CQC report explained · a residential care home
What the CQC found at Carnalea Residential Home
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, February 2023
Carnalea Residential Home is rated Requires Improvement; inspectors found gaps in risk and medicines management, staff recruitment and oversight.
This was an unannounced focused inspection on 17 and 18 November 2022. Inspectors looked at Safe and Well-led because concerns had been raised about leadership, governance and staff culture. They spoke with 11 people and eight staff, observed care, and checked care, medicines, recruitment and management records.
The home was not always safe. Risks were not consistently assessed or managed, medicines records were sometimes inaccurate, and some staff recruitment checks were incomplete. Some people said they had to wait for help, although staff generally felt there were enough staff on duty.
The home was not well-led. Audits and checks did not reliably find problems, care plans lacked important detail, and accidents and incidents were not properly reviewed. The overall rating changed from Good to Requires Improvement. The report says the provider must send an action plan and that progress will be monitored.
Safeguarding
Staff understood different types of abuse and knew how to report concerns. People told inspectors they felt safe and secure.
“There were systems and processes in place to support people from the risk of abuse.” from the report
Infection control
Inspectors were assured that infection prevention measures, protective equipment and outbreak arrangements were in place.
“We were assured that the provider was preventing visitors from catching and spreading infections.” from the report
Mental capacity
Inspectors found that decisions were made within the principles of the Mental Capacity Act, with appropriate legal authorisations where needed.
“We found the service was working within the principles of the MCA and if needed, appropriate legal authorisations were in place to deprive a person of their liberty.” from the report
Risks were not consistently managed
seriousSome people did not have complete or individual risk assessments for conditions such as diabetes, epilepsy, allergies or pressure sores. Emergency information and some fire safety checks were also out of date or incomplete.
“Risks to people's health and safety were not always identified and mitigated sufficiently.” from the report
Medicines records and instructions
seriousStock counts did not always match medicines records. Some people lacked clear instructions for medicines taken when needed, and records did not always show that medicines had been given or used correctly.
“Some people who were prescribed PRN medicines did not have guidance in place to make sure their medicines were administered safely.” from the report
Recruitment checks
seriousSeveral staff files had gaps in employment histories or weak references. One staff member had started work before the provider had seen their DBS check.
“Three out of the 4 staff recruitment files we looked at showed gaps in staff employment histories, or missing dates of previous employments.” from the report
Weak management checks
seriousAudits did not reliably identify problems with care plans, medicines, risks or incidents. The provider did not have effective oversight of the quality and safety of the home.
“The provider was not able to evidence regular monitoring to ensure the quality and safety of the service.” from the report
Staff deployment
needs fixingSome people said they had to wait for help. The provider did not use dependency assessments to show how many staff were needed for people's changing needs.
“However, the individual assessment outcomes were not used to fulfil the purpose of calculating how many staff were needed on shift to meet people's individual needs.” from the report
- 01What has been done to correct the medicines recording problems and make sure Parkinson's, pain and as-needed medicines are given safely?
- 02How are individual risks for diabetes, epilepsy, allergies, pressure sores and moving and handling now assessed and reviewed?
- 03Has the new registered manager started and applied to register with the CQC?
- 04How do you now calculate staffing levels from each person's needs, and how do you check that people are not waiting too long for help?
- 05What changes have been made to audits, care plans and incident reviews since the inspection?
This was a focused inspection of Safe and Well-led only; the other key question ratings were carried over from the previous inspection. This explanation was written from the published report of 10 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, March 2021
Rated Good overall; inspectors found kind, person-centred care, but Safe was Requires Improvement because medicine checks were not always reliable.
Inspectors visited without notice on 25 and 26 February 2021. They spoke with people, relatives and staff, observed care, and checked care plans, medicine records, recruitment files and management records.
The overall rating was Good. Effective, Caring, Responsive and Well-led were all rated Good. The home had improved since its previous inspection in 2019 and was no longer in breach of regulations.
Safe remained Requires Improvement. Inspectors saw medicines given during lunch without checking that three people had taken them. They also recommended that checks on fire safety equipment and evacuation chairs should be recorded formally.
Personalised care records
The new electronic care planning system gave staff clearer information about people's needs, preferences and risks.
“Updated person-centred care plans and risk assessments had been created, detailing individual support needs and how to minimise risks to people.” from the report
Kind and respectful care
Inspectors saw staff treating people patiently and respectfully. People were supported with privacy, dignity and independence.
“People were treated with respect. We observed interactions between staff and people at lunch and staff treated people with patience and were not rushed.” from the report
Improved mealtimes
People were served more promptly than at the previous inspection and were offered choices, including alternatives when they changed their minds.
“This had improved on this inspection with people being observed seated and served in a timely manner.” from the report
Improvement since the previous inspection
The home had addressed earlier problems with care planning, consent, staffing records and quality monitoring. It was no longer in breach of regulations.
“At this inspection we found improvements had been made and the provider was no longer in breach of regulations.” from the report
Medicine administration checks
seriousDuring one lunchtime medicine round, staff gave medicines to three people without checking that they had taken them. The manager acted immediately, but inspectors recommended competency reviews and spot checks.
“Medication was administered to three people during meals with no observation to ensure it was taken.” from the report
Equipment checks not formally recorded
needs fixingSenior staff carried out visual checks of fire safety equipment and evacuation chairs, but inspectors recommended that these checks should be formally recorded.
“We recommended this be formally recorded to ensure compliance.” from the report
Some people had less engagement at mealtimes
minorInspectors saw that some people received less interaction than others while eating. This was raised with the manager.
“We observed some people had less engagement than others and this was fed back to the registered manager.” from the report
- 01What competency checks and spot checks are now used to make sure people take their medicines safely?
- 02How are fire safety equipment and evacuation chair checks recorded now?
- 03How do staff make sure everyone receives enough interaction and support during meals?
- 04How are care plans reviewed when someone returns from hospital or their needs change?
- 05How will activities and one-to-one sessions be provided if group activities remain limited?
This was a planned inspection based on the previous rating and covered all five key questions, including infection prevention and control under Safe during the COVID-19 pandemic. This explanation was written from the published report of 27 March 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 Carnalea Residential Home
5 rated inspections over 7 years: the service has slipped, from Good to Requires improvement.
- February 2023Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- March 2021Goodup from Requires improvementSafe: Requires improvementWell-led: Good
- June 2019Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- September 2018Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- August 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- January 2014
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 9 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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39 live-in carers within about an hour of Kent
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 £1,260 a week. 33 can care for a couple. 12 years' experience on average.
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