CQC report explained · a residential care home
What the CQC found at Carlton House
Rated Outstanding: inspectors found the home performing exceptionally well.
What inspectors found, October 2020
Not rated in this targeted inspection; the previous overall rating remains Requires Improvement, with improvements and no current breaches found.
This was a targeted inspection on 10 September 2020. Inspectors checked infection control and whether the home had fixed problems found at the previous inspection. They looked around the home, observed care, spoke with staff and a relative, and reviewed records and quality checks.
The home was clean, odour free and well presented. Inspectors found improved cleaning arrangements, safer laundry systems and regular cleanliness checks. They were assured about most infection control measures, although regular COVID-19 testing was not yet fully available.
The home had improved its governance systems. End of life care plans were in place, accident and incident reviews had improved, and medicines protocols had been corrected. The inspection did not give new ratings, so the previous overall rating of Requires Improvement remains.
Cleaner environment
The home was clean, odour free and well presented. Cleaning responsibilities and monthly checks were clearer.
“we found the home to be clean and well presented” from the report
Improved care records
End of life care plans were in place and were written in a person-centred, easy-read format.
“People had end of life care plans in place.” from the report
Better oversight
Inspectors found that the quality monitoring systems had improved and that the issues identified previously had been resolved.
“we found issues identified at the last inspection were resolved.” from the report
Improved medicines protocols
Protocols for medicines given when needed had been improved and administration records matched those protocols.
“This issue had been resolved and we reviewed PRN protocols which demonstrated a good level of person-centred detail” from the report
Testing was not fully available
needs fixingInspectors were only somewhat assured that people using the service and staff could access regular testing. This was a shortfall in the infection control arrangements checked.
“regular testing had not yet been made fully available to the service.” from the report
- 01How often are residents and staff currently tested, and what happens when regular testing is not available?
- 02How are cleanliness audits checked, and how quickly are any problems put right?
- 03How are end of life wishes kept up to date and shared with the people responsible for following them?
- 04How are accidents, incidents and medicine issues reviewed to prevent them happening again?
This was a targeted inspection of specific parts of Safe and Well-led, including infection control, and did not assess the full five key questions; the previous ratings therefore carry over. This explanation was written from the published report of 23 October 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; inspectors found kind, effective support but serious cleanliness and management problems.
This was an unannounced inspection on 5 and 6 June 2019. One inspector spoke with people, staff, managers and professionals, and checked care, medicines and management records.
The home supported 14 adults with learning disabilities. Inspectors found enough staff, accurate medicine records, suitable training and kind, respectful support. People were helped to make choices, stay independent, eat well and use local services.
There were serious problems with cleanliness and infection control. The premises and laundry rooms were dirty, hazardous cleaning materials were accessible, and waste was stored outside. Care plans did not include end of life choices for people who needed them.
The overall rating was Requires Improvement. Safe, responsive and well-led were rated Requires Improvement. Effective and caring were rated Good. The previous overall rating was Good, published in December 2016.
Kind and respectful support
People had positive relationships with staff and management. Staff supported people with dignity, relationships, religion and personal goals.
“Staff treated people with kindness and respect at all times.” from the report
Enough staff
Inspectors found enough staff to meet people's needs safely, and staff were visible. Agency use had recently reduced, although staff said it had previously affected people and staff.
“There were enough staff on duty to meet people's needs individually and safely. Staff were always visible.” from the report
Medicines managed accurately
Regular medicines were given as prescribed and recorded fully. People also had medicine reviews with health professionals.
“Medicine administration records (MARs) were clear and completed fully. People received their medicines as prescribed, at the right time.” from the report
Support for choice and independence
People were involved in decisions, planned meals and activities, and learned practical skills such as cooking, shopping and budgeting.
“People were supported to learn skills to promote their independence such as meal planning, shopping, budgeting, handling money, meal prepping and cooking.” from the report
Poor cleanliness and infection control
seriousThe premises and laundry rooms were unclean. There were cross-infection risks, malodour and accessible hazardous cleaning materials. This created a risk of harm and was a breach.
“The laundry rooms in both houses were unclean with no system in use to prevent cross infection from dirty laundry to clean laundry.” from the report
Management checks missed serious problems
seriousThe home's audits and safety checks did not identify or deal with the cleanliness, infection control and care planning problems. This was a breach.
“Audits carried out by the provider failed to identify actions to address issues found during our inspection.” from the report
End of life plans were missing
seriousPeople who needed them had not been supported to make end of life plans. Their preferences about culture and spiritual needs were not recorded. This was a breach, although the provider said it had updated records after the inspection.
“People who needed them were not supported to make end of life care plans.” from the report
Some medicine instructions needed improving
minorInstructions for medicines given when needed were not always personalised, and records did not show the outcomes after they were given. Inspectors made a recommendation.
“However, these were not always personalised and there were no outcomes recorded from administering these types of medicines to show if they were successful or not.” from the report
- 01What has been done to keep the premises and laundry rooms clean and prevent cross-infection?
- 02How are hazardous cleaning materials now stored and checked?
- 03How does the manager make sure every person has an up-to-date end of life care plan that records their cultural and spiritual wishes?
- 04How are accidents and incidents now analysed for patterns and shared with staff?
- 05How much agency staff is currently being used, and how is continuity of support being protected?
This was an unannounced inspection of both the premises and care provided, covering all five key questions; the previous overall rating was Good in 2016, while Effective and Caring remained Good at this inspection. This explanation was written from the published report of 13 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 Carlton House
3 rated inspections over 4 years: the service has held its Requires improvement rating throughout.
- October 2020Inspected but not ratedcurrent ratingSafe: Inspected but not ratedWell-led: Inspected but not rated
- July 2019Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- December 2016Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- September 2015Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Good
- October 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- November 2011
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 8 December 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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What to check when you visit
At least 100 live-in carers within about an hour of Leeds
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 £1,250 a week. 89 can care for a couple. 11 years' experience on average.
“Carla has been a god send with the implementation of bringing mum back home from respite care.”
“Took his time to learn about me read my care plan and to listen to me. great companionship with lots of laughing.”
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.