We carried out a review of the data available to us about Carlton House on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Carlton House, you can give feedback on this service.
We found the following examples of good practice.
National guidance was followed on the use of personal protective equipment (PPE). The service had good supplies of PPE and stations were in place to ensure staff had access to PPE in a safe and accessible area.
Staff monitored people for signs and symptoms of COVID-19, and appropriate processes were in place should anyone display any symptoms of COVID-19. Staff maintained social distancing where possible and encouraged people to remain socially distanced.
At the time of our visit the service was closed for non-essential visitors. A visitor’s protocol was in place to ensure anyone entering the service received a lateral flow coronavirus test prior to entry, was temperature tested and provided with PPE to remain safe during their visit.
Staff supported people’s social and emotional wellbeing. People who used the service were supported to maintain contact with their families and friends through phone and video calls.
Further information is in the detailed findings below.
Carlton House is a residential care home providing personal and nursing care to eight people aged 65 and over at the time of the inspection. The service can support up to ten people.
People’s experience of using this service and what we found
People living at Carlton House were happy and well cared for. People felt safe and were encouraged to be independent with all area of daily living. Staff provided support in line with people’s diverse needs. People received their medicines as prescribed and systems were in place to ensure these were administered according to best practice guidelines.
Staff were kind and caring and promoted positive relationships with people within the environment. Staff understood their roles clearly and knew what was expected of them. People were treated with respect and dignity and were also supported to maintain their safety and wellbeing. Relatives spoke positively about the service.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
People and their relatives told us they were able to spend time in a way they chose to. staff understood the importance of supporting people to be socially included and prevented from social isolation.
The registered manager knew people well and staff felt supported in their role. Quality assurance systems in place, monitored the service effectively and drove improvements when they were needed.
For more details, please see the full report which is on the Care Quality Commission website at www.cqc.org.uk
Rating at last inspection;
At the last inspection this service was rated Good, (published 06 January 2017).
Why we inspected;
This was a planned inspection based on the previous rating.
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.
The service had a registered manger in place, who is the registered provider. 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.
People we spoke with and their relatives were positive about the care and provided at the service.
A health care professional we spoke with was complimentary about the service and they had no concerns to raise.
Staff understood they had a duty to protect people from harm and abuse. Staff knew how to report abuse and confirmed they would report any issues straight away. This helped to protect people.
People living at the service had their needs met by adequate numbers of skilled staff. People told us they felt safe living at the service. People lived the life they chose and were supported by caring attentive staff. End of life care was provided at the service.
People living at the service were provided with home cooked food. Their fluids and food intake was monitored to make sure people’s nutritional needs were maintained. People who required prompting or support to eat were assisted by patient and attentive staff. Staff gained help and advice from relevant health care professionals which helped to maintain their wellbeing.
People’s privacy and dignity was respected. People were involved in making their own decisions, about their care and treatment. People made decisions about what they wanted to do and how they wanted to spend their time. Staff reworded questions or information to help people understand what was being said. This promoted people’s independence and choice.
Medicine systems in operation were robust which helped to protect people’s wellbeing.
People’s views were sought along with those of their relatives. Information received was listened too and acted upon. There was a complaints procedure in place.
The quality of the service was monitored by the registered manager and staff to make sure the service met people’s needs and people remained happy living there. Regular audits of the service were undertaken which helped to monitor, maintain or improve the quality of service provided to people.
This inspection was undertaken on 14 September 2015, and was unannounced. The service was last inspected on 28 January 2014 the service was compliant with the regulations that we looked at.
Carlton House is registered with the Care Quality Commission [CQC] to provide care and accommodation for up to ten people who may be living with dementia. Accommodation is provided over two floors with a secure garden at the rear of the service and situated close to local amenities. There is a car park, but this is not in use, street parking is available for visitors.
The registered provider is the registered manager for this service. 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 the legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
Staff had a clear understanding about their duty to protect people from abuse. Staff knew they must report concerns or potential abuse to the management team, local authority or to the Care Quality Commission [CQC]. This helped to protect people.
There were enough staff on duty to support people during our visit. Staff understood people’s needs and were aware of potential risks to people’s health and wellbeing. Staff received training in a variety of subjects, this was updated, as required to maintain the staff’s skills and knowledge.
People’s nutritional needs were assessed and monitored. Food provided was home cooked and
people’s preferences and special dietary needs were catered for. Staff assisted and encouraged people to eat and drink with patience and kindness. Advice was sought from relevant health care professionals to ensure people’s nutritional needs were met.
A visiting health care professional confirmed that the staff sought their advice, reported issues and followed their guidance to help maintain people’s wellbeing.
People who used the service were supported to make their own decisions about aspects of their daily lives. Staff followed the principles of the Mental Capacity Act 2005 when there were concerns people lacked capacity and important decisions needed to be made.
The service was undergoing a programme of refurbishment and internal redecoration. People’s bedrooms were personalised. The pictorial signage was down where painting was taking place and this was to be replaced to help people find their way around. Staff helped guide people to where they wished to go. Service contracts were in place to maintain equipment so it remained safe to use.
Staff respected people’s individuality, privacy and dignity. People made decisions about what they wanted to do and how they wanted to spend their time. Staff reworded questions or information to help people understand what was being said so people could respond.
A complaints procedure was in place for people, relatives and visitors to use to raise concerns. This information was provided to people in a format that met their needs. Staff asked for people’s views and they acted upon what was said. This helped to ensure people remained satisfied with the service they received.
The registered provider and senior staff undertook regular audits to help them monitor, maintain or improve the service provided. However, we found there were some issues to be addressed during our inspection; two fire doors were held open by inappropriate means and light cords required cleaning to maintain infection control. Night checks undertaken to help maintain people’s wellbeing needed to be recorded in more detail by staff.
Staff acknowledged people's gestures and expressions if they were unable to communicate verbally. One person's relative told us, 'The staff talk to XXX really well; they seem to understand his wishes and choices.'
We noted people's care plans gave information about their food preferences. One person's care plan stated, 'I only like plain food and like my food to look inviting.'
We looked around the home and observed a high overall standard of cleanliness. One relative told us, 'I think the home is very, very clean.'
We saw each person's care file contained an assessment of their ability to administer medication themselves and maintain their independence in this area.
The home was warm and comfortable. One person's relative told us, 'It's a lovely home; the rooms are every so well kept.'
There was evidence that external contracts were in place that ensured specialist equipment was appropriately serviced and safe to use.
We spent time in the lounge and dining room and chatted to people who lived at the home. We observed the interaction between people and staff and we found communication and rapport to be positive. Staff displayed a good understanding of people's individual needs and people responded well to interactions from staff (and vice versa).
Throughout our visit we observed positive interaction between the staff and people who use the service. The staff were respectful and polite towards people and showed a good understanding of their needs.
People using the service appeared relaxed and comfortable in their surroundings and were supported where possible to choose how they spent their time. We observed people using the service participating in a range of activities during the inspection. We also observed that staff had time to spend with people on an individual basis.