CQC report explained · a nursing home
What the CQC found at Ann Charlton Lodge
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Risks, accidents, incidents, medicines, staffing, recruitment and infection control were managed safely. Inspectors noted that some improvement was still needed in records for creams and medicines bought by people.
- Effective?
- Good
- People's needs and choices were assessed and reviewed. Staff received training and supervision, and people were supported with eating, drinking and access to healthcare.
- Caring?
- Good
- People and relatives described staff as caring and kind. Inspectors saw respectful support and found that people were involved in decisions and supported to maintain independence.
- Responsive?
- Good
- Care plans gave staff detailed guidance based on people's needs and preferences. People were supported with communication, activities, relationships and complaints.
- Well-led?
- Good
- Quality checks had improved and were effective at identifying and resolving issues. The provider and manager worked with external professionals, and people, relatives and staff spoke positively about the improvements.
What inspectors found, January 2020
Ann Charlton Lodge rated Good; inspectors found safe, kind and personalised care, with minor medicines-record improvements still needed.
Inspectors visited without notice on 03 and 08 January 2020. They spoke with people, relatives and staff, observed care, and reviewed care, medicine, staffing and management records.
The home was rated Good overall and Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. People said they felt happy and safe, and inspectors found kind care, suitable support, safe medicines systems and improved management.
The previous rating was Requires Improvement, with three regulatory breaches. Inspectors found enough improvement had been made and said the home was no longer in breach of those regulations.
People felt safe
People told inspectors they felt happy and safe. Staff understood people's needs and staffing was stable and consistent.
“People told us they felt happy and safe at the service.” from the report
Kind and respectful care
Inspectors saw caring interactions. People were treated with dignity and involved in decisions about their care.
“Staff treated people with dignity and respect.” from the report
Personalised support
Care plans reflected people's assessed needs and preferences. People and relatives helped design and review the support provided.
“People received support based on their assessed needs and preferences, which were regularly reviewed.” from the report
Improved leadership
Management checks had improved since the previous inspection. The provider worked with external professionals to improve standards.
“Quality assurance audits had been improved and were effective at identifying and resolving issues.” from the report
Some medicines records needed improvement
needs fixingInspectors found that records for creams and medicines bought by people needed further improvement. The manager had identified this and was addressing it.
“Some improvement was needed in records for creams and in managing medicines people bought themselves.” from the report
Communication was still being reviewed
minorThe manager was considering how to make communication improvements. Ask what changes were made and how people and relatives are kept informed.
“Regular meetings took place, and the manager was reviewing how further improvements to communication could be made.” from the report
- 01How are records for creams checked now, and what action is taken if they are incomplete?
- 02How do you record and manage medicines that residents buy themselves?
- 03What changes have been made to communication with residents, relatives and staff since the inspection?
- 04Who is the registered manager now, and how has the management arrangement changed since January 2020?
- 05How do people and relatives take part in reviewing care plans and support?
This was an unannounced planned inspection based on the previous rating and covered the care provided, the premises and all five CQC questions. This explanation was written from the published report of 28 January 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.
What inspectors found, July 2019
Rated Requires Improvement, with unsafe record keeping and inadequate leadership creating risks for people.
Inspectors visited on three dates and spoke with people, relatives, staff, managers and health professionals. They reviewed care records, medicines records, staff files, training information and quality checks.
People said they felt safe and described staff as kind. There were enough staff on duty, recruitment checks were carried out, and people were supported with activities, healthcare, privacy and independence.
However, important risks were not managed reliably. Records about pressure ulcers, nutrition, weights, wounds, medicines and people's care needs were incomplete or unclear. Mental capacity assessments and best-interest decisions were also not recorded properly.
The overall rating was Requires Improvement. Safe, effective, caring and responsive were all rated Requires Improvement, while well-led was rated Inadequate. The home had received Requires Improvement at the previous inspection, and the report says not enough improvement had been made.
Staffing and recruitment
Inspectors found enough staff on duty to meet people's needs. Recruitment checks were in place to help ensure suitable staff were employed.
“There were enough staff employed to meet people's needs.” from the report
Respect and independence
People said staff respected their privacy and dignity. Staff encouraged people to remain as independent as possible.
“People told us their privacy and dignity were respected and their independence encouraged.” from the report
Activities and social contact
People were offered activities and outings, and family and friends were encouraged to visit. People described regular trips and social events.
“People told us they enjoyed quizzes, coffee mornings and trips out to Whitby, York Railway Museum and shopping.” from the report
End-of-life support
The home had gained renewed accreditation under the Gold Standards Framework. Inspectors found that people's end-of-life wishes were discussed and, where possible, followed.
“Compassionate care was provided at the end of people's lives.” from the report
Clinical risk monitoring
seriousRisks linked to malnutrition, dehydration, weight loss and pressure ulcers were not always assessed or monitored correctly. Records about wounds, weights and nutrition were poor.
“People's health was not always monitored effectively.” from the report
Medicines records
seriousFood supplements were not always recorded as given. Pain records were inconsistent, and staff did not always follow instructions for changing the site of medicine patches.
“Medicines were not always managed safely and record keeping was not robust.” from the report
Mental capacity decisions
seriousDecision-specific mental capacity assessments and best-interest decisions were missing. Some consent forms had been signed by people who did not have capacity to make those decisions.
“Decision specific MCA assessments had not been not carried out to establish if people had the ability to make informed decisions for themselves.” from the report
Care plans
seriousCare plans did not always explain how to meet people's needs or manage conditions such as diabetes and mental health problems. Some records had not been updated.
“Care plans were insufficiently detailed to ensure the needs of people were met.” from the report
Leadership and quality checks
seriousManagers did not have sufficient oversight of the service. The home's checks were not strong enough to find and correct the problems identified by inspectors.
“The provider's quality assurance processes and systems continued to be insufficiently robust to identify the issues we found during this inspection.” from the report
- 01How are you now checking and recording people's weights, nutrition, hydration and pressure ulcer risks?
- 02How do you make sure medicines, food supplements and pain relief records are completed correctly?
- 03How are mental capacity assessments and best-interest decisions recorded for each person?
- 04How have care plans for conditions such as diabetes, continence and mental health been updated?
- 05What changes have been made to leadership and quality checks since this inspection, and what evidence can you show of improvement?
This was a planned inspection that considered all five key questions and looked at both the premises and the care provided; the first day was unannounced and later dates were announced. This explanation was written from the published report of 6 July 2019 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 Ann Charlton Lodge
4 rated inspections over 4 years: the service has held its Good rating throughout.
- January 2020Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2019Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- June 2018Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- January 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2014
Report published without a new overall rating.
- August 2013
Report published without a new overall rating.
- October 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 19 January 2011.
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.
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