Archived: Charlotte House

The home is required to have a registered manager. 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 had a registered manager who had been in post for one year.

At our last inspection of the home in February 2017 we found a breach of Regulation 12 of the Health and Social Care Act 2008 because people’s medication was not always managed safely. During this inspection we found that improvements had been made and medication was managed safely.

People we spoke with believed the home was safe. Maintenance records showed that regular checks of services and equipment were carried out by the home’s maintenance person and testing, servicing and maintenance of utilities and equipment was carried out as required by external contractors. We found concerns regarding fire doors and this was addressed swiftly.

All parts of the premises looked clean. The home had received a good score following an infection control inspection and the kitchen had a five star food hygiene rating.

Before the inspection we received concerns regarding staffing levels, however during our visits to the home we found there were enough qualified and experienced staff to meet people’s care and support needs. Recruitment records showed that robust procedures had been followed to ensure new staff were suitable to work with adults at risk of abuse or neglect..

Risk assessments were recorded in people’s care notes and plans were put in place to reduce the risks identified. A log of accidents and incidents was maintained and the records showed that appropriate action had been taken when accidents occurred.

Staff received training about safeguarding as part of their induction, with updates periodically. The manager had reported safeguarding incidents as required and full records were kept of safeguarding referrals that had been made.

The service complied with the requirements of the Mental Capacity Act 2005 and appropriate Deprivation of Liberty Safeguard applications had been made to the local authority.

People told us they enjoyed their meals and had plenty to eat and drink. The cooks were aware of people’s preferences and individual dietary needs.

There was a comprehensive programme of training for all staff to ensure that they knew how to work safely. New staff had a five day induction before starting work.

People who lived at the home told us that the staff provided them with good care and support. One person commented “I couldn’t wish for better staff. They’re all lovely.” Another person said “They go out of their way to help you, they’re so caring.” Everyone had their own bedroom and personal care was provided in a discreet way in the privacy of the person’s room.

The care files we looked at showed that people’s care and support needs were assessed covering all aspects of their health and personal care needs and personalised plans were written for the care and support people needed. These were kept up to date with monthly reviews.

There was a planned programme of regular social activities, including trips out.

Regular meetings were held for staff and for people living at the home and their families. The staff we spoke with told us they enjoyed working at the home and found the management very supportive.

There was a schedule of quality audits for the year and these had all been completed to date. These were accompanied by action plans for improvement as needed.

Charlotte House is registered to provide accommodation for persons who require nursing or personal care to up to 103 people. However, there had been some changes to the accommodation in recent years and at the time of our inspection, there were 42 people living as permanent residents in the home. Charlotte House also offered a periodic intermediary care service (IMC), often known as ‘winter pressure’ beds. This means the home offers support to people discharged from hospital but who need a period of rehabilitation before they are ready to return home independently. There were 5 beds reserved for this purpose on the first floor. In total, there were 47 people living in Charlotte House at the time of our inspection.

The main accommodation was purpose built and has three floors with two lifts to access the floors. It is attached to a period building which had ‘listed’ status. The main building and accommodation had been re-furbished over the last year. The newer building was in two wings, named the south and the north wing. The older part of the building was in the process of refurbishment and was destined to become a staff resource, including staff training rooms, offices and staff changing rooms.

The home required a registered manager. 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, until recently, had a registered manager who had been transferred to another service by the provider and a new manager had been appointed in the last few months. This manager had applied for registration with CQC.

At this inspection we found a breach of regulation 12 of the Health and Social Care Act 2008 in relation to safe medication administration.. This related to medication record keeping and safe storage of medication and staff ensuring that monitoring records for the medication rooms and medication fridge temperatures were taken to ensure medication was stored at a safe temperature.. You can see what action we told the provider to take at the back of the full version of the report.

The manager had been in post for several months and had two deputy managers to support them in the running of the home. The home manager was in the process of setting up systems to monitor the quality of the service and to produce audits of all aspects of it. We saw that most of these had been implemented in January 2017.

Staff were safely recruited all received the same induction. They had received training in safeguarding, mental capacity and other topics pertinent to their role.

The home followed the principles of the Mental Capacity Act 2005 and the associated deprivation of Liberties Safeguards.

People and their relatives told us that staff were caring, that there was plenty to do in the home and that the food had improved. They also told us that the home was now, “Like a palace” after a recent refurbishment.

Staff told us they had support from their managers and that they were working as a team.