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Charlton House Community Resource Centre Requires improvement

The provider of this service changed - see old profile

Reports


Inspection carried out on 12 March 2019

During a routine inspection

About the service:

Charlton House Community Resource Centre is a nursing home. It was providing personal and nursing care to 28 people aged 65 and over at the time of the inspection.

People’s experience of using this service:

• Risks to people and staff had not been consistently assessed. For example, regular checks of some areas of health and safety.

• The provider had failed to notify CQC about some incidents which had taken place at the service.

• There were enough staff to meet people’s needs. The provider was recruiting to vacant posts, and safe recruitment processes were followed.

• People's medicines were mostly administered as prescribed and managed safely by competent staff. Staff did not consistently record information about the application of creams and ointments.

• Staff felt supported by the management team, and received training and induction to ensure they could effectively perform their role. Staff received supervision, but this had not consistently met the provider’s standard for supervision to take place every 4-6 weeks since the last inspection.

• People were supported by staff to eat and drink enough to maintain a balanced diet. We received mixed feedback about the meals provided.

• The environment was bright, clean and well maintained, although there were few points of interest for people to interact with. The registered manager had plans to improve areas of the service.

• People accessed routine and specialist healthcare appointments. Relatives told us they were consulted with and informed about people’s care.

• People were assisted to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

• People were supported by staff who were kind and respectful. Staff knew people well and were aware of their preferences, likes and dislikes.

• People were supported to participate in activities, and choices were respected.

• People's care considered their individual needs and preferences. Some care plans and records required reviewing to ensure staff had the information they needed to provide high quality care. Care records were being updated at the time of our inspection.

• Some checks and quality assurance systems were in place, but other tools were being set up. These needed to be put into practice and checks recorded. Where these were in place, they were clear and action plans identified ways to improve the service.

• The service met the characteristics for a rating of "good" in caring and responsive. The other areas were rated as “requires improvement". The overall rating for the service remained at "requires improvement".

• More information is in our full report.

Rating at last inspection:

Requires improvement (report published 16 March 2018)

Why we inspected:

This was a planned inspection based on the rating at the last inspection.

Follow up:

We will continue to monitor the service through the information we receive. We will visit the service in line with our inspection schedule, or sooner if required.

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

Inspection carried out on 29 January 2018

During a routine inspection

The inspection took place on 29 and 30 January and was unannounced. At the last inspection the service was rated as Good. At this inspection we found that improvements were needed relating to the key questions of safe, effective, responsive and well-led and the service was rated Requires Improvement overall.

Charlton House Community Resource Centre is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Charlton House Community Resource Centre provides accommodation and nursing care for up to 30 older people in a purpose built building across two floors known as Abbey Park and Somerdale. At the time of our inspection there were 27 people living at the service.

The registered manager had recently left the service. A new manager had been employed but had not yet applied to be 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.

The provider had not ensured that effective systems were in place to monitor the service consistently to maintain the quality and safety of the service. There had not been consistent management in the home since it opened. There had been a succession of different managers. This had led to inconsistency in the management of the home. The provider’s systems to manage quality had not always been used which meant the provider had not identified the issues we found at this inspection. The provider had not identified the lack of use of these systems. However the new manager had started to identify shortfalls and areas for improvement and was developing an action plan. We will be asking the provider to keep us updated with the progress of this action plan.

Staff did not always record the amounts of controlled drugs or account for their disposal properly. This meant that they could not be sure that these medicines had been managed safely at all times. Medical equipment used to measure blood pressure and blood oxygen levels had not been tested. This meant that staff could not be sure this equipment worked effectively. Staff had ordered new medical devices but had not identified which were old and which new so could not be sure of using the correct device. There had been no systematic audit of medicines management within the service for several months.

The provider had not always dealt with concerns effectively through the complaints system.

Whilst staff knew how to raise a concern about a person’s well-being this had not always been followed up according to the provider’s safeguarding policy. Some incidents and concerns had not been notified to the relevant safeguarding adults’ team.

