The Care Quality Commission
  • Care Home
  • Care home

Archived: Carrington House Care Home

Overall: Requires improvement read more about inspection ratings

25 Mayo Road, Sherwood, Nottingham, Nottinghamshire, NG5 1BL (0115) 962 1100

Provided and run by:
Virk Family Limited

Important: The provider of this service changed. See new profile
Important: The provider of this service changed. See old profile

All Inspections

14 and 29 October 2015

During a routine inspection

We inspected the service on 14 October and 29 October 2015. Carrington House Care Home is registered to provide accommodation for up to 27 older people. The service is situated over three floors with a small shaft lift for access to the upper floors. On the day of our inspection 22 people were using the service.

A new manager was in place at the service. The new manager confirmed that they had applied to become the registered manager and we received confirmation that their application had been successful following our inspection. 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 and associated Regulations about how the service is run.

At the last inspection on 19 November 2014, we asked the provider to take action to ensure people were protected against the risks of receiving care that was unsafe. This was because we found that the procedures in place to ensure that a person received their diet and medicines in an appropriate form were not effectively managed. This placed the person at risk.

On this inspection we found that procedures had improved but the provider was still not fully effective in managing risks to people. We found that some people’s care plans did not contain the required information as to how risks to people could be reduced or staff were not always following guidance on how to keep people safe.

People were protected from the risk of abuse and staff had a good understanding of their roles and responsibilities if they suspected abuse was happening. Staffing levels were sufficient to support people’s needs and people received care and support when required.

We found that people received their medicines as prescribed but the management of medicines required further improvement.

People were supported to make their own decisions where they were able. For people who lacked capacity to make their own decisions, capacity assessments were in place for some decisions but not for others. Applications had been made to ensure that people were not deprived of their liberty without the required authorisation.

People were supported to eat and drink enough, however there was a lack of care plans to ensure that people had their nutritional needs properly assessed. Referrals were made to health care professionals for additional support or guidance when needed.

People were treated in a caring and respectful manner and staff delivered support in a friendly and supportive manner. People who used the service and their relatives knew who to speak with if they had concerns and were confident that these would be responded to.

The views of people who used the service were sought in monitoring the quality of service provision. Regular audits were undertaken within the service and action taken where required.

19 November 2014

During a routine inspection

We inspected the service on 19 November 2014. Carrington House Care Home is registered to provide accommodation for up to 27 older people. The service is situated over three floors with a small shaft lift for access to the upper floors. On the day of our inspection 20 people were using the service.

The service did not have a registered manager in place at the time of our inspection. 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 on 25 November 2013, we asked the provider to take action to make improvements in relation to the cleanliness of the service and protecting people from an unsafe environment and these actions had been completed and the improvements made.

People were living in a cleaner and safer environment than when we last visited

During this inspection we found there had been a breach of regulation 9 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. This was because people were not always supported with risks to their care and welfare.

People were supported to make decisions and where people did not have the capacity to make decisions this had been assessed appropriately under the Mental Capacity Act 2005 (MCA) and decisions had been made in people’s best interests. However there were restrictions on some people’s freedom to leave the home alone and applications had not been made to ensure people were protected under the Deprivation of Liberty Safeguards.

People felt safe in the service and we saw the manager shared information with the Local Authority when needed and staff knew how to respond to incidents if the manager was not in the service. However we found that where a person was at risk of choking, staff were not following professional guidance to minimise this risk.

Medicines were administered to people as prescribed and people were supported by staff who had the knowledge and skills to provide safe and appropriate care and support.

People were supported to eat and drink enough. Referrals were made to health care professionals for additional support or guidance if people’s health changed.

We observed people were treated with dignity and respect and had their choices acted on. We saw staff were kind and caring when supporting people.

People did not always have the opportunity to follow their hobbies and interests. People were listened to and any concerns were acted on. People were involved in giving their views on how the service was run through the systems used to monitor the quality of the service. Audits had been completed that resulted in the provider implementing action plans to improve the service.

