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We are carrying out a review of quality at Charlton House. We will publish a report when our review is complete. Find out more about our inspection reports.

Inspection Summary


Overall summary & rating

Good

Updated 26 March 2020

About the service

Charlton House is a residential care home in Plymouth providing personal and nursing care to 41 people aged 65 and over at the time of the inspection. The service can support up to 44 people, has multiple split levels and is in an older style building with some original architectural features.

People’s experience of using this service and what we found

People told us they were happy living in the service, some people said they might like to get out more. Relatives fed back to us their loved one was safe, and the care was good.

There were enough staff to meet the needs of people and staff were well organised and clearly delegated to by duty managers at the start of each shift. Staff were safely recruited, although we did discuss how some aspects of recruitment could be more clearly recorded.

Improvements had been made in areas we identified were unsafe at the last inspection. This included equipment posing a trip hazard as it was cluttering up hallways, and some infection control measures not being robust enough. We suggested some further improvements in this regard during the inspection and they were implemented by the end of the first day, showing the manager to be responsive and keen to consider signposting and best practise guidance.

Staff had completed mandatory training and were supported through supervision, team meetings and daily handovers. We identified some staff would benefit from further training to boost their confidence in managing skin integrity, identifying when a person became unwell and in further understanding the Mental Capacity Act 2005.

People told us they liked the food and we saw positive outcomes where people were supported to eat more of a range of healthy foods through encouragement and support from staff and put on weight where needed.

Risks people faced were assessed and minimised where possible. The building was checked regularly for key safety aspects such as fire, gas safety and risks of falls. Maintenance works were reported and carried out promptly. The age and layout of the building posed some potential added risks, but staff managed this well, regularly checking on people. We fed back the laundry was small and made it difficult for staff to work in efficiently and with ease.

People were supported to take part in activities where they wished to. The management team said they were thinking about how they could further engage people in activities and this was still being worked on.

Staff interactions we observed were kind and caring, people were spoken to with dignity and respect. We heard laughter and banter during our visit and staff were learning more to engage with people around their interests.

People were supported to have maximum choice and control of their lives and staff supported support them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

There was a clear management hierarchy, the provider, care manager, general manager for all four services in the group, and registered managers from the other services in the group all had input into the running of the service. However, there was no registered manager in post. A manager had been recruited to the post and was due to start in the weeks after our inspection visit. Due to the registration requirement that the service should have a registered manager in post the rating of the well-led domain was limited to requires improvement.

We made a recommendation regarding checking staff understanding of key areas people were supported with.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 20 February 2019). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This was a planned inspection based on the previous rating.

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.

Inspection areas

Safe

Good

Updated 26 March 2020

The service was safe.

Details are in our safe findings below.

Effective

Good

Updated 26 March 2020

The service was effective.

Details are in our effective findings below.

Caring

Good

Updated 26 March 2020

The service was caring.

Details are in our caring findings below.

Responsive

Good

Updated 26 March 2020

The service was responsive.

Details are in our responsive findings below.

Well-led

Requires improvement

Updated 26 March 2020

The service was not always well-led.

Details are in our well-led findings below.