We carried out a review of the data available to us about Carleen Nursing and Residential Care Home 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 Carleen Nursing and Residential Care Home, you can give feedback on this service.
Carleen Nursing and Residential Care Home is a care home. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Carleen Nursing and Residential Care Home is registered to provide care for up to 40 people, including people living with nursing needs and dementia. At the time of the inspection, there were 35 people living at the service.
People’s experience of using this service:
• People were happy with the care they received from the staff at Carleen Nursing and Residential Care Home.
• People told us they received safe care. People were supported by suitably trained staff.
• People received support to take their medicines safely and as prescribed.
• Risks to people's well-being and environmental safety were recorded and updated when the circumstances changed.
• People's rights to make their own decisions were respected. Staff supported people to make choices in line with legislation.
• People were supported to access health and social care professionals if needed.
• People's dietary needs were assessed and where required, people were supported with
their meals.
• People were supported to participate in a range of activities of their choice.
• People were supported to be as independent as possible.
• Care plans were detailed and person centred. People were involved in deciding how they wished to be supported and in reviewing their care plans when needed.
• Staff were kind, patient and responsive to people's needs. People were treated with dignity and staff respected their privacy.
• People knew how to complain and were confident that if they raised concerns, the management would act promptly to address these.
• People and staff were fully engaged in the running of the service.
• The management team had effective quality assurance systems in place.
• The service worked well with other partners, organisations and commissioners.
The service met the characteristics of Good in all areas. More information is in the full report.
Rating at last inspection:
The service was rated as Good at the last full comprehensive inspection, the report for which was published on 14 November 2016.
Why we inspected:
This was a planned inspection based on the previous inspection rating.
A registered manager was in post. 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 were supported by staff who had a good understanding of how to keep them safe, identify signs of abuse and report these appropriately. Robust processes to check the suitability of staff to work with people were in place. There were sufficient staff available to meet the needs of people and they received appropriate training and support to ensure people were cared for in line with their needs and preferences.
Medicines were administered, stored and ordered in a safe and effective way.
Risks associated with people’s care were identified. Staff had a very good understanding of these risks and how to ensure the safety and welfare of people. Incidents and accidents were clearly documented and investigated. Actions and learning were identified from these and shared with all staff.
People were encouraged and supported to make decisions about their care and welfare. Where people were unable to consent to their care the provider was guided by the Mental Capacity Act 2005. Where people were legally deprived of their liberty to ensure their safety, appropriate guidance had been followed.
People received nutritious meals in line with their needs and preferences, in an environment which had been adapted to provide a calm and relaxing dining experience for them. Those who required specific dietary requirements for a health need were supported to manage these.
People’s privacy and dignity was maintained and staff were caring and considerate as they supported people. People and their relatives met with staff to discuss the planning of their care, any concerns they may have and developments in the service provided at the home.
Care plans in place reflected people’s identified needs and the associated risks. However these lacked organisation and the registered manager was working to address this to ensure records could be accessed more easily.
Staff were caring and compassionate and knew people in the home well. External health and social care professionals spoke highly of the care and support people received at the home, although some felt staff called them frequently without need. The registered manager was working with health and social care professionals to address this.
Effective systems were in place to monitor and evaluate any concerns or complaints received and to ensure learning outcomes or improvements were identified from these. Staff encouraged people and their relatives to share their concerns and experiences with them.
The structure of staffing in the home was under review. The registered manager was visible in the service and available to provide support, guidance and stability for people, staff and their relatives.
A robust system of audits was in place at the home to ensure the safety and welfare of people and actions from these were completed.
People told us they were treated with dignity and respect.
We saw that each person's needs were comprehensively assessed before being admitted to the home. Care plans were devised for each person. People and their relatives said the home looked after people well. This was also the view of the health and social care professionals we spoke to.
People said they were consulted about their care and treatment and we saw that people, or their relative, had signed to agree the contents of their care plan. We noted the home did not have policies and procedures for assessing people under the Mental Capacity Act 2005 who were not able to give consent to their care and treatment.
People had a choice of nutritious food and were supported with food and fluid intake.
During the lunchtime we used our SOFI (Short Observational Framework for Inspection) tool to help us see what people's experiences at mealtimes were. The SOFI tool allows us to spend time watching what is going on in a service and helps us to record how people spend their time and whether they have positive experiences. This includes looking at the support that is given to them by the staff. We saw people had positive experiences. The mealtime was well organised. Meals were brought promptly and staff helped people if they needed it.
The home was adequately staffed.
There were a number of systems used by the home to monitor and evaluate its own performance. These included asking people for their views about the service they received.
The people we spoke to told us they liked living at the home they felt well cared for and felt safe.
Visitors we spoke to told us they were fully consulted in the care of their relative and that the staff were committed in the care they provided. One Visitor told us 'The manager really values the people who live here, that culture goes throughout the staff team'.
We saw that people's privacy and independence were respected. People experienced safe and effective care based on detailed care plans and risk assessments that met individual needs.
People were protected from abuse as they were supported by a staff team who had appropriate knowledge and training on safeguarding adults. We saw policies on whistle blowing and safeguarding.
The Provider had effective systems in place to monitor quality assurance and compliance.
People told us that they were happy at the home; it was easy for them to move about the home if they are able and access facilities such as the bathroom and garden. They like the interaction with the staff and were very fond of some of the staff. They said they are able to give their opinion for example about the food and staffing and they feel respected and heard. They are able to have visitors at any time.
Many people need a lot of support so activities usually take place in the afternoon. People said that they do like to go the lounge and meet others but they are not always able to speak with their fellow residents. Others prefer to stay in their rooms and keep their own company. People said that although they would not choose to spend their final days in a care home they are content with the care and facilities at Carleen.
Staff told us that they receive regular training, are supported by the management of the home and that they can speak with senior staff about any concerns they have about the running of the home.