25 November 2013

During a routine inspection

When we last visited the service we told the registered provider improvements were needed in relation to the service. During this visit we saw many improvements had been made. However some improvements still needed to be made in relation to cleanliness and the environment.

We found people's privacy and dignity was respected and they were given choices about their care and treatment. People's needs were assessed and care and treatment planned and delivered in line with their individual care plan. People were happy with the care they were receiving. One person had been staying in the home for the last week and told us, 'It has been very nice here. I have been really well looked after.'

People were protected from the risks of inadequate nutrition and dehydration. There were care plans in place telling staff how to manage the risks of people who were at risk of weight loss and other nutritional risks. Staff we spoke with were knowledgeable about the nutritional needs of people.

Some areas of the service were not clean and hygienic and there were some maintenance issues which needed addressing.

There were systems in place to ensure staff were recruited who were appropriate to work with vulnerable adults. There were enough staff employed to meet the needs of people using the service. One person said, 'There is always staff around if you need them. '

People who use the service, their representatives and staff were asked for their views about their care and treatment and they were acted on. There were appropriate records kept of the care people received.

21 March and 2 July 2013

During an inspection looking at part of the service

This inspection took place to assess improvements made to the service following previous inspections completed. The provider had made many improvements but there were still improvements needed. Since our visit in March 2013 the name of the service had been changed from Arden lea Nursing home to Carrington House Care Home.

People were given choices about their care and treatment. However their dignity was not always respected. People we spoke with were happy with the care they were receiving. One person said, 'I have been here for two and a half years and seen changes.'

We saw people were given a choice of meal and the meals looked appetising and nutritious, however people were not always given the support they needed to eat and drink sufficient amounts.

Although there had been many improvements in relation to the cleanliness of the service, there were still improvements to be made, especially in the laundry area of the home.

We found that although there had been improvements in the training provided, staff were not always being recruited safely and there were inadequate numbers of staff on duty to care for people safely.

The quality of the service being provided was not being assessed and monitored effectively to ensure people were being cared for safely and effectively and this impacted on the care people were receiving. Staff were not always recording care and treatment appropriately.

5 February 2013

During an inspection looking at part of the service

When we inspected the service in December 2012 we had concerns about the way people were being supported and cared for. We took action against the registered provider and manager and told them they must make improvements. This visit was carried out to see if the improvements had been made. We found some improvements had been made but we found further concerns relating to the way people's needs were being assessed, monitored and acted on.

We found that there was poor management of people's risks and care for nutrition and pressure ulcer care. People were not being supported to maintain healthy skin or a healthy weight. We saw two people had recently had pressure ulcers, they had received intervention from external professionals and these had now healed. However they both remained at high risk of redeveloping these. Despite this neither had a plan of care in place to instruct staff how to reduce the risk and maintain healthy skin and there were gaps in the records of care given to maintain healthy skin.

We found action had been taken to address the areas of concern we had in relation to safeguarding people in the service from abuse or the risk of abuse. We spoke with three people using the service and they told us they felt safe in the home. They told us if they had any concerns they would speak with the owner and they felt any issues would be addressed. One person told us, 'I feel much safer, things have got better.'

11, 13, 17 December 2012

During an inspection in response to concerns

We had concerns that some people did not look clean and they had long fingernails and toe nails. We also saw that male people who required help to shave had not been supported to have a shave for some time. We found people were not having their needs assessed and planned for appropriately and were not always receiving appropriate or safe care.

We found incidents and allegations of abuse which had not been responded to appropriately and referred to the safeguarding vulnerable adult's team in line with local procedures. We found the risks to people using the service had not been assessed despite there being a high number of incidents which posed a risk to people.

We found staff were not always being recruited safely with a high number of staff files having gaps in the recruitment procedures which should be in place to ensure staff are safe to work with vulnerable adults. We found staff were not being fully supported or trained to deliver care appropriately or safely.

