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

Inspection Summary


Overall summary & rating

Requires improvement

Updated 11 December 2018

This unannounced inspection took place on 31 October 2018. At the last inspection on 18, 24 January 2018 and 02 February 2018 breaches of legal requirements were found. This was because repairs were required to the home environment to ensure it was clean and safe for people to live in. There was improvement required involving people in the planning of their care and delivery of personalised activities. The provider’s systems in place to assess and monitor the quality of the service provided to people were not always used effectively and also required improvement. During this inspection, we found the provider had made the necessary improvements to meet the breaches.

Charles House is a care home registered to accommodate up to 10 people who have a learning disability. The home is not purpose built or modified. At the time of our inspection five people were living at the home. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided and both were looked at during this inspection.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

There was a registered manager in post at the time of the 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.

The home environment had undergone some repairs and improvements. However, there were areas of the home that required further improvement. There was also some improvement required to ensure people received equal opportunities to engage in individual and personalised interests in an environment that was suitable for people living with learning disabilities. Systems and processes in place to monitor the safety and quality of the service required further improvement.

People were protected from the risk of abuse and avoidable harm because staff knew what action to take and the provider had safeguarding systems and processes in place to keep people safe. People were supported by sufficient numbers of staff who were kind and respectful and had the knowledge they required to care for people safely.

People were also protected against risks associated with their health and care needs because risk assessments and associated care plans were in place and had been reviewed within the last 12 months. People received support from staff to take their prescribed medicines. Systems and processes were in place to ensure medicines were managed safely and only staff who had undergone training were permitted to administer medicines.

People and their relatives were involved as much as practicably possible alongside healthcare professionals, to ensure that any decisions made in respect of their care and support needs, were done so within their best interests and in accordance with the Mental Capacity Act 2005.

Where people were assessed to lack the capacity to consent to the support they received, the provider followed key processes to ensure the care being provided was in the least restrictive way possible. Applications had been made to safeguard people against the unlawful deprivation of their liberty, where necessary. People’s privacy, dignity and independence were respected.

People were supported to maintain a healthy diet with choices of different foods available and all their health needs were met with the support from staff and healthcare professionals. Staff knew people very well. The p

Inspection areas

Safe

Good

Updated 11 December 2018

The service was safe:

People were safe with the staff that provided them with support. Staff recognised signs of abuse. Systems were in place to protect people from the risk of harm and staff knew how to report any suspicions of abuse.

People were safeguarded from the risk of harm because risk assessments were in place to protect them.

People were supported by sufficient numbers of staff that were recruited safely, to ensure that they were suitable to work with people.

People were protected from infection and cross contamination because staff members were provided with sufficient personal protective equipment.

People were supported by staff to take their medicines safely and as prescribed by the GP.

Effective

Requires improvement

Updated 11 December 2018

The service was not consistently effective:

There had been some improvement to the home environment but further improvements were still required.

People received care and support with their consent, where possible and people’s rights were protected because key processes had been followed to ensure that people were not unlawfully restricted.

People received care from staff that had the knowledge they required to do their job.

People’s nutritional needs were assessed and they had food that they enjoyed.

People were supported to maintain good health because they had access to other health and social care professionals when necessary.

Caring

Good

Updated 11 December 2018

The service was caring:

People were supported by staff that was caring, kind and respectful.

People’s independence was promoted as much as possible and staff supported people to make some decisions about the care they received.

People were cared for by staff members who protected their privacy and dignity.

Responsive

Requires improvement

Updated 11 December 2018

The service was not consistently responsive:

People were not always offered opportunities to engage in activities or hobbies that interested them.

Some people and their relatives were involved in the planning and review of their care.

The provider had a system in place to manage complaints to ensure they were dealt with to the satisfaction of the complainant.

Well-led

Requires improvement

Updated 11 December 2018

The service was not consistently well-led:

Although the provider had systems and processes in place to monitor the safety and quality of the service, there was further improvement required to ensure the service operated effectively.

Relatives spoken with were complimentary of the management and staff members.