Archived: Carrington House Care Home

Carrington House Care Home is a residential care home registered to provide personal care for up to 28 people aged 65 and over. At the time of the inspection 19 people were living at the service.

The care home accommodates people in one building over three floors. There is some outdoor space for people and three communal living areas for people to relax.

People’s experience of using this service and what we found

People’s needs were assessed, and risk assessments were in place to support people and keep them safe. Records were updated on a regular basis. Improvements had been made to the environment, and environmental safety checks were undertaken.

Improvements had been made and the home was clean and tidy, staff had training in how to control and prevent infections. Staff were wearing personal protective equipment (PPE) in line with current guidance.

Staff had training in safeguarding and incidents were reported effectively.

Improvements had been made and medicines were administered and manged safely, audits were in place to monitor practice.

Staff training was up to date and suitable for people’s healthcare needs.

Improved staffing levels meant staffing levels were adequate, and staff were recruited safely.

There was improved analysis of incidents and accidents to prevent reoccurrence and learn lessons.

Governance had improved under a new registered manager and new measures were in place with better provider oversight of the service. Oversight of staffing and staff training had improved.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Requires Improvement (published 22 December 2020) and there were breaches in Regulation 12 (Safe Care and Treatment) and Regulation 17 (Good Governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We undertook this focused inspection to check whether the Warning Notice we previously served in relation to Regulation 12 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been met. The overall rating for the service has changed from Requires Improvement to Good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Carrington House on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Carrington House Care Home is a residential care home registered to provide personal care for up to 28 people aged 65 and over. At the time of the inspection, 22 people were living at the service. The accommodation is over three separate floors.

People’s experience of using this service and what we found

People were not always protected against the spread of infection. Staff were not always following infection control policies and procedures.

People at the service were at risk of harm due to concerns identified around medicines management which was not always safe.

Staff were not always recruited safely, and the provider did not always follow its recruitment policies and procedures.

There were occasions when there was not enough staff on the rota at weekends and on nights.

Staff told us the training was good; however the training record was not up to date and some staff working at the service were not on the training record.

Care records were detailed, and risk assessments to support people were in place.

There was analysis of incidents to prevent reoccurrence.

Governance arrangements did not provide assurance that the service was well-led.

Staff were positive about the service and told us they fell well supported.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Good (published 8 December 2017).

Why we inspected

We received concerns in relation to poor kitchen hygiene; neglect of a person; poor infection control; inexperienced management and poor leadership. A decision was made to inspect and examine those risks. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them.

The ratings from the previous comprehensive inspection for the key questions not looked at on this occasion, were used in calculating the overall rating at this inspection. The overall rating for the service has changed from Good to Requires Improvement. This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvement. Please see the safe and well-led sections of this full report. We identified breaches in relation to medicines, recruitment, preventing the spread of infection and improving the quality of the service. The provider took immediate action to mitigate the risks identified. You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Carrington House on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to safe care and treatment and good governance at this inspection. Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

The service had a registered manager in place at the time of our 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.

People felt safe in the service and staff understood their responsibility to protect people from the risk of harm or abuse. Risks to people’s health and safety had been assessed and were kept under review. When incidents had occurred at the service measures were implemented to reduce the risk of reoccurrence. There were sufficient numbers of staff to meet people’s needs in a timely manner and safe systems were in place to support people to take their medicines.

People were supported by staff who received relevant training and felt supported. People were asked for their consent before support was provided and people who lacked capacity to make certain decisions were supported in their best interests in accordance with legislation. People were supported to eat and drink enough and were supported to maintain good health. Referrals were made to health care professionals for support and guidance if people’s health changed.

People were supported by a caring staff team who communicated with people in a friendly and supportive way. Staff offered people explanations and provided them with information in order to promote choice and independence. Staff supported people to maintain their privacy and dignity.

People’s needs were responded to by staff who knew people well. Care plans were in place which provided information about the care people required although these had not always been updated when people’s needs had changed. However, the registered manager took immediate action to rectify this. People were encouraged to raise any concerns or complaints they had about the service and records showed that complaints had been responded to appropriately.

People and their relatives commented positively on the atmosphere and the management of the service. People’s views about the quality of the service they received were actively encouraged and records showed that suggestions about improvements had been acted upon. Effective systems were in place to monitor the quality and safety of the service.

The home did not have a registered manager at the time of our inspection. The registered manager left the home in August 2016 and a new manager had been appointed and was in the process of applying to become registered. 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.

Improvements were required to the management of medicines. Although people told us they were happy with the support they received to take medicines we found a number of issues which meant that the management of medicines was not safe. The manager introduced a weekly medicines audit following our visit to help identify issues in future.

Risks to people and the measures required to keep people safe were not always clearly identified and monitored. However, care plans did contain good guidance for staff about how to monitor and respond to people’s health conditions and staff were knowledgeable about how to reduce risks to people.

People were protected from the risk of abuse as management and staff understood their role in keeping people safe from harm. People were also supported by enough staff.

People were supported by staff who had received training and were supported by the management team to ensure they could perform their roles and responsibilities effectively.

People were encouraged to make independent decisions. Staff told us about how they supported people to make choices and decisions, and authorisations to deprive people of their liberty had been applied for. The manager told us they were liaising with outside professionals to check the status of applications and would review capacity assessments to ensure these were in place when needed.

People told us they enjoyed the food and we found that they were protected from the risks of inadequate nutrition. Specialist diets were provided if needed and people received the support they required during mealtimes. Referrals were made to health care professionals for additional support if required.

People were treated with dignity and respect and their choices and preferences were respected. We saw staff were kind and caring when supporting people. People and their relatives contributed to the planning of their care as appropriate.

People received person centred care. People told us that staff provided support in line with their wishes and encouraged their independence. We found that people were supported to maintain their interests and supported to engage in activities as they wished.

People and their relatives felt able to raise issues with the management team and complaints were dealt with appropriately.

Management systems were not effective in identifying and responding to issues which could affect people’s health and safety. At the time of our visit, regular audits were not carried out. The manager told us of systems they had introduced in respect of medicines management and cleanliness of the kitchen following our visit.

People told us that the manager and owner were visible and approachable and staff felt supported and motivated to provide good care to people.