Carolyne House

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.

The manager at the service had been in post for five months and was going through the registration process with the CQC. They had completed all the relevant documentation and were waiting for the CQC registration team to contact them with a date for their fit person interview. 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.

At the last inspection the service was rated as Good.

The service was safe. Staff showed a good knowledge of safeguarding procedures and were clear about the actions they would take to protect people. People were kept safe and risk assessments had been completed to show how people were supported with everyday risks. Recruitment checks had been carried out before staff started work to ensure that they were suitable to work in a care setting. There were sufficient numbers of staff on duty and this was regularly monitored and reviewed. People’s medication was well managed and people received their medication as prescribed.

The service was effective. New staff completed an induction and staff were offered on going training to help ensure they had the skills and knowledge required for their role as a care worker. They also received regular support and told us they felt well supported by management.

People were supported to be able to eat and drink sufficient amounts to meet their needs. They told us that the food was good and said that they were able to choose alternatives if they were not happy with the choices offered on the menus. People were supported to maintain good healthcare and had access to a range of healthcare providers such as their GP, dentists, chiropodists and opticians. The service kept clear records about all healthcare visits.

The service was caring. People were treated with dignity and respect and staff provided care in a kind, caring and sensitive manner. Meetings had been held for the people living at the service, relatives and for the staff. People felt listened to and that their views and opinions had been sought and the service had made appropriate improvements.

The service was responsive. Detailed assessments had been carried out and care plans were developed around people’s needs and preferences. The service had a clear complaints procedure in place which was clearly displayed. This provided information on the process and the timespan for response.

The service was well-led. Staff, relatives and those living at the service spoke positively about the new manager and they felt the service was well managed. There were systems in place to regularly assess the quality of the service and that people were kept safe.

Staff were observed speaking with people with dignity and respect and involving them in their care. People appeared relaxed and staff were viewed helping them to make choices on how they wanted their care provided. Staff were observed interacting with people and there was a homely atmosphere.

People and relatives spoken with were complimentary about the care they received at Carolyne House. Feedback included 'They look after you well,' 'You only have to call and they will come and help,' 'It is like a hotel' and 'The staff are very good, even the young ones and the boys.' Others who were unable to verbally communicate were observed with staff and they appeared relaxed in their company.

People told us they knew how to raise any concerns. Relatives spoken with stated that they found the manager to be approachable and felt they could take any concerns they may have to her. Staff spoken with also added that they felt that they could raise any concerns they may have with the manager.