Background to this inspection
Updated
21 June 2018
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.
We visited the service on 15 and 16 May 2018. The inspection was unannounced and was carried out by two adult social care inspectors 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.
Before our inspection we looked at the information CQC had received about the service including notifications of incidents that the provider had sent us, complaints and safeguarding. The manager had completed a ‘Provider Information Return’. 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 read the report from Healthwatch Cheshire West following their visit to the home in 2017, and information received from the local authority.
During our visit to the service we spoke with 12 people who used the service, five visitors and 15 members of staff including the manager and the deputy manager.
We observed care and support in communal areas and staff interaction with people. We looked at six people’s care records and records relating to health and safety, staff, and the management of the service.
Updated
21 June 2018
This unannounced inspection took place on 15 and 16 May 2018. Charlotte House 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. The home is registered to accommodate up to 103 people in purpose-built three-storey premises, and 65 people were living there at the time of this inspection.
The home 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. 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 home had a registered manager who had been in post for one year.
At our last inspection of the home in February 2017 we found a breach of Regulation 12 of the Health and Social Care Act 2008 because people’s medication was not always managed safely. During this inspection we found that improvements had been made and medication was managed safely.
People we spoke with believed the home was safe. Maintenance records showed that regular checks of services and equipment were carried out by the home’s maintenance person and testing, servicing and maintenance of utilities and equipment was carried out as required by external contractors. We found concerns regarding fire doors and this was addressed swiftly.
All parts of the premises looked clean. The home had received a good score following an infection control inspection and the kitchen had a five star food hygiene rating.
Before the inspection we received concerns regarding staffing levels, however during our visits to the home we found there were enough qualified and experienced staff to meet people’s care and support needs. Recruitment records showed that robust procedures had been followed to ensure new staff were suitable to work with adults at risk of abuse or neglect..
Risk assessments were recorded in people’s care notes and plans were put in place to reduce the risks identified. A log of accidents and incidents was maintained and the records showed that appropriate action had been taken when accidents occurred.
Staff received training about safeguarding as part of their induction, with updates periodically. The manager had reported safeguarding incidents as required and full records were kept of safeguarding referrals that had been made.
The service complied with the requirements of the Mental Capacity Act 2005 and appropriate Deprivation of Liberty Safeguard applications had been made to the local authority.
People told us they enjoyed their meals and had plenty to eat and drink. The cooks were aware of people’s preferences and individual dietary needs.
There was a comprehensive programme of training for all staff to ensure that they knew how to work safely. New staff had a five day induction before starting work.
People who lived at the home told us that the staff provided them with good care and support. One person commented “I couldn’t wish for better staff. They’re all lovely.” Another person said “They go out of their way to help you, they’re so caring.” Everyone had their own bedroom and personal care was provided in a discreet way in the privacy of the person’s room.
The care files we looked at showed that people’s care and support needs were assessed covering all aspects of their health and personal care needs and personalised plans were written for the care and support people needed. These were kept up to date with monthly reviews.
There was a planned programme of regular social activities, including trips out.
Regular meetings were held for staff and for people living at the home and their families. The staff we spoke with told us they enjoyed working at the home and found the management very supportive.
There was a schedule of quality audits for the year and these had all been completed to date. These were accompanied by action plans for improvement as needed.