CQC report explained · a residential care home
What the CQC found at 92 Carlton Road
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found good safeguarding, risk management, staffing, medicines and infection control systems. The home used positive behaviour plans and least restrictive approaches.
- Effective?
- Good
- Care plans were up to date and staff were trained and supervised. People were supported with food, healthcare, communication, independence and decisions.
- Caring?
- Good
- Staff knew people well and treated them with dignity and respect. People were supported to make choices and keep in touch with relatives and friends.
- Responsive?
- Good
- Care was planned around people's individual needs, preferences and communication styles. People were supported with activities, relationships, community access and complaints.
- Well-led?
- Good
- Inspectors found good management systems, teamwork and openness. There was no registered manager at the visit, but an interim manager was providing leadership while recruitment took place.
What inspectors found, June 2022
92 Carlton Road is Rated Good; inspectors found personalised, respectful care, with no registered manager in post and a serious incident outside the inspection's scope.
One inspector visited on 28 April 2022. The home was supporting five people with a learning disability or autism, and could support up to six. Inspectors spoke with people, staff and relatives, and reviewed care, medicines, recruitment and management records.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough skilled staff, good medicines systems, person-centred care, support with communication and activities, and strong monitoring of quality.
All five areas had improved from Requires Improvement at the previous inspection, published in November 2020. The home did not have a registered manager because the previous manager had left, but an interim manager was in place.
Personalised support
Care plans reflected people's individual needs, preferences, communication styles and goals. Staff supported people to develop skills and independence.
“The service supported people to have the maximum possible choice, control and independence over their own lives.” from the report
Safe staffing
Inspectors found enough suitably skilled staff to meet people's needs. Staffing was often arranged around individual support needs.
“The home had a stable staff team and enough staff to meet the needs of people using the service.” from the report
Medicines and behaviour support
Medicines were managed carefully, including medicines used only when needed for severe distress. Positive behaviour plans aimed to avoid physical intervention.
“Records showed that staff rarely used chemical restraint, and only as a last resort, for managing unsafe behaviours.” from the report
Respect and choice
People were treated with dignity and had freedom to choose where they went, what they did, and what they ate and drank.
“All staff recognised they were working in people's home.” from the report
Learning and improvement
The provider had introduced electronic incident reporting and used incidents, complaints and audits to identify learning and make changes.
“The provider showed a strong commitment to learning lessons and continuous improvement.” from the report
No registered manager
needs fixingThere was no registered manager in post when inspectors visited. An interim manager was running the home while the provider recruited a replacement.
“At the time of our inspection, the home did not have a registered manager.” from the report
Serious incident not examined
needs fixingBefore the visit, a person had sustained a serious injury. The report says the circumstances were not examined during this inspection because they were subject to further investigation.
“Prior to our visit, we received notification of a specific incident in which a person using the service sustained a serious injury. This incident is subject to further investigation.” from the report
Sensory room still being developed
minorThe home had identified a sensory room as beneficial, but it was not complete at the time of the inspection.
“At the time of our inspection, the service was developing a sensory room.” from the report
- 01What progress has been made in recruiting and registering a permanent manager?
- 02What was learned from the serious injury incident, and what changes were made while the separate investigation continued?
- 03Has the sensory room now been completed, and how is it being used to meet people's sensory needs?
- 04How are staff trained to follow each person's positive behaviour plan and use least restrictive approaches?
- 05How will you make sure staffing remains stable if there are staff shortages?
This was a full inspection of all five key questions, but it did not examine the circumstances of a serious injury incident that was subject to further investigation. This explanation was written from the published report of 2 June 2022 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, November 2020
Rated Requires Improvement; the home had made significant progress since an earlier Inadequate rating, but inspectors wanted improvements to be sustained.
This was a focused inspection on 7 and 8 October 2020. Inspectors reviewed records, toured the home, spoke with relatives and staff, and checked how the home had acted after the previous inspection.
The home had improved its systems for managing risks, safeguarding concerns, accidents, incidents, medicines and quality checks. Staffing levels were sufficient, infection control was managed well, and staff recruitment checks were robust.
Some work was still unfinished. Training changes had been delayed by COVID-19, some staff needed further support to record and report incidents clearly, and fire drill records could be more accurate.
The overall rating changed from Inadequate to Requires Improvement. The home was no longer in breach of regulations, but the CQC needed to see that the improvements continued over a longer period.
Improved risk management
The home had introduced better systems for identifying and reviewing risks. Staff were given information about people's specific risks and how to manage them.
“The service was better organised and had introduced effective systems to identify risks connected to the service.” from the report
Sufficient staffing
Inspectors found enough staff to meet people's needs and support their routines. The home had also added a flexible 12-hour daily shift.
“Staffing levels were appropriate to meet the needs of the people using the service.” from the report
Safe medicines practice
Medicines were administered by trained staff, records were complete, and guidance was available for medicines taken only occasionally.
“People's medicines continued to be managed safely and only administered by staff with the relevant training and ongoing competency assessments.” from the report
Better management oversight
The provider had strengthened the management structure and introduced more audits, spot checks and reviews of incidents and safeguarding concerns.
“The provider made improvements to the management structure, with additional support offered to the management team from the internal quality assurance team” from the report
Infection control
Inspectors were assured that the home managed COVID-19 risks, used protective equipment safely and followed infection control procedures.
“We were assured that the provider was using PPE effectively and safely.” from the report
Training was not fully in place
needs fixingThe provider had developed new training systems, but parts of the training programme had been delayed by COVID-19. The new approach to supporting people with challenging behaviour was not yet fully delivered.
“Work in this area was at the early stages due to constraints of COVID-19 delaying some aspects of the training implementation.” from the report
Emergency drill records
needs fixingFire drills were happening more often, but inspectors said the records did not always show clearly whether the drills went to plan or whether staff understood evacuation procedures.
“Fire drills were conducted more often, however we discussed with the management team there was further scope for improvement to accurately record whether the drill went to plan” from the report
Incident recording still needed work
needs fixingThe new incident monitoring system had improved oversight, but some support workers still needed to record and report incidents more clearly.
“Work was still ongoing with a small number of support workers to ensure they clearly recorded and reported incidents.” from the report
- 01What training has now been completed on the new person-centred approach to behaviours that challenge others?
- 02How do you check that all staff understand the fire evacuation procedure?
- 03How do you make sure accidents, incidents and safeguarding concerns are recorded and reviewed consistently?
- 04What evidence can you show that the improvements found at this inspection have been maintained?
- 05What were the previous ratings for Caring and Responsive, which were not inspected on this visit?
This was a focused inspection of Safe, Effective and Well-led; Caring and Responsive were not inspected and their previous ratings were carried forward. This explanation was written from the published report of 13 November 2020 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of 92 Carlton Road
3 rated inspections over 2 years: the service has improved, from Inadequate to Good.
- June 2022Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2020Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- April 2020InadequateSafe: InadequateEffective: InadequateCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- February 2019
Registered with the Care Quality Commission on 1 February 2019.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
Weigh the report against the rest
Fees, photos and reviews from families
How to read CQC ratings and reports
What to check when you visit
At least 100 live-in carers within about an hour of Manchester
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £980 to £1,260 a week. 89 can care for a couple. 10 years' experience on average.
“Primrose is a very kind and compassionate healthcare professional”
“She is an exemplary carer, she is knowledgable empathetic and very respectful in the home.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.