CQC report explained · a residential care home
What the CQC found at Carleton Court Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People felt safe, staffing levels were sufficient and risks such as falls, pressure damage and emergency evacuation were managed. Inspectors found one medicine record where key information had not been transferred to the medication administration sheet.
- Effective?
- Good
- People's needs were assessed and staff received induction, training and regular supervision. Food and drink, healthcare support and consent arrangements were also found to be well managed.
- Caring?
- Good
- Staff were kind, patient and respectful. People were involved in their care choices and were supported to maintain independence and dignity.
- Responsive?
- Good
- Care records were personalised and staff understood people's preferences and communication needs. Structured activities were limited, although people could read, chat and join in some staff-led activities.
- Well-led?
- Good
- The home had visible leadership, regular feedback from people and relatives, and a quality assurance system that reviewed care and acted on concerns.
What inspectors found, November 2019
Carleton Court Care Home was rated Good; inspectors found safe, kind and person-centred care, with some limited activities and a medicines recording issue.
This was a planned inspection of the home. It took place on 15 and 21 October 2019. The first day was unannounced and the second was announced. Inspectors spoke with six people, seven relatives and eight staff, and reviewed care, medicines, recruitment and management records.
Inspectors found that people felt safe and settled. Staff knew people well, treated them with kindness and supported their choices. Care plans were detailed and personalised. Food, cleanliness, staffing, healthcare support and medicines were generally well managed.
There were some smaller shortfalls. Structured activities were limited. Help with eating was not always discreet because of limited dining-room space. One medicine record had not been fully updated when medication was prescribed outside the usual cycle.
The overall rating was Good, with Good ratings in all five areas. Effective care improved from Requires Improvement at the previous inspection, published in April 2017. The other four ratings remained Good.
Kind and respectful staff
People described staff as kind and sensitive. Inspectors saw staff paying close attention to comfort, wellbeing, dignity and personal preferences.
“Staff were warm and empathetic in their manner and promoted high levels of interaction.” from the report
Safe staffing and risk management
Staffing levels were sufficient and dependency needs were reviewed. Risks involving moving and handling, falls, pressure care and emergencies were managed.
“Staffing levels were sufficient to meet people's needs promptly.” from the report
Good food and cleanliness
People said food was plentiful and choices were available. The home was clean and had achieved a high score in an external infection control audit.
“The home was clean and had scored 92% in a recent external infection control audit.” from the report
Personalised care records
Care records reflected people's needs, preferences and routines. They gave staff clear information about the support to provide.
“Care records were person-centred and reflected people's needs well.” from the report
Strong leadership and oversight
Leaders were visible and accessible. The home used meetings, surveys and regular checks to involve people and review the quality of care.
“The service had a robust quality assurance process in place which reviewed all aspects of the support given regularly” from the report
Limited structured activities
minorThe report says structured activities were limited. Some people entertained themselves by reading and talking, and staff offered activities when people wanted to take part.
“Structured activities were limited in availability, but many people were able to entertain themselves through reading and chatting to peers.” from the report
Mealtime assistance was not always discreet
minorPeople received help with meals when needed, but inspectors said this was not always discreet because there was not enough space in the dining room.
“Assistance was given by staff if needed although this wasn't always discreetly done due to lack of space in the dining room.” from the report
- 01What structured activities are currently available, and how do you match them to each person's interests?
- 02How do you make support with eating private and discreet for people who need help?
- 03What checks ensure that medicines prescribed outside the usual cycle are fully recorded on the medication administration sheet?
- 04How are people's care choices and end of life wishes recorded and reviewed with them and their relatives?
- 05What refurbishment or building alteration work was planned, and has it been completed?
This was a planned inspection covering all five key questions, with the first day unannounced and the second day announced; Effective improved from Requires Improvement while the other ratings remained Good. This explanation was written from the published report of 22 November 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.
What inspectors found, April 2017
Carleton Court Care Home was rated Good overall; inspectors found kind, safe care, but mental capacity assessments needed improvement.
Inspectors visited without warning on 28 February and 2 March 2017. They spoke with people living at the home, relatives, staff and a visiting health professional. They reviewed care records, staff files, training information and management records, and looked around the building.
The home was rated Good overall. Safe, caring, responsive and well-led were rated Good. People told inspectors they felt safe, staff were kind, medicines were managed safely and care was personalised. Complaints were recorded and acted on.
Effective was rated Requires Improvement. Some mental capacity assessments were too general and did not relate to the particular decision being made. Some consent forms had not always been signed by someone with the right authority. The home agreed to address these issues.
The home had no breaches at its previous inspection in June 2015. Inspectors found improvements since then, including a more proactive approach to identifying and reducing risks.
Kind and respectful care
Inspectors saw staff being patient, reassuring and attentive. People were supported to remain as independent as possible and their privacy and dignity were respected.
“Throughout our inspection we heard staff treat people with dignity and respect.” from the report
Safe medicines management
Medicines were stored securely and given by trained staff. Records, controlled drugs and as-needed medicines were checked and audits were used to improve practice.
“Medicines were administered in a calm, patient and kindly manner by a staff member who was wearing a tabard to indicate they should not be disturbed.” from the report
Personalised support and choice
Care plans included people's interests, histories, preferences and cultural wishes. Staff offered choices about food, drinks, activities, seating and daily care.
“We saw people were offered choices throughout the day, in relation to what they wanted to eat, or drink, what they wanted to do and where they wanted to sit.” from the report
Active management and improvement
The manager and directors were visible and knew people well. Audits, meetings and feedback were used to identify actions and make changes.
“Regular audits were undertaken to help ensure improvements were sustained and continued to develop.” from the report
Mental capacity records
needs fixingSome assessments were generic rather than linked to the specific decision a person needed to make. Inspectors highlighted this to the directors, who agreed to address it.
“We saw some mental capacity assessments that were generic, that is, not decision specific.” from the report
Consent records
needs fixingSome consent forms had not always been signed by a person with the appropriate authority. Inspectors raised this with the directors.
“However, these had not always been signed by a person with appropriate authority to do so.” from the report
Some care plans lacked detail
minorTwo care plans did not give enough detail about continence support and help with meals and drinks. Inspectors asked the home to consider adding clearer instructions for staff.
“We felt the plan would benefit from further information regarding exactly how staff should assist the person.” from the report
Limited dementia navigation signs
minorThere was limited signage on the first floor to help people find their way around. After the inspection, the home said it had increased the size of toilet signs and sought specialist guidance.
“Although toilets were signposted and names were indicated on bedroom doors, there was limited signage on the first floor, where most bedrooms were situated, to assist people to navigate.” from the report
- 01What has changed since the inspection to make sure every mental capacity assessment is specific to the decision being made?
- 02Who is responsible for signing consent forms, and how do you check that they have the right authority?
- 03Have the care plans for continence support and help with meals and drinks been updated with clearer instructions?
- 04What dementia-friendly signs are now in place on the first floor?
- 05How do you decide whether staffing levels are enough at night and during busy periods?
This was an unannounced inspection covering all five CQC questions, with the overall rating and each question rating assessed during the visit. This explanation was written from the published report of 21 April 2017 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 Carleton Court Care Home
4 rated inspections over 5 years: the service has improved, from Inadequate to Good.
- November 2019Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2017Goodup from Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- July 2015Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- March 2015InadequateSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: GoodWell-led: Inadequate
- July 2014
Report published without a new overall rating.
- September 2013
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- November 2011
Report published without a new overall rating.
- November 2010
Registered with the Care Quality Commission on 30 November 2010.
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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