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 enough suitable staff, safe medicines systems, risk assessments and a clean home. They suggested that longer-serving staff revisit safeguarding and whistle-blowing policies.
- Effective?
- Good
- Care plans and staff training supported good outcomes, independence and personal goals. Inspectors asked the home to keep evidence of follow-up on applications linked to possible deprivation of liberty.
- Caring?
- Good
- Staff knew people's preferences and treated them with kindness, compassion, dignity and respect. People were involved in care planning and could opt out of activities if they felt overwhelmed.
- Responsive?
- Good
- Care was individualised and reviewed regularly. The home offered different ways to communicate and supported interests, relationships, work placements and community activities.
- Well-led?
- Good
- Management changes and audits had helped identify and address earlier shortfalls. Inspectors found an open culture and good oversight, but said time was needed to sustain the improvements.
What inspectors found, August 2019
Rated Good; all five areas were rated Good after improvements since the previous inspection.
The CQC carried out a planned inspection over several visits. Inspectors visited the office and the home, met the person living there, spoke with a family member and talked to staff. They also checked care records, medicines, training, recruitment, incidents and quality checks.
The home supported adults with a learning disability and autism. At the time, one person lived there. Inspectors found personalised care, kind staff and support that promoted choice, independence and community involvement. They found the home was safe, effective, caring, responsive and well-led.
The home had previously been rated Requires Improvement, with two breaches of regulation. Inspectors found that improvements had been made and that the home was no longer in breach. All five ratings were Good at this inspection.
Choice and independence
The person living there helped decide daily routines and activities. Staff supported independence and used the least restrictive approach.
“People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests” from the report
Kind and respectful staff
Inspectors saw warm, compassionate interactions and staff using detailed knowledge of people's lives and preferences.
“We observed staff consistently treated people with a very kind and compassionate manner.” from the report
Safe medicines practice
Staff received training, medicines were audited and staff practice was checked. People were supported to be as independent as possible with medicines.
“Senior staff audited medicines regularly and checked that staff were administering medicines safely by observing their practice.” from the report
Improved management
Changes to the management structure and better audits helped the provider address the breaches found at the previous inspection.
“The management restructuring had assisted the service to make the necessary improvements.” from the report
Safeguarding knowledge
needs fixingMost staff understood safeguarding, but inspectors suggested that longer-serving staff revisit safeguarding and whistle-blowing policies.
“We spoke with the manager and suggested that the more longstanding staff revisit some of the organisations policies on safeguarding and whistle-blowing.” from the report
Mental capacity follow-up
needs fixingMental capacity and deprivation of liberty checks had been completed, but inspectors wanted clearer evidence that applications had been followed up with the local authority.
“We asked the service to keep evidence of when they had followed up on any application progress with the local authority.” from the report
Complaint records
minorThe home responded to concerns, but one concern about storage had not been entered in the complaint log.
“This was not however recorded in the complaint log.” from the report
Keeping improvements in place
needs fixingThe new systems were working, but inspectors said the home needed time to show that the improvements would continue.
“The improved structure and the audits in place were effectively monitoring the service and time was needed to sustain the improvements made.” from the report
- 01How do you make sure longer-serving staff keep their safeguarding and whistle-blowing knowledge up to date?
- 02How do you record and follow up applications about possible deprivation of liberty?
- 03How are complaints and informal concerns logged, investigated and checked for completed actions?
- 04How will you show that the improvements made since the previous inspection are being sustained?
- 05How do you balance offering activities with respecting a person's choice not to take part?
This was a planned comprehensive inspection covering all five key questions, with inspection activity at the office and the home. This explanation was written from the published report of 8 August 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.
What inspectors found, May 2018
Rated Requires Improvement; inspectors found kind care and safe medicines, but important records, staff training and management checks were not reliable enough.