Staff had not received regular supervision for many years to support them in their work. The new manager had recently begun to meet staff for supervision. Staff received an induction and training in subjects the provider considered necessary for them to carry out their role safely.

People and their relatives were complimentary about the staff team and the quality of service they received. People felt safe, supported and respected. Staff were caring and the regular members of staff knew people well. Care plans were well written and identified people’s preferences for the way their care was delivered.

We found three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

Inspection carried out on 14 August 2015

During a routine inspection

The inspection took place on 12 August 2015 and was unannounced. The service was last inspected in April 2013 and met with legal requirements.

Charlton House is registered to provide personal care for up to 31 people. There were 31 people at the home on the day of our visit.

The previous registered manager had recently left. There was an acting manager for the service. They were being well supported by senior managers. They had worked at the home before they were appointed in a senior position. This meant they knew the people who lived there and the staff team they were managing. 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 said that they always felt safe at the home and the staff always treated them properly. When risks to people were identified suitable actions were put in place to reduce the likelihood of them occurring.

There were systems in place to help keep people safe from abuse. The staff had been on safeguarding training to help them to understand abuse and how to report concerns.

People were supported by enough staff to meet their needs. Staffing numbers were adjusted when they needed to be, for example when people’s needs changed and they required more support with their care.

Staff were caring in their approach to people when they assisted them with their needs. One person said “They are fantastic every one of them”. Staff were polite and respectful to the people they supported with their care.

People were supported to eat and drink enough to be healthy and menus were planned based on what people liked. People spoke positively about the food that they were served at the home.

Peoples legal rights were protected by the provider’s system for implementing the requirements of the Mental Capacity Act 2005. This legislation protects the rights of people who may not have capacity to make informed decisions.

People were able to choose to take part in a number of different individual activities and groups that they enjoyed.

People’s care plans were informative and they clearly explained how to provide people with the care they needed. If people were able to and chose to, they were involved in devising their care plans. Families were also asked for their views to help to ensure that people received care and support in the way they preferred.

People were well supported with their physical health care needs and the staff consulted with external healthcare professionals to get specialist advice and guidance when required.

Staff felt they were well supported in their work. People who lived at the home and the staff said they felt they could approach the manager at any time if they needed to see them.

There was a system in place to properly check and improve the quality of the service. Audits demonstrated that regular checks were undertaken on safety and quality.

Inspection carried out on 4 December 2013

During a routine inspection

Everyone we spoke with confirmed they were happy with the service they received at Charlton House Community Resource Centre. Comments from everyone we spoke with included: �staff are very kind and caring.� A person who lived at the home explained: �all of the staff who work with me know me very well.�

A person we spoke with told us they made day to day decisions regarding what they did and what they ate. They explained they would talk to their relatives or staff if they had to consent to decisions such as having a flu vaccination.

We found the management of people's medicines was well organised and staff were trained effectively to carry this out safely.

Everyone we spoke with were confident any concerns would be dealt with effectively.

Inspection carried out on 7 February 2013

During a routine inspection

We spoke with 14 of the 30 people who used the service. We spoke to the registered manager, a senior care worker, and three support workers.

People who used the service felt positive about the care and support at Keynsham Resource Centre. Comments people made included �the staff are all lovely girls�, �it�s so relaxed it�s like a hotel here�, �they have been pretty good to me� and �on the whole it has been surprisingly good here�.

People�s care needs were identified in their individual care plans. Care plans effectively set out how to assist each person effectively with their needs.

People�s needs were effectively meet as they were supported by staff who had a good understanding about the type of care and assistance they required.

The staff who supported people who used the service were not all being formally developed to improve in their work during their supervision meetings. This could have a negative impact on the care people received if staff were not being effectively supervised to understand their needs.

People benefited because there was an effective system in place to monitor and check the quality of care and service they were receiving at Keynsham Community Resource Centre.