Background to this inspection
Updated
22 January 2016
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This inspection took place on 04 November 2015 and was unannounced.
The inspection team consisted of three inspectors and a nurse specialist who was experienced in caring for elderly people.
Before the inspection we gathered information about the home by contacting the local authority safeguarding and quality assurance team. In addition, we reviewed records held by CQC which included notifications, complaints and any safeguarding concerns. A notification is information about important events which the service is required to send us by law. This enabled us to ensure we were addressing potential areas of concern at the inspection.
We also reviewed the 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.
During our inspection we spoke with ten people, three relatives, and seven staff which included the manager and area manager. We observed how staff cared for people, and worked together. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We also reviewed care and other records within the home. These included six care plans and associated records, seven medicine administration records, seven staff recruitment files, and the records of quality assurance checks carried out by the staff.
At our previous inspection in January 2015 we had identified three concerns at the home. At this visit we saw the provider and manager had taken action to improve the home for people.
Updated
22 January 2016
Charters Court Nursing and Residential Home provides care and support for up to 60 people. The home is divided into three suites, and people live in the suite that best suits their needs. They cover residential, nursing and dementia care. Care is provided over two floors with a passenger lift and stairs to meet people’s needs. The home has been purpose built to meet the needs of elderly people with physical and mental health support needs. At the time of our visit 27 people lived at the home.
There was not a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. The manager of the home had submitted their application to the Care Quality Commission to become the registered manager of the home.
The home was light and airy. Excellent adaptations had been made for people with mobility needs, such as wide corridors and doorways. Good provision was provided for people that lived with dementia, to prompt memory’s and remain active. The manager and staff worked well to keep the environment clean and feeling homely for people. People were positive about their experiences at the home. One person told us, “It’s very nice here. Staff come and have a chat, and we have a laugh together.” Staff said, “It’s all about the people here; making sure they are happy enjoying themselves in their home, and looked after in a proper way.”
The inspection took place on 04 November 2015 and was unannounced. At our previous inspection in January 2015 we had identified three concerns. These have since been addressed by the manager.
There was positive feedback about the home and caring nature of staff from people and their relatives. One person said, “I am perfectly content and happy here.” When asked if anything could be improved they said, “Quite honestly, no. They give exactly what I need.”
People were safe at Charters Court Nursing and Residential Home. There were sufficient staff deployed to meet the needs and preferences of the people that lived there. Staff were available when people at risk of falls were moving around, or when people asked for help. One person said, “I never have to wait for staff.”
Risks of harm to people had been identified and clear plans and guidelines were in place to minimise these risks, without restricting people’s freedom. One person said, “I get to go out for a walk every day. The first time staff helped and showed me around (for safety), now I go out on my own when I want.” Staff understood their duty should they suspect abuse was taking place.
In the event of an emergency people would be protected because there were clear procedures in place to evacuate the building.
The provider had carried out appropriate recruitment checks to ensure staff were suitable to support people in the home. Staff received training and induction to support the individual needs of people in a safe way.
People received their medicines when they needed them. Staff managed the medicines in a safe way and were trained in the safe administration of medicines.
Where people did not have the capacity to understand or consent to a decision the provider had followed the requirements of the Mental Capacity Act (2005). An appropriate assessment of people’s ability to make decisions for themselves had been completed. People told us that staff did ask their permission before they provided care.
Where people’s liberty may be restricted to keep them safe, the provider had followed the requirements of the Deprivation of Liberty Safeguards (DoLS) to ensure the person’s rights were protected.
People had enough to eat and drink, and received support from staff where a need had been identified. One person said, “We have a choice of meals and can always ask for something different.” Specialist diets to meet medical or religious or cultural needs were provided.
People were supported to maintain good health as they had access to relevant healthcare professionals when they needed them. When people’s health deteriorated staff responded quickly to help people and made sure they received appropriate treatment. People’s health was seen to improve due to the care and support staff gave.
The staff were kind and caring and treated people with dignity and respect. One person said, “Staff are nice; I’m very impressed, they are all very friendly.” Good interactions were seen throughout the day of our inspection, such as staff holding people’s hands and sitting and talking with them. People could have visitors from family and friends whenever they wanted.
Care plans were based around the individual preferences of people as well as their medical needs. They gave a good level of detail for staff to reference if they needed to know what support was required. People’s involvement in the review and generation of these plans had been recorded. People received the care and support as detailed in their care plans.
People had access to activities that met their needs. Group activities were available to people during the week. Individualised activity plans were being further developed. The staff knew the people they cared for as individuals.
People knew how to make a complaint. Documents recorded that complaints had been responded to in accordance with the provider’s policy.
Quality assurance records were kept up to date to show that the provider had checked on important aspects of the management of the home. Records for checks on health and safety, infection control, and internal medicines audits were all up to date. Accident and incident records were kept, and were analysed and used to improve the care provided to people.
People had the opportunity to be involved in how the home was managed. Meetings and surveys were completed and the feedback was reviewed, and used to improve the service.