Archived: Sweet Homes Limited t/a Carshalton Nursing Home

Updated 22 July 2022

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. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by two inspectors and a specialist nursing advisor.

Service and service type

Sweet Homes Limited t/a Carshalton Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Sweet Homes Limited t/a Carshalton Nursing Home is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced. Inspection activity started on 22 June 2022 and ended on 24 June 2022.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements plan to make. We took this into account when we inspected the service and made the judgements in this report.

During the inspection

We spoke with five people, five staff, one visitor, the registered manager and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We checked four people’s care records and case tracked two of them.

We looked at three staff recruitment files and the supervision and appraisal records of four staff. We checked medicines records and medicines storage. We carried out observations of interactions in the communal lounge. We also checked water temperatures and window restrictors throughout the care home.

After the inspection

We contacted additional health and social care professionals and continued to request and clarify additional information with the provider.

Updated 22 July 2022

About the service

Sweet Homes Limited t/a Carshalton Nursing Home is a care home providing accommodation, personal care and nursing to people over 65. The care home is registered to accommodate up to 33 people. At the time of our inspection eight people were living there. The service is provided in one adapted, three-floor building on a residential road.

People’s safety had improved. People’s risks were assessed and mitigated. The care home environment was safe, with some safety features improved after we identified them during our inspection. Staff were trained to safeguard people and meet their needs. There were enough staff available at all times to deliver care and support safely. Medicines were managed and administered appropriately, and staff practices reduced the risk and spread of infection.

The décor of the care home had improved. People’s bedrooms had been redecorated and refurbished. People’s needs were assessed, and they were supported to participate in the assessment process. Staff supported people’s oral hygiene and to eat and drink enough. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. Staff received training, supervision and appraisal to enable them to deliver effective care.

We found the care people received had improved compared to the findings of our previous inspection. However, staff interaction and communication was inconsistent. We have made a recommendation about staff receive training to improve their communication with people who may be living with dementia. Staff supported people to celebrate cultural events and their spiritual needs were met. People were supported to make decisions about how they received their care and support.

The level of activity available to people in the service had increased and people had the opportunity to use other areas within the service and its garden if they wanted to. People were supported to maintain contact with their families, friends and faith groups and the provider hosted events to which they were invited. People receiving end of life care were treated with dignity while nursing staff ensured people were not in pain or distressed.

The provider had hired a consultant to improve the service’s quality assurance processes and action planning. Further improvements in quality checks were required as the provider’s audits did not identify the shortfalls we found. The service was also assisted by the local authority’s monitoring and support measures. The views of people were gathered in residents’ meetings and those of staff in team meetings. The service was in the process of transitioning to electronic care records to improve assessments, care plans and quality assurance. These will replace the provider’s paper-based care records.

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

Rating at last inspection and update

The last rating for this service was Inadequate (published 03 February 2022). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of four regulations. However, not enough improvement had been made in relation to quality assurance and the provider remained in breach of regulation 17 Good Governance.

This service has been in Special Measures since 03 February 2022. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

This inspection was carried out in line with enforcement action we had begun against the provider following our last inspection. Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

We have found evidence that the provider needs to make improvements. Please see the Safe, Caring and Well-led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Sweet Homes Limited t/a Carshalton Nursing Home on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to Good Governance at this inspection. Please see the action we have told the provider to take at the end of this report.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.