This was the first comprehensive inspection since the home registered in December 2016. The inspection visits took place on 22 and 26 January 2018. The first visit was unannounced and the second was announced. Inspectors spoke with the person living there, a relative, staff, managers and a social care professional. They also checked care records, recruitment and training files, medicines, the building and management records.
The home supported one adult with learning disabilities, autism and complex needs. Inspectors found enough staff, a clean home, safe storage and administration of medicines, and good health and safety checks. The person was supported to make choices, stay in contact with family and access activities.
However, recruitment checks were incomplete, staff did not all have enough training for the person's complex needs, and incidents were not properly reviewed. Care plans and risk assessments contained old or incorrect information. The provider's checks had not found or dealt with these problems quickly enough. The home breached Regulations 17 and 19.
Kind and respectful support
Staff were patient and caring. They respected the person's privacy, dignity, choices and preferred routines.
“We saw that the staff were kind and caring although at times unable to settle the person being supported.” from the report
Safe medicines administration
Medicines were ordered, stored and administered by staff who had been trained and assessed as competent. Administration records were complete.
“Medication administration records were fully completed.” from the report
Choice and independence
The person chose meals, activities, clothing and daily routines. They were supported to do some tasks independently and to keep in contact with family.
“The person supported told us they were encouraged to make choices and be independent.” from the report
Clean and well-maintained home
The home was clean and free from odours. Inspectors found suitable hand-washing facilities and documented health and safety checks.
“The home was clean, odour free and there were provisions for hand washing.” from the report
Incomplete recruitment checks
seriousReferences were not always obtained before staff started work. Where DBS disclosures had been made, the provider had not always recorded risk assessments.
“The recruitment process was not always robust as all required checks had not been completed.” from the report
Out-of-date care and risk information
needs fixingCare plans and risk assessments had not been reviewed on time. They included incorrect details about a previous home, former staff and activities, and one environmental assessment related to another property.
“The care plans were out of date and did not accurately reflect the person's individual needs.” from the report
Staff training did not fully match needs
needs fixingNot all staff had enough training in autism and challenging behaviour. Some staff and a healthcare professional said staff were not fully prepared for the role.
“They stated they had not received sufficient training in autism awareness and challenging behaviour to fully understand how to meet the needs of the person they supported.” from the report
Weak incident monitoring
needs fixingIncident forms were only partly completed and there was no evidence that management had reviewed them for patterns or trends.
“There was no evidence of review within the incident reports reviewed during inspection.” from the report
Management systems missed problems
seriousThe provider's audits had identified some overdue records but had not dealt with them promptly and had not identified all the issues inspectors found. Some policies were also out of date or unclear.
“The registered providers quality monitoring systems had not identified areas for development and improvement within the home.” from the report
No as-required medicine protocols
needs fixingMedicines were generally managed safely, but staff did not have written guidance explaining when and how as-required medicines should be given.
“A PRN protocol was not in place for the management and administration of 'as required' medicines.” from the report
- 01What recruitment checks are now completed before each staff member starts, including references and risk assessments for DBS disclosures?
- 02What autism, challenging behaviour and person-specific training has each staff member completed, and how is competence checked?
- 03Have the care plans and risk assessments been fully updated to reflect the person's current needs, risks and actual activities?
- 04How are incidents and accidents now reviewed for patterns, trends and follow-up actions?
- 05What written protocols are now in place for as-required medicines, and how are staff trained to use them?
This was a comprehensive inspection of all five key questions and was the first comprehensive inspection since the home registered in December 2016. This explanation was written from the published report of 2 May 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 Charlotte House
2 rated inspections over a year: the service has improved, from Requires improvement to Good.
- August 2019Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2018Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- December 2016
Registered with the Care Quality Commission on 21 December 2016.
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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At least 100 live-in carers within about an hour of Warrington
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. 90 can care for a couple. 10 years' experience on average.
“He developed a close affinity with Terence, spending time talking with him before he retired to bed and looking after his needs during the night.”
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.