You are here

Charlton Grange Care Home Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 30 March 2019

Charlton Grange is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided and both were looked at during this inspection.

Charlton Grange accommodates a maximum of 62 older people in one adapted building. There were 24 people living at the home at the time of our inspection, all of whom were accommodated on the ground floor. The home is owned and operated by Golden Manor Healthcare (Ealing) Limited. This is the provider’s only registered care home.

This inspection took place on 12 December 2018 and was unannounced.

At our last inspection on 1 and 8 March 2018 we identified two areas in which the provider needed to improve. There were few opportunities for people to take part in meaningful activities. The service had been without a registered manager for 12 months and no application to register a manager had been submitted to CQC. A registered manager is a person who has registered with CQC 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.

Following this inspection, the provider sent us an action plan setting out how they would make improvements in order to meet the relevant legal requirements.

At this inspection we found the provider had taken action to address these requirements. The availability of activities had increased, which had improved people’s experience of living at the home. The provider planned to further improve activities with the recruitment of a directly-employed activities co-ordinator. The manager had submitted an application for registration with CQC although, since our visit, the manager has left their post and the Operations Director has applied for CQC registration.

People told us they felt safe at the home and when staff provided their care. However, some servicing of equipment, such as the lift, was out-of-date. Following the inspection, the provider provided evidence that appointments for servicing had been booked.

We found that medicines were managed safely overall, although we identified an issue with one person’s topical medication. The provider addressed this issue during our inspection.

The manager and Operations Director had improved the home’s quality monitoring systems, although these had not been effective in identifying the shortfalls we found during our inspection, such as out-of-date safety certification.

The manager and Operations Manager had made a number of changes designed to benefit people who lived at the home, such as changes to staffing shift patterns and expectations in terms of staff perfomance and practice. The feedback we received from people and their relatives indicated that these changes had led to improvements. However, it was clear that the changes had affected the morale of some staff.

There were enough staff available to meet people’s needs without delay. However, the home was heavily reliant on agencies to provide nursing staff at the time of our inspection. The manager told us of the provider’s plans to address this issue, which included the appointment of a clinical lead to improve the support available to permanently-employed nurses.

The provider followed safe recruitment processes. Staff understood their responsibilities in keeping people safe and knew how to report concerns. The manager had notified relevant agencies when concerns about people’s care had been raised and worked co-operatively with other professionals to investigate these. Risks to people were assessed and managed appropriately. The home was clean and hygienic and staff maintained appropriate standards of infection control.

People’s needs were assessed to ensure staff could provide the care they required. Care plans were

Inspection areas

Safe

Requires improvement

Updated 30 March 2019

The service was not always safe.

Some health and safety certification was out-of-date at the time of our inspection.

Medicines were managed safely overall.

There were sufficient staff deployed to meet people’s needs.

Risks to people had been assessed and steps taken to minimise these.

Staff were recruited safely.

Staff understood their responsibilities in keeping people safe from abuse.

Staff maintained appropriate standards of infection control.

There were plans in place to ensure people would continue to receive care in the event of an emergency.

Effective

Good

Updated 30 March 2019

The service was effective.

Staff had access to the training they needed to carry out their roles.

People’s care was provided in accordance with the Mental Capacity Act 2005.

People’s needs were assessed before they moved into the home to ensure staff could provide their care.

People enjoyed the food provided and were satisfied with the choice of meals.

Staff kept people’s healthcare needs under review and supported them to access treatment if they needed it.

Caring

Good

Updated 30 March 2019

The service was caring.

People were supported by kind and caring staff.

People had positive relationships with the staff who supported them.

Staff treated people with dignity and respect.

Staff supported people in a way that promoted their independence.

Responsive

Good

Updated 30 March 2019

The service was responsive to people’s needs.

People had opportunities to take part in meaningful activities.

People’s care plans were personalised and provided guidance for staff about how to meet their needs.

People’s wishes about their end-of-life care were recorded.

Complaints were managed and investigated appropriately.

Well-led

Requires improvement

Updated 30 March 2019

The service was not always well-led.

Although the management and oversight of the home had improved, some issues had not been identified through the provider’s quality monitoring systems.

The manager and Operations Director had made changes to benefit people as a result of management monitoring.

The manager and Operations Director had improved communication with people and their relatives.

The manager worked co-operatively with other agencies when required and had notified relevant agencies of any significant events.