CQC report explained · a residential care home
What the CQC found at Carleton Court Residential Home Limited
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from avoidable harm. Medicines, infection control, fire safety, staffing, recruitment and safeguarding were managed well, although call-bell access was identified as a safety concern in the well-led findings.
- Effective?
- Good
- This key question was not inspected during this visit. The report says ratings for key questions not inspected were carried over from the previous inspection.
- Caring?
- Good
- This key question was not inspected during this visit. The report says ratings for key questions not inspected were carried over from the previous inspection.
- Responsive?
- Good
- This key question was not inspected during this visit. The report says ratings for key questions not inspected were carried over from the previous inspection.
- Well-led?
- Requires improvement
- The home had improved its quality checks and records, but audits had not identified missing or inaccessible call bells. The management and leadership rating therefore remained Requires Improvement.
What inspectors found, February 2023
Rated Good; inspectors found safe, caring support and improved medicines management, but call-bell access and quality checks still need attention.
This was an unannounced inspection on 18 January 2023. An inspector and an Expert by Experience spoke with six people, one relative, four care staff and managers. They also reviewed care, medicines, recruitment and management records.
The home was rated Good overall and Good for Safe. People and relatives said they felt safe and were happy with their care. Medicines, infection prevention, fire safety, staffing and safeguarding arrangements were found to be managed well.
Well-led was rated Requires Improvement. Some call bells were missing or not accessible in communal areas, and one person did not have a call bell in their bedroom. The home had improved since the previous inspection and was no longer in breach of the regulations previously breached, but its checks had not found these safety issues.
Medicines
Medicines were stored, administered and recorded safely. Staff had clear instructions for medicines given when needed.
“People received their medicines as prescribed and at the right time.” from the report
Infection control
The home used appropriate protective equipment, cleaning routines and infection control checks.
“We were assured that the provider was using PPE effectively and safely.” from the report
Staffing and safeguarding
There were enough staff to meet people's needs, and recruitment checks were described as robust. Staff knew how to report abuse or unsafe practice.
“There were enough staff to meet people's individual needs and maintain their safety.” from the report
Positive atmosphere
Inspectors found the atmosphere relaxed and welcoming. Staff felt supported and people’s needs and wishes were central to the service.
“The atmosphere within the home was relaxed and welcoming.” from the report
Call bells not always available
seriousCall bells were missing or inaccessible in the TV lounge, shower room and hair salon. One person did not have a bedroom call bell, and there was no recorded plan showing how other options would be provided.
“Call bells were not always available for people and staff to use in communal areas.” from the report
Checks missed safety issues
needs fixingThe registered manager carried out audits, but these checks did not identify the problems with call-bell access. Inspectors recommended improving the audits and checking maintenance records.
“However, these audits had failed to identify the environmental risks identified on inspection such as the accessibility of call bells.” from the report
- 01What has been done to make sure call bells are available and accessible in every communal area?
- 02What alternative way of calling for help is in place for the person without a bedroom call bell?
- 03How will you update audits so they identify missing or inaccessible safety equipment?
- 04How often are maintenance records and call bells checked, and who reviews the results?
- 05What improvements to medicines records and infection control have been maintained since the previous inspection?
This inspection covered Safe and Well-led; the report says the other key-question ratings were carried over from the previous inspection. This explanation was written from the published report of 16 February 2023 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, May 2021
Requires Improvement; inspectors found infection-control failures, weak records and quality checks, although people spoke highly of the care and staff.
This was a focused inspection on 3 and 9 February 2021. It began as a targeted check of infection prevention during the coronavirus pandemic, but was widened to look at Safe and Well-led after concerns were found.
The home did not consistently follow infection-control guidance. Visitor screening was not effective, and the use and location of protective equipment increased the risk of infection. Care plans, medicine records and accident records were also not always complete or up to date.
The home was rated Requires Improvement overall, and also Requires Improvement for Safe and Well-led. The other areas were not inspected at this visit, so their previous ratings were used in the overall rating. The provider took immediate action on the infection-control concerns after the inspection.
Kind relationships
People and relatives spoke positively about the care and staff. Inspectors found that people had good relationships with staff and were supported with choice and control.
“People who used the service and their relatives spoke highly of the care and staff.” from the report
Enough staff
Inspectors found enough staff to meet people's needs. Recruitment checks were also in place to help ensure suitable staff were employed.
“There were enough staff available to meet people's needs.” from the report
Safeguarding
Safeguarding systems were in place, and concerns had been reported appropriately to the local authority and the CQC.
“Staff had a good knowledge and understanding of safeguarding risks and when to raise concerns to the registered manager of local authority.” from the report
Working with professionals
The home had good working relationships with commissioners, the local authority and healthcare staff.
“The service had good working relationships with commissioners, the local authority and external healthcare staff.” from the report
Infection-control failures
seriousStaff did not consistently follow national infection-control guidance. Visitor screening was also not effective, putting people at increased risk of infection.
“The provider had failed to implement effective infection prevention and control practices which placed people at risk of infection.” from the report
Weak quality checks
seriousAudits did not identify problems in infection control, medicines, risk management, accidents and care plans. The provider was not reliably learning from incidents.
“Quality assurance systems had not identified or addressed the shortfalls identified during the inspection.” from the report
Incomplete care records
needs fixingCare plans were not always updated when needs changed. Records did not always show dates, mental capacity assessments or best-interest decisions.
“Care plan audits did not identify issues.” from the report
Medicine records
needs fixingCreams and ointments were not always dated when opened, and records did not accurately show when or why they were used. Guidance for some as-needed medicines was incomplete.
“Creams and ointments were not consistently dated when opened and records did not accurately reflect when or why creams and ointments had been applied.” from the report
- 01What changes have you made to visitor screening and the use and placement of protective equipment since this inspection?
- 02How do you now check that care plans are updated when a person's needs change?
- 03How are creams, ointments and as-needed medicines recorded and handed over between staff teams?
- 04How do you review accidents and incidents for patterns, and when was the last review completed?
- 05What action has been taken to meet the conditions placed on the registration and the requirements for better quality checks?
This was a focused inspection of Safe and Well-led, following an initial targeted infection-control inspection; the other key questions were not inspected and previous ratings were used. This explanation was written from the published report of 28 May 2021 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 Residential Home Limited
7 rated inspections over 8 years: the service has improved, from Requires improvement to Good.
- February 2023Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
Read what inspectors found at Carleton Court Residential Home Limited →
- May 2021Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
Read what inspectors found at Carleton Court Residential Home Limited →
- June 2018Goodup from Requires improvementSafe: Requires improvementWell-led: Good
- May 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- June 2016Requires improvementstayed Requires improvementSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- August 2015Requires improvementstayed Requires improvementSafe: Requires improvement
- March 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- June 2013
Report published without a new overall rating.
- July 2012
Report published without a new overall rating.
- February 2012
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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