The Queen Charlotte

Updated 22 January 2020

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 Care Act 2014.

Inspection team

The inspection was carried out by two inspectors and an assistant inspector.

Service and service type

The Queen Charlotte is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

There was no registered manager running the home at the time of our inspection. The registered manager and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. The previous registered manager left the service in October 2019. The provider was ensuring oversight and had a plan to appoint to the registered manager post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We looked at all the information we have received from, and about, this service since the last inspection. We had not requested a provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. We were able to gather this information during our inspection.

We also gathered information from the local authority quality monitoring team.

We used this information to plan our inspection.

During the inspection

During the inspection we spoke with six people who lived at the home, two visiting relatives, two representatives from the provider, two staff with management responsibilities in the home and nine members of staff. Throughout the visits we were able to observe staff interactions with people in the communal areas. 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 looked at a selection of records which included;

Ten people’s care records

Three staff files

Quality assurance questionnaires

Medication Administration Records (MARs.)

Health and safety records

Training matrix

Policies and procedures

Updated 22 January 2020

About the service

The Queen Charlotte is a residential care home providing personal and nursing care up to to 51 older people. At the time of our inspection there were 39 people living in the home. The home specialises in the care of older people who are living with dementia and older people with nursing needs.

The home is a combination of adapted and purpose-built accommodation arranged over three floors. There are lifts to enable people to access all areas including a secure outside space.

People’s experience of using this service and what we found

The home had experienced a period of unsettled leadership. The staff team and new leadership team were committed to supporting each other and promoting person centred care. However, the impact of change in leadership had been felt by the staff team and there was evidence of some uncertainty about expectations. The senior team had a plan in place to address this.

We received positive feedback about the initial impact of the current senior team from staff. We were not able to determine the sustainability of this team at this inspection.

There were systems in place to monitor standards and plan improvements. These were being improved to ensure any shortfalls would be picked up. For example, they had added to their daily walk round checks to include people’s experience.

People felt safe at the home and with the regular staff who supported them. The staff understood their responsibilities and how to protect people from abuse. There had been an increase in staffing and there were adequate numbers of staff to meet people’s needs and keep them safe. There had been high turnover of nurses which had an impact on treatment. Recruitment had been successful to fill vacant posts.

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 respected people’s choices and preferences.

People were cared for by staff who knew them well and were kind and compassionate. Staff were committed to the home and to providing the best care they could. People had built strong relationships with staff and appreciated the familiarity they had. People were unsettled by unfamiliar staff and gave examples of the impact of this.

People enjoyed the food and were supported to eat and drink safely.

People received care and support in a way that met their personal needs and enabled them to follow their own routines, interests and beliefs. The recording of some care was not accurate or consistent. This made it difficult to effectively review care delivery.

There were organised activities, informal chats and entertainment which provided people with meaningful things to do. We received mixed feedback about the sufficiency of support with things to do and ways people could fill their time. People were supported to maintain contact with friends and family members.

Rating at last inspection

The last rating for this service was good (published October 2017).

Why we inspected

We brought forward our scheduled inspection due to concerns raised about risk management at the home. These concerns related specifically to falls management and staffing levels. We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe section of this full report.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

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