Background to this inspection
Updated
13 April 2017
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Our inspection of Carlton Manor Care Home took place on 7 March 2017 and was unannounced.
The inspection team consisted of two Adult Social Care inspectors and an expert by experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. The expert used on this occasion had experience with older people and dementia care.
Before the inspection we gathered and reviewed information we had received from the service such as statutory notifications and intelligence gathered from the local authority contracts and safeguarding teams. We usually ask the provider to send us a Provider Information Return (PIR). This is a form which asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We had not asked the provider to complete a PIR prior to this inspection.
During the inspection we used a number of different methods to help us understand the experiences of people who used the service. We spent time observing care and support, and spoke with four people and two relatives of people living at the home. We spoke with four care staff, two ancillary staff, the chef, the activities co-ordinator, the registered manager, the group governance lead and a visiting health and social care professional.
We also looked at elements of four people's care records, Medicines Administration Records (MARs) and other records which related to the management of the service such as training records, three staff recruitment records, quality assurance documentation and policies and procedures.
Updated
13 April 2017
Our inspection of Carlton Nursing Home took place on 7 March 2017 and was unannounced.
At the last inspection in March 2016 the service had been in breach of the Health and Social care Act 2008 (Regulated Activities) regulations 2014 regarding the management of medicines. At this inspection we saw improvements had been made and the service was meeting the relevant requirements.
Carlton Manor provides care and support for up to 32 older people who may be living with dementia or mental illness and younger adults with a physical or learning disability. At the time of our inspection there were 25 people living at the service.
The service had a registered manager who had been in post since March 2015. 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.
Staff told us they felt well supported by the registered manager and they were approachable. This was confirmed by comments from people and their relatives.
Effective safeguarding procedures were in place. Staff were trained in safeguarding and understood how to keep people safe. Assessments were in place to mitigate risks to people and these were updated appropriately.
Accidents were documented with actions taken and outcomes including reviews and amendments of care plans and risk assessments.
Systems for managing medicines safely were in place. People received medicines appropriately from regular staff although some medicines administered by agency staff were not always given at the required time.
The service was meeting the legal requirements relating to the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS).
The service was clean and well maintained and a range of checks was in place to ensure this. People's bedrooms were homely and personalised.
Staffing levels were sufficient to keep people safe and staff training was up to date or booked. The recruitment process ensured staff employed were suitable to work with vulnerable people and regular supervision and appraisal was in place.
A range of activities was on offer and we saw planned activities took place.
People were supported to consume a varied and nutritious diet and people's choices were respected. People told us they enjoyed the food.
Complaints were taken seriously and addressed. People and their relatives told us they knew how to complain if necessary.
Staff knew people's care and support needs and people told us staff were kind and caring. We saw people were treated with dignity and respect. There was a relaxed and welcoming atmosphere at the service.
People had access to a range of healthcare professionals.
Care records were mainly person centred and appropriate to people's needs although further work was being undertaken to improve these including further documented evidence of people's involvement in care reviews. Some people's plans of care were not always fully understood and accurately followed by staff.
Systems were in place to monitor and improve the quality of the service and people and staff were encouraged to voice their opinions through surveys, meetings and questionnaires.