place at the service.

• There were enough staff to meet people’s needs. The provider was recruiting to vacant posts, and safe recruitment processes were followed.

• People's medicines were mostly administered as prescribed and managed safely by competent staff. Staff did not consistently record information about the application of creams and ointments.

• Staff felt supported by the management team, and received training and induction to ensure they could effectively perform their role. Staff received supervision, but this had not consistently met the provider’s standard for supervision to take place every 4-6 weeks since the last inspection.

• People were supported by staff to eat and drink enough to maintain a balanced diet. We received mixed feedback about the meals provided.

• The environment was bright, clean and well maintained, although there were few points of interest for people to interact with. The registered manager had plans to improve areas of the service.

• People accessed routine and specialist healthcare appointments. Relatives told us they were consulted with and informed about people’s care.

• People were assisted to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

• People were supported by staff who were kind and respectful. Staff knew people well and were aware of their preferences, likes and dislikes.

• People were supported to participate in activities, and choices were respected.

• People's care considered their individual needs and preferences. Some care plans and records required reviewing to ensure staff had the information they needed to provide high quality care. Care records were being updated at the time of our inspection.

• Some checks and quality assurance systems were in place, but other tools were being set up. These needed to be put into practice and checks recorded. Where these were in place, they were clear and action plans identified ways to improve the service.

• The service met the characteristics for a rating of "good" in caring and responsive. The other areas were rated as “requires improvement". The overall rating for the service remained at "requires improvement".

• More information is in our full report.

Rating at last inspection:

Requires improvement (report published 16 March 2018)

Why we inspected:

This was a planned inspection based on the rating at the last inspection.

Follow up:

We will continue to monitor the service through the information we receive. We will visit the service in line with our inspection schedule, or sooner if required.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk