CQC report explained · a nursing home
What the CQC found at Carolyne House
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, March 2020
Rated Requires Improvement; inspectors found kind and effective care, but staffing, activities and management checks needed improvement.
This was an unannounced inspection on 7 February 2020. Three inspectors, supported by an expert by experience, spoke with people, relatives, staff and visiting professionals. They observed care and meals, and checked care, medicine, staffing and management records.
People were generally treated with kindness and respect. Staff training was up to date, people received their medicines as prescribed overall, and healthcare support was arranged when needed. The ratings for Effective and Caring were Good.
There were not always enough staff available or deployed to meet people's needs promptly. One call bell took 15 minutes to answer. People also had too few meaningful activities, especially if they stayed in their room or bed. Medicine storage and recording of some creams needed improvement.
The overall rating was Requires Improvement. Safe, Responsive and Well-led were also Requires Improvement. The previous overall rating was Good in September 2017. The provider made changes after the inspection, including increasing staffing and activity hours, but CQC said it would check whether these changes worked.
Kind and respectful care
People and relatives spoke positively about staff. Inspectors saw caring interactions and found that people's privacy and dignity were protected.
“Staff were kind, considerate and treated people with respect.” from the report
Healthcare support
Healthcare appointments and professional advice were arranged when needed. Visiting professionals were positive about how the home followed up care.
“Where people required access to healthcare services, this was organised, and staff followed guidance provided.” from the report
Medicine administration
Medicine records had no gaps, and staff were trained and assessed before giving medicines. Staff explained medicines to people and took time when administering them.
“People's medicines were recorded on all the Medicines Administration Records (MARs) and there were no gaps.” from the report
Response to inspection findings
The provider acted straight away on several issues raised during the visit, including cleaning the medicine room and increasing staffing and activity hours.
“The service had responded straight away to the concerns identified during the inspection.” from the report
Staffing and call bell response
seriousThere were not always enough staff or the right deployment of staff to meet people's needs promptly. One call bell took 15 minutes to receive a response.
“There were not always enough staff on duty or suitably deployed to meet people's needs.” from the report
Medicine storage and records
needs fixingThe first-floor medicine room was cluttered and untidy. Records did not always show that topical creams had been applied, and oxygen was not stored in line with best practice.
“The medicine room was very cluttered and untidy on the first floor.” from the report
Too few meaningful activities
needs fixingPeople, especially those staying in their rooms or beds, did not have enough suitable activities. Inspectors said this placed people at risk of social isolation.
“The provision of activities did not provide enough stimulation for people who used the service and placed people at risk of social isolation.” from the report
Care preferences not always recorded
needs fixingRecords did not always make clear whether bathing and showering preferences had been met. Some people were unsure whether they could choose when to have a shower.
“It was not always easy to see if people's preferences for bathing and showering had been met.” from the report
Management checks missed problems
needs fixingThe home's audits had not identified the staffing and activity concerns found by inspectors. A pressure sore was also not included in the manager's overview and the related risk assessment was inaccurate.
“Systems in place to monitor the performance of the service had not identified the concerns people and their relatives had in relation to staffing and provision of activities.” from the report
- 01How many staff are now on duty on each floor during busy periods, and how do you check that call bells are answered promptly?
- 02What meaningful activities are available for people who stay in their rooms or are cared for in bed?
- 03How do you now record and check that topical creams, bathing and showering preferences have been provided?
- 04Where are oxygen cylinders stored now, and how is the medicine room kept organised?
- 05What checks now show that the staffing and activity changes made after the inspection are working?
This was a planned but unannounced inspection covering all five CQC questions, including both the care provided and the premises. This explanation was written from the published report of 17 March 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, September 2017
Rated Good; inspectors found safe, kind and responsive care, with only minor record-keeping points noted.
This was an unannounced comprehensive inspection on 23 and 29 August 2017. Inspectors spoke with people living at the home, visitors, staff and managers. They also observed care and meals, and checked care records, medicines, staffing, training, complaints and quality checks.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe medicines practice, suitable recruitment checks and good safeguarding knowledge. People were supported with food, drink, health care and everyday risks.
Inspectors found that staff treated people with kindness, dignity and respect. Care plans were detailed and regularly updated. People and relatives were able to give their views, use activities and raise complaints. The manager had been in post for five months and was still completing the CQC registration process.
Safe staffing and medicines
Inspectors found enough staff to meet people's needs. Medicines were administered, stored and recorded safely, with regular checks.
“People had received their medicines safely and as prescribed.” from the report
Kind and respectful care
Staff were seen treating people with kindness and compassion. Privacy, dignity and personal choices were respected.
“Care was provided with kindness and compassion and people had regular contact from staff during our inspection to ensure they did not need anything and were comfortable.” from the report
Individual care planning
People's physical, psychological, social and emotional needs were recorded in detailed care plans. These plans were reviewed and updated.
“The care plans we reviewed were very in-depth and contained a variety of information about each individual person, including their physical, psychological, social and emotional needs.” from the report
Food and health support
Staff understood people's nutritional needs and supported them to eat and drink enough. People had access to health professionals when needed.
“There was good evidence of where staff had worked with the speech and language therapist (SALT) to ensure people received the right textured food to help assist with their swallowing” from the report
Activities and choice
People could join activities, go on trips and use the garden or café. Their choice to take part or stay in their room was respected.
“People we spoke with told us they could join in with the organised activities if they wished, but some preferred to watch the television or stay in their room” from the report
Capacity records could be clearer
minorInspectors found that people's capacity to make everyday decisions had been assessed, but the paperwork used to record this was not as clear as it could be.
“People's capacity to make day to day decisions had been assessed to help ensure they received appropriate support, but the paperwork used to record this could be clearer.” from the report
Manager registration was still in progress
minorThe manager had been in post for five months and was waiting for a CQC fit person interview as part of the registration process.
“The manager at the service had been in post for five months and was going through the registration process with the CQC.” from the report
- 01How will you make the paperwork about people's capacity to make day-to-day decisions clearer?
- 02What nursing support is available on the ground floor, and how would you meet my relative's particular nursing needs?
- 03How do you review staffing levels when people's care needs change, including at night?
- 04How will you keep me informed about changes in my relative's health, care plan or treatment?
- 05What activities and outings would be suitable for my relative, and how do you support people who prefer not to join in?
This was an unannounced comprehensive inspection covering all five questions, with ratings for each area remaining Good from the previous inspection. This explanation was written from the published report of 21 September 2017 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 Carolyne House
4 rated inspections over 5 years: the service has held its Requires improvement rating throughout.
- March 2020Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- September 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2015Goodup from Requires improvementSafe: GoodWell-led: Good
- June 2015Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- September 2014Inspected but not rated
- June 2013
Report published without a new overall rating.
- October 2012
Registered with the Care Quality Commission on 8 October 2012.
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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