Although the registered provider visited the service and spoke with people regularly, we found there was a lack of audits in place to monitor the quality of the service being delivered. We found areas of concern in relation to other outcomes of the essential standards of quality and safety. These areas of concern had not been identified by the registered manager or provider.

4 October 2012

During a themed inspection looking at Dignity and Nutrition

People told us what it was like to live at this home and described how they were treated by staff and their involvement in making choices about their care. They also told us about the quality and choice of food and drink available. This was because this inspection was part of a themed inspection programme to assess whether older people living in care homes are treated with dignity and respect and whether their nutritional needs are met.

The inspection team was led by a CQC inspector joined by an 'expert by experience' (people who have experience of using services and who can provide that perspective) and a practising professional.

To help us understand people's experiences we used the Short Observational

Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us

understand the experiences of people who could not talk with us. We chose to use

SOFI in the main dining room on the ground floor, because this was where most people ate their lunch. We observed the lunch time for a period of 50 minutes noting the experiences of four people.

Throughout our visit we generally saw staff talking to people with dignity and respect, in a kind and appropriate manner. For example staff spoke in calm, low tones addressing people by the person's preferred name.

However, we saw some examples of where people's dignity was not upheld. For one person was in bed and their bedroom door was open. This person was not fully covered by their bedding and people passing the room could see them exposed.

Staff interactions were positive; staff were caring and demonstrated a good knowledge of the needs of the people they were supporting. We observed that staff were polite and attentive when speaking with people. We spoke with four people using the service and one relative. All of the people we spoke with told us they were happy with the way they are spoken to and cared for by staff.

We noted several bedrooms smelled of urine and were not very hygienic. This does not promote dignity for people living in the service and would make some bedrooms an unpleasant place to sleep.

During our observations of the main dining room, we saw that dining tables were set with napkins and the dining environment looked clean and well organised. We saw people were provided with adapted cutlery, crockery and plate guards where needed, to support them to eat independently.

During our SOFI observations we saw one person who chose to eat in the lounge. They refused to eat either of the meals on offer and we saw staff asking if they would eat a sandwich. The person agreed with this and we saw they sat and ate all of the sandwich. This means staff were supporting this person to maintain their nutritional intake.

We observed one person who was confined to their bed and staff supported them to eat there. We saw this person was on a special diet and staff did not support them to eat this safely.

People were not supported to have a fortified diet to increase their nourishment. For example there was no evidence of the use of full fat dairy products, sugar or adding extra cheese, cream, evaporated milk or butter to their food to given them they extra nourishment.

All of the four people we spoke with told us they felt safe in the home. However, we received mixed comments when we asked people if they felt their concerns would be listened to. One person said, 'If I had any concerns I would speak to the staff and I am confident they will help me." However two people told us they did not feel confident their concerns would be acted on. One person said, 'I don't think the management would take much notice of my concerns."

Not all staff had received any training to give them knowledge of how to prepare food safely or how to ensure people were supported to maintain adequate nutrition.

We found that records were not always stored securely and some care records were not being maintained appropriately by staff.

18 October 2012

During an inspection in response to concerns

We previously visited the home on 4 October 2012 to carry out a themed inspection in relation to how people's dignity and nutrition was managed. During that visit we had concerns about the cleanliness and hygiene of the home.

During this visit we spoke with two people using the service and they said they were happy with the cleanliness of their bedroom. However, our findings did not support what people told us in relation to the cleanliness and hygiene of the service.

We found several areas of the home to be unclean and unhygienic placing service users, staff and other people at risk of acquiring or transferring infections. We found some areas were not cleaned appropriately and some areas such as bedrooms, lounges and other communal areas had an offensive odour of urine. This would be unpleasant for people to sleep or sit in.

There were several radiator covers in bedrooms which were broken and had not been repaired. We saw some radiators in communal areas did not have a radiator cover and they were so hot we could not touch them for more than a second. This posed a risk of harm to people if they were to fall against one of these radiators.