Carolyne House

Updated 17 March 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

Three inspectors carried out this inspection. An expert by experience supported the inspection. 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 had knowledge of services for people living with dementia.

Service and service type

Carolyne House 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 did not have a manager registered with the Care Quality Commission (CQC). The manager had started in post just before the inspection and was in the process of applying to CQC to become the home's registered manager.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

Before our inspection we reviewed the information we held about the service including previous inspection reports. 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 they plan to make. We took this into account when we inspected the service and made the judgements in this report. We looked at safeguarding alerts and notifications which had been submitted. A notification is information about important events which the provider is required to tell us about by law.

We used the Short Observational Framework for Inspection (SOFI). A SOFI is a tool for observing interactions between care staff and people who may not be able to communicate with us verbally. This gives us an idea of what their care experience might be like for the time we are there. We observed the lunchtime meal and conducted a SOFI in the communal lounge.

We spoke with eleven people using the service and eight relatives about their experience of the care provided. We spoke with eight staff, including the manager and the regional operations director. We spoke with two visiting professionals.

We reviewed six peoples care records and other records relating to the management of the service. These included two staff recruitment records, training documents, rotas, accident and incident records, complaints, health and safety information, quality monitoring and medicine records.

After the inspection

We received updates from the regional operations director about improvements that had been made, in areas such as staffing, meaningful activities and medicines.

Updated 17 March 2020

About the service

Carolyne House is a care home providing personal and nursing care to 52 people at the time of inspection. The service can support up to 52 people. Carolyne House accommodates people across two separate floors. Each floor provides care and support to people with different needs, including residential, nursing care and some people living with dementia.

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

There were not always enough staff adequately deployed or on duty to meet people's needs in a timely way. People consistently told us there was not enough staff. Staff were not able to spend meaningful time with people. Following our feedback, the provider increased staffing levels. Procedures had been followed to ensure staff were recruited safely. Risk assessments were carried out and overall these were managed well. Staff understood how to protect people from the risk of abuse and how to report any concerns.

Medicines management required improvement. Overall people received their medicines as prescribed, however we identified some concerns in relation to the medicine room being very untidy and cluttered, oxygen storage was not following best practice and a lack of recording in relation to topical creams being applied. We made a recommendation in relation to the storage of oxygen.

Staff training was up to date and staff felt supported by the management team. 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.

People and relatives told us staff were caring and respectful and we saw examples of this throughout the day.People told us there was not enough to do. Whilst the wellbeing lead was enthusiastic about their role their capacity to provide meaningful activity and respond to people who remained in their room or were cared or in bed was limited. Following the inspection, the provider increased the hours of the wellbeing lead from 25 to 40.

The management team regularly completed a variety of checks and audits of the service; however, the audits had not been effective in identifying the concerns we found during the inspection. The management team responded immediately to the feedback to make improvements

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

The last rating for this service was good (21 September 2017).

Why we inspected

This was a planned inspection based on the previous rating.

We have found evidence the provider needs to make improvement. Please see the safe, responsive and well led sections of this full report.

Follow up

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