CQC report explained · a residential care home
What the CQC found at Carlton Hall Residential Home and Village
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and avoidable harm. Medicines, infection control, staffing and incident monitoring were generally managed safely, but inspectors recommended a fuller assessment of risks linked to the stairs.
- Effective?
- Good
- People's needs were assessed and care plans reflected their needs. Staff had relevant training, people received suitable food and drinks, and staff worked with health professionals.
- Caring?
- Good
- Inspectors saw respectful and compassionate interactions. People and relatives said staff were kind, involved people in decisions and respected privacy, dignity and independence.
- Responsive?
- Good
- Staff responded to people's needs and call bells. Activities, trips and individual interests were supported, and there was a complaints process, although one relative had not initially received a response.
- Well-led?
- Good
- Audits, meetings and a service development plan helped managers monitor and improve the service. At the time of the inspection there was no registered manager, but a new manager had applied to register.
What inspectors found, July 2022
Rated Good overall; inspectors found kind, responsive care, with a recommendation to improve stair risk checks.
Inspectors visited the home on 15 and 20 June 2022. They spoke with people living there, relatives, staff and managers. They observed care, checked the building and reviewed care, medicines, staffing, complaints and management records.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. People generally received safe and kind care. Staff supported people with food, medicines, health needs, activities and personal choices.
The inspectors recommended that the home improve its risk assessment for the stairs. They also found that one incident had not been shared with a relative and that one complaint had not received a response, although both issues were addressed during the inspection.
Kind and respectful care
Inspectors saw staff treating people with compassion and respect. People and relatives gave positive feedback about staff relationships.
“We observed that staff were respectful and compassionate in their interactions with people and how they talked about the people they supported.” from the report
Medicines managed safely
The home had systems for administering, recording, storing and checking medicines. Inspectors saw part of a medicines round and found it was done safely.
“Records showed people received their medicines as prescribed.” from the report
Activities and personal interests
People had access to group activities, trips and support with individual interests. Inspectors saw people taking part in activities during their visits.
“There was a programme of activities in place and during our visits we saw lots of things happening.” from the report
Monitoring and improvement
Managers used audits, surveys and a development plan to identify shortfalls and make improvements. The home had also introduced actions after issues were found during the inspection.
“A range of audits were undertaken, which supported the management team to monitor the service effectively and independently identify shortfalls and address them.” from the report
Stair safety assessment
needs fixingInspectors recommended that the risk assessment cover the possibility of people accidentally climbing the stairs and falling. The manager said it would be reviewed.
“We recommend the risk assessment relating to the stairs be reviewed and consider how to reduce risks if a person accidently went up the stairs and then fell.” from the report
Sharing information about incidents
needs fixingOne relative said they had not been told about an incident involving their family member. The manager investigated and responded after inspectors raised it, and introduced extra checks.
“However, we received information from one relative about an incident which they had not been made aware of.” from the report
Complaint follow-up
minorOne relative had not received a response to a concern. The manager addressed this immediately after inspectors brought it to their attention.
“However, we received feedback that a relative had not had a response, this was immediately addressed by the manager when we told them.” from the report
- 01What changes have you made to the stair risk assessment since the inspection?
- 02How do you make sure relatives are told promptly about incidents involving their family members?
- 03How are complaints and informal concerns recorded, answered and checked for lessons learned?
- 04What are the current staffing levels on each unit, and how often are agency staff used?
- 05Who is currently responsible for managing the home while the new manager's registration application is being considered?
This was a comprehensive inspection of the residential care home and the personal care part of the domiciliary service, including infection prevention and control; it was the first inspection under the new provider and location name. This explanation was written from the published report of 27 July 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.
Every inspection of Carlton Hall Residential Home and Village
4 rated inspections over 5 years: the service has improved, from Requires improvement to Good.
- July 2022Goodcurrent ratingSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
Read what inspectors found at Carlton Hall Residential Home and Village →
- January 2021Inspected but not ratedSafe: Inspected but not rated
- December 2018Goodup from InadequateSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2018InadequateSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- April 2017Inspected but not ratedSafe: Inspected but not rated
- March 2017Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- September 2021
Registered with the Care Quality Commission on 6 September 2021.
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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