Carter House

Updated 28 October 2022

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

The inspection was carried out by an inspector.

Service and service type

Carter House is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Carter House is a care home without nursing care. CQC regulates both the premises and the care provided, but only how safe and well-led the service was were looked at during this inspection.

This service 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. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

At the time of our inspection there was not a registered manager in post. However, a new permanent manager was appointed in August 2022 and has applied to the CQC to be registered with us which we are currently reviewing. This means that they and the provider will be legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and a community based pharmacist who has worked closely with the care home in the last 12 months. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with four people who lived at the care home and various members of staff who worked there including, the new manager, the new deputy manager, area manager, and five care workers, including two seniors.

We looked at a range of records that included three people’s electronic care plans and multiple medication records. A variety of other records relating to the management and governance of the service, were also looked at.

After the inspection we continued to seek clarification from the provider to validate evidence found. We requested the provider send us additional evidence after our inspection in relation to staff recruitment and training, their fire safety arrangements and the outcome of the most recent stakeholder satisfaction surveys.

Updated 28 October 2022

About the service

Carter House is a residential care home providing personal care and support to older people. At the time of our inspection 42 people were living at the care home. Approximately a third of the people who resided there were living with dementia. The premises is divided into three separate units/floors, each of which has their own adapted facilities.

People’s experience of using this service

People living in Carter House and staff working there told us the service had improved in the last 12 months since the last CQC inspection and said the care home was now a safe, well-managed service.

Medicines were now well-organised and staff helped people take their prescribed medicines in a safe way. The service has ensured there are always sufficient numbers of suitably trained staff to support people to stay safe and meet their needs and wishes.

Staffs suitability and fitness to work in an adult social care setting have been properly assessed.

People were protected against the risk of avoidable harm and abuse. The risks people might face were assessed and their safety monitored and managed so they were supported to stay safe. This included routinely monitoring the care homes fire safety arrangements to ensure they continued to be fit for purpose.

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.

The environment was clean and staff followed current best practice guidelines regarding the prevention and control of infection (IPC), including those associated with COVID-19.

The new manager and her deputy manager were both clear about their roles and responsibilities. They understood regulatory requirements and how to ensure people received high-quality, person-centred, safe care. This was achieved by routinely monitoring and analysing the safety and quality of the care people received.

The management team also recognised the importance of learning lessons when things went wrong and was keen to continuously improve the service.

The managers promoted an open and inclusive culture and worked in close partnership with other health and social care professionals and agencies to plan and deliver positive outcomes for people.

People living at the care home and staff working there were complimentary about the way the management team ran the service, and how approachable they all were. In addition, staff told us they received all the support they needed from their managers and felt staff morale had significantly improved in the last 12 months.

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

Rating at the last inspection

The last rating for this service was requires improvement (published 2 November 2021).

Why we inspected

We carried out an unannounced focused inspection of this service in October 2021 and breaches of legal requirements were found. The provider completed an action plan after the last inspection to show us what they would do and by when to improve the safe management of medicines and the effectiveness of how they operated their governance systems.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. At this inspection we found improvements had been made and the provider was no longer in breach of regulations. The overall rating for the service has therefore changed from requires improvement to good.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Carter House on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.