CQC report explained · a residential care home
What the CQC found at Charlotte House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found safe medicines systems, suitable risk assessments, appropriate recruitment checks and enough staff to support people safely. They noted that limited staffing sometimes meant people could not access the local community when two staff were needed.
- Effective?
- Good
- Care plans and assessments reflected people's physical, mental and social needs, and staff worked with healthcare professionals. Inspectors found that Mental Capacity Act decisions were not always recorded robustly and made a recommendation for improvement.
- Caring?
- Good
- People had caring relationships with staff who respected their privacy, dignity and independence. People and relatives were involved in decisions about care where possible.
- Responsive?
- Good
- Care was personalised and reflected people's needs, preferences and communication methods. The home supported activities, holidays, relationships and complaints appropriately.
- Well-led?
- Good
- Inspectors found clear management, effective audits and an open culture. The provider had improved its governance systems since the previous inspection and was no longer in breach.
What inspectors found, April 2020
Rated Good; inspectors found safe, caring and personalised support, with some records under the Mental Capacity Act needing improvement.
Inspectors visited on 11 March 2020. They observed care, spoke with staff, relatives and community professionals, and reviewed care, medicine, recruitment and management records.
The home supported five people with autism and associated conditions. Inspectors found safe care, suitable medicines systems, trained staff, kind relationships and detailed, personalised support. People were helped to make choices, build skills and become more independent.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. The previous rating was Requires Improvement. The home had improved and was no longer in breach of the regulations identified at the last inspection.
Personalised support
Care plans included people's individual needs, likes and dislikes. Staff knew people's preferences and supported them in line with this information.
“Care plans were individual with detailed information about people's needs, likes, and dislikes across different areas of care.” from the report
Kind and respectful care
People appeared comfortable with staff and were treated with respect. Staff supported privacy, dignity and independence.
“There were caring relationships between people and staff.” from the report
Improved management
The provider had strengthened its quality checks and introduced a new medicines audit. Earlier breaches about medicines and governance had been addressed.
“At this inspection we found the provider had made improvements and was no longer in breach of regulations.” from the report
Mental Capacity Act records
needs fixingAlthough staff assessed capacity and understood best-interest decisions, the records were not always robust. Inspectors recommended that the provider improve its systems and record keeping.
“However, we found that these decisions had not always been robustly recorded.” from the report
Community access when staffing was short
needs fixingAt times, people could not access the local community because two staff members were needed and were not always available. The provider said it was taking recruitment action.
“Staff reported that on occasion this meant people within Charlotte House were not able to access the local community as they required two staff members, which was not always available.” from the report
- 01How do you now record mental capacity assessments and best-interest decisions?
- 02How often are two staff members unavailable for community activities, and what is being done to prevent this?
- 03How do you check that medicines continue to be administered safely and that any errors are corrected?
- 04How are people and their relatives involved when care plans or routines change?
- 05What progress has been made with the three new staff members mentioned in the report?
This was a follow-up inspection after the previous Requires Improvement rating, and the report gives ratings for all five questions. This explanation was written from the published report of 8 April 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, March 2019
Charlotte House was rated Requires Improvement; inspectors found caring, personalised support but weaknesses in medicines and quality checks.
This was the home’s first inspection since it joined the provider’s registration. It was an unannounced, comprehensive inspection on 20 February 2019. One inspector reviewed records, observed people and staff, and spoke with staff, relatives and health and social care professionals.
People appeared happy and were supported with kindness, respect and patience. Inspectors found personalised care, good activities, support with independence, and suitable help with communication, food and healthcare.
The home was not always safe because some staff had not had recent medicine competency checks. Guidance for some medicines was incomplete, and refrigerator temperatures were not always recorded. Quality audits had also been missed or had failed to identify these problems.
The overall rating was Requires Improvement. Effective, caring and responsive care were rated Good. Safe and well-led were rated Requires Improvement. The provider was required to send CQC a report explaining what action it would take.
Kind and respectful care
People were supported with patience and compassion. Relatives and professionals also described positive caring relationships.
“People were provided with sensitive and compassionate support by a kind, committed and caring staff team.” from the report
Personalised support
Care plans reflected people's preferences, goals and communication needs. Staff knew people well and responded to changes in their needs.
“People received person-centred care that was responsive to their needs.” from the report
Independence and activities
People were supported to build skills, take part in varied activities and pursue work placements.
“People were encouraged to develop their skills and knowledge at the local learning centre provided by Priors Court Foundation.” from the report
Good risk planning
Individual risks were assessed and staff followed plans to support people safely, including when taking positive risks.
“Staff were familiar with and followed people's risk management plans.” from the report
Medicine competency checks
seriousNot all staff giving medicines had completed the required training and competency assessment. Some staff had not had their skills reviewed for several years.
“We found not all staff administering medicines had been competency assessed.” from the report
Incomplete medicine guidance
seriousSome as-needed medicines did not have clear instructions explaining when staff should give them or what signs to look for.
“Where people were prescribed 'as required' (PRN) medication, the service did not always have protocols or guidance in place to ensure that staff knew when to administer PRN medicine.” from the report
Missed quality audits
needs fixingMonthly audits had not been completed for four months. Existing checks did not always identify medicine and record-keeping problems.
“However, we found that these had not been completed in the last 4 months.” from the report
Mandatory training gaps
needs fixingThe provider’s training records showed that not all staff had completed training the provider considered mandatory.
“We found that not all staff had completed this training.” from the report
Inconsistent incident records
needs fixingRecords did not always explain the manager’s investigation or what should be done to prevent an incident happening again.
“Accidents and incidents records did not always identify what investigation had taken place by a manager and did not clearly highlight what action may need to be taken (if any) to prevent recurrence.” from the report
- 01How are all staff who administer medicines now trained and regularly assessed as competent?
- 02What clear guidance is now available for each person’s as-needed medicine?
- 03How are medicine refrigerator temperatures recorded and checked every time?
- 04Have monthly quality audits restarted, and how do managers make sure they identify trends and gaps?
- 05How do you check that all mandatory staff training is complete and kept up to date?
This was an unannounced comprehensive inspection covering all five key questions and both the care provided and the premises. This explanation was written from the published report of 13 March 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 Charlotte House
2 rated inspections over a year: the service has improved, from Requires improvement to Good.
- April 2020Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2019Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- February 2018
Registered with the Care Quality Commission on 28 February 2018.
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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42 live-in carers within about an hour of West Berkshire
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 £1,020 to £1,260 a week. 36 can care for a couple. 14 years' experience on average.
“Titus has compassion, patience, a great sense of humour and a very professional attitude.”
“Barbara treated my mother-in-law with enormous love and compassion and provided an environment where she could feel safe and seen”
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.