CQC report explained · a residential care home
What the CQC found at Caroline House
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, March 2023
Rated Good overall; inspectors found safe care, but the home's leadership and record keeping required improvement.
Inspectors visited without warning on 7 and 8 March 2023. They spoke with eight people, one relative, staff and health professionals. They observed care, checked the building and reviewed care, medicine, staffing and management records.
The home was rated Good for Safe. Inspectors found enough trained staff, safe medicines practice, suitable safeguarding arrangements and generally clear risk assessments. The home was clean and supported unrestricted visits.
The home was rated Requires Improvement for Well-led. Some records were incomplete or inaccurate, including fluid intake, accident follow-up and oral care. Inspectors said immediate action was taken during the inspection to reduce risks.
The overall rating remained Good. The previous overall rating was also Good, published in March 2018. This inspection looked at Safe and Well-led, while the other key-question ratings were carried forward from the earlier inspection.
Safe staffing
Inspectors found enough suitably qualified staff to meet people's needs. Staff were recruited using pre-employment checks.
“There were sufficient numbers of suitably qualified staff to meet people's needs.” from the report
Medicines
Medicines were administered by trained staff whose competence had been checked. Records, storage and arrangements for ordering medicines were in place.
“Systems and processes were in place to make sure people received their medicines safely and as prescribed.” from the report
Kind and responsive staff
People, relatives and staff spoke positively about the care team. Inspectors observed staff responding to people's individual needs.
“Our observations confirmed that staff were attentive and responsive to individual peoples' needs.” from the report
Safeguarding
Staff understood how to recognise and report abuse. Safeguarding records showed that allegations were reported and investigations supported.
“Staff had a good understanding of safeguarding and knew how to recognise and report signs of abuse and who to report to.” from the report
Working with professionals
The home worked with health and social care professionals, including GPs, nurses and therapists, to support people's needs.
“Staff worked closely with GPs, district nurses, speech and language therapists, community rehab teams and occupational therapists to ensure people received the specialist support they needed.” from the report
Fluid records
seriousFluid intake records were not consistently completed or accurate. This meant people's hydration was not always monitored effectively and could affect their health.
“Inaccurate fluid records had the potential to impact on peoples' health.” from the report
Environmental safety
seriousTwo radiators were hot to touch and had no covers. One pressure-relieving mattress was also set incorrectly, although this was corrected during the inspection.
“Environmental audits had not identified two radiators that were hot to touch and not covered” from the report
Accident follow-up
needs fixingAccident records were analysed, but did not show the actions needed to prevent incidents happening again. This was added during the inspection.
“Accident records were documented and analysed but did not include actions to prevent a re-occurrence.” from the report
Oral care records
needs fixingStaff did not record when people declined oral care or whether it was offered again. The manager said more training and monitoring would be provided.
“Staff were not recording when people declined oral care, and not updating records to show oral care was offered later and accepted or again declined.” from the report
Care plan updates
needs fixingSome care plans had not been updated when people's care changed, including the reasons for one-to-one support. The documentation was updated during the inspection.
“Not all care plans had been updated to reflect changes to care, for example, the reasons for 1 to 1 support.” from the report
- 01What changes have been made to ensure fluid intake records are complete and accurate?
- 02How are uncovered hot radiators now checked and kept safe?
- 03How do you record actions taken after accidents and check that they prevent a repeat?
- 04How are staff recording declined oral care and checking that it is offered again?
- 05What evidence can you show that care plans are updated promptly when people's needs change?
This was a focused inspection of Safe and Well-led; Effective, Caring and Responsive were not inspected and their previous ratings were carried forward. This explanation was written from the published report of 21 March 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 2018
Caroline House was rated Good overall; inspectors found kind, safe care, with small gaps in safety and end-of-life records.
Inspectors visited without notice on 3 January 2018. They spoke with people, visitors, staff and a healthcare professional. They observed care and reviewed care plans, staff files, safety records and management audits.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. People said they felt safe, liked the staff and were involved in their care. Staff supported people's choices, health needs, nutrition and independence.
The previous inspection had found a breach about assessing health and safety risks. Inspectors found that the provider had taken sufficient action, including replacing flooring and improving guidance about pressure mats. Two minor record or safety issues were still identified.
Kind and respectful care
People spoke warmly about the care and staff. Inspectors saw staff being patient, offering reassurance and maintaining privacy and dignity.
“People told us that they liked living at the home.” from the report
Personalised support
Care plans reflected individual needs, preferences and emotional responses. Staff supported people to remain independent and adapted activities and equipment to suit them.
“People's preferences and choices were reflected in the care they received.” from the report
Good health and nutrition support
Staff followed dietary guidance, offered regular drinks and referred people to healthcare professionals when needed.
“People were supported to maintain healthy diets and had their nutritional needs appropriately assessed and supported.” from the report
Open management
The manager was approachable and used audits, surveys and meetings to improve the service.
“The quality of the service was assessed an monitored and actions were implemented as a result of audits.” from the report
Unlocked sluice room
needs fixingThe sluice room was unlocked during the visit and there was no risk assessment to decide whether this could put people at risk. The manager said this would be reviewed.
“The sluice room was found to be unlocked on the day of the inspection however there was no risk assessment in place to determine whether this would pose a risk to people living at the home.” from the report
DNAR records not stored consistently
needs fixingRecords showing whether people had a Do Not Attempt Resuscitation decision were not always kept in the same place. Staff were nevertheless recorded as being aware of whether someone had one.
“DNAR forms were not consistently kept in the same place in people's care files, however it was recorded whether someone had one or not so that staff were aware in an emergency.” from the report
- 01What has been decided about the unlocked sluice room, and is there now a risk assessment in place?
- 02Where are DNAR forms kept now, and how do staff find them quickly in an emergency?
- 03How will you support my relative's particular dementia, mental health or sensory needs?
- 04How are staffing levels decided for the people living in the home, including at night?
- 05How are families involved in care reviews and decisions about activities or end-of-life wishes?
This was an unannounced inspection of the overall service, including care and the premises, and all five CQC questions were rated Good. This explanation was written from the published report of 22 March 2018 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 Caroline House
4 rated inspections over 6 years: the service has held its Good rating throughout.
- March 2023Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- March 2018Goodstayed GoodSafe: GoodWell-led: Good
- June 2017Goodstayed GoodSafe: Requires improvementEffective: Good
- November 2016GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- September 2013
Report published without a new overall rating.
- October 2012
Report published without a new overall rating.
- July 2011
Registered with the Care Quality Commission on 11 July 2011.
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.
Weigh the report against the rest
Fees, photos and reviews from families
How to read CQC ratings and reports
What to check when you visit
19 live-in carers within about an hour of East Sussex
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 £1,000 to £1,400 a week. 13 can care for a couple. 10 years' experience on average.
“When he point blank refused to go into hospital for a life saving blood transfusion she talked him through the situation and agreed to go in the ambulance with him and stayed until he was settled.”
“Una felt safe, secure and loved in her time with Debbie which is a gift that I am eternally grateful for.”
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.