Archived: Charlton House Community Resource Centre

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

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.

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.

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.