The inspection took place on 3 November 2015 and was unannounced.
The last inspection of the service was on 29 September 2014 when we found no breaches of Regulation.
Charlotte House is a nursing home for up to 56 older people, some people are receiving support at the end of their lives and some people are living with the experience of dementia. At the time of our inspection 49 people were living at the home. The home is managed by Care UK, a national organisation who provide care and support.
There was a registered manager 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 and associated Regulations about how the service is run.
People were at risk because the staff followed practices which were not safe and put them at risk of choking.
There were not enough staff deployed to keep people safe and meet their needs.
There were risks to people’s wellbeing because the environment was not well maintained or clean.
People could not always access call bells and were unable to alert staff when they needed support.
People were not asked for their consent and there was limited evidence that people had consented to their care and treatment.
The staff had the training they needed but did not always feel supported.
The staff did not always respect the people who they were caring for.
People’s privacy and dignity was not maintained.
The staff tended to focus on the task they were performing rather than the person they were supporting.
People’s individual needs were not always being met and sometimes they were put at risk because the staff failed to notice and act on their needs.
People’s social needs were not being met and they were not being cared for in a person centred way.
The provider had not responded appropriately to complaints and people could not be confident that complaints would be acted upon.
The provider had failed to assess, monitor and mitigate the risks of inappropriate and unsafe care and treatment.
People using the service, their relatives and the staff felt that their opinions were not listened to and improvements to the service were not being made as a result of their feedback.
Records relating to care and the management of the service were not always clear and accessible.
People had received their medicines as prescribed.
People’s nutritional needs were assessed, monitored and met.
People’s health was monitored and they had access to external health care services.
The record of care needs and the plans to meet these were detailed and regularly updated.
We observed some interactions that were kind and caring. People told us that the regular staff were kind.
We found breaches of the Health and Social Care Act 2008 and associated Regulations. We are taking action against the provider for the breach of the Regulations in relation to the safe care and treatment of people using the service (Regulation 12) and the good governance of the service (Regulation 17). We will report on it when our action is completed.
CQC is considering the appropriate regulatory response to resolve the problems we found.
The overall rating for this provider is ‘Inadequate’. This means that it has been placed into ‘Special measures’ by CQC. The purpose of special measures is to:
• Ensure that providers found to be providing inadequate care significantly improve
• Provide a framework within which we use our enforcement powers in response to inadequate care and work with, or signpost to, other organisations in the system to ensure improvements are made.
• Provide a clear timeframe within which providers must improve the quality of care they provide or we will seek to take further action, for example cancel their registration.
Services placed in special measures will be inspected again within six months. If insufficient improvements have been made such that there remains a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating the service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. The service will be kept under review and if needed could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement we will move to close the service by adopting our proposal to vary the provider’s registration to remove this location or cancel the provider’s registration.
You can see what action we told the provider to take at the back of the full version of the report.