CQC report explained · a nursing home
What the CQC found at Charlotte House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Risks to people were identified and managed. Inspectors found enough suitably qualified staff, safe recruitment, safe medicines systems and effective infection control.
- Effective?
- Good
- Staff had the knowledge, skills and training needed for their roles. People's health, nutrition, hydration, communication needs and legal consent arrangements were assessed and supported.
- Caring?
- Good
- Inspectors observed positive interactions and found that people were treated with dignity and respect. People were encouraged to express their wishes and maintain their independence.
- Responsive?
- Good
- Care was personalised and plans were reviewed and updated. People had access to activities, support with relationships and communication, and information about making complaints.
- Well-led?
- Good
- The management team had effective checks on quality and safety. Inspectors found an open culture, good partnership working and systems for using feedback and incidents to improve care.
What inspectors found, April 2023
Charlotte House is rated Good; inspectors found safe, kind and personalised care, with improvements since the previous inspection.
Inspectors visited without notice on 21 February 2023. They spoke with people living at the home, relatives and staff. They observed care and reviewed care plans, medicines records, recruitment files and management records.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found that risks were managed, medicines were given safely, the home was clean and there were enough suitably qualified staff.
People were treated with kindness and respect. Care was personalised, records were kept up to date, activities were available and complaints were listened to. The previous rating was Requires Improvement, but the provider had made improvements and was no longer breaching regulations.
Safe staffing
Inspectors found enough suitably qualified staff and said staffing levels were based on people's assessed needs.
“There were enough suitably qualified staff to support people.” from the report
Safe medicines
Medicines were administered as prescribed. Staff training and competency checks were in place, with regular audits.
“Medicines were managed safely and administered as prescribed.” from the report
Kind and respectful care
People were treated as individuals, with staff responding to requests and protecting privacy, dignity and independence.
“People were well treated and supported. We observed positive interactions between staff and people and saw staff spending time with people in a meaningful way.” from the report
Personalised support
Staff knew people well and care plans reflected their preferences, risks and changing needs.
“People were supported with person-centred care.” from the report
Improved management
The home had strengthened its quality checks and used incidents, feedback and partnership working to improve care.
“Effective quality assurance systems were in place. The quality and safety of the service was well monitored and follow up actions had been taken appropriately.” from the report
Inspectors raised no specific concerns in this report.
- 01How do you check that staffing levels remain suitable for my relative's needs, particularly when their needs change?
- 02How often are medicines audits carried out, and how are any problems identified and corrected?
- 03How often will my relative's care plan be reviewed, and how will their wishes be included?
- 04What activities and support would be available for my relative's interests, communication needs and relationships?
- 05How will you show families that the improvements made since the previous inspection are being maintained?
This was an unannounced inspection covering all five key questions, including infection prevention and control; the report says improvements had been made since the previous inspection. This explanation was written from the published report of 4 April 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, May 2022
Rated Requires Improvement; inspectors found kind care and good infection control, but concerns about safety, staffing, medicines and management.
Inspectors visited unannounced on 30 March and 5 April 2022. They spoke with people, relatives, staff and managers, and checked care records, medicines, staff files and service monitoring records.
The home was caring and people were treated with dignity and respect. Infection control was effective, meals were generally enjoyed, activities were available and relatives were usually kept informed.
However, records did not always show that planned care had been delivered. Risks were not always managed safely, staffing could leave people waiting, medicines information was incomplete and staff support and management systems needed improvement.
The overall rating Requires Improvement means the home was not consistently meeting the expected standard. The report identified breaches of Regulation 12 on safe care and treatment and Regulation 17 on good governance.
Kind and respectful care
People and relatives described staff as caring. Inspectors found that privacy, dignity and independence were respected.
“People told us they were treated well and their dignity and privacy was respected.” from the report
Food and healthcare support
People generally enjoyed the food and had enough to eat and drink. Staff contacted healthcare professionals when needed.
“People received sufficient food and drinks and most people told us that they enjoyed the food available and that they always had choices.” from the report
Activities and family contact
People could join activities and were supported to keep in touch with friends and family, including during the pandemic.
“There was an activities programme in place to encourage stimulation and participation in social interaction, if people chose to join in.” from the report
Care and risk records
seriousRecords did not always show that planned care was provided. Gaps included falls checks, personal care, oral care and skin monitoring.
“Records did not show that people received planned care when they required it.” from the report
Staffing levels
needs fixingInspectors received feedback that there were not always enough staff to meet people's needs promptly. Some people had to wait for personal care or help with meals.
“There were not always enough staff on duty to meet people's needs in a timely way.” from the report
Medicines management
needs fixingThere were no homely remedies available during the inspection, and staff did not have enough information about medicines given when needed.
“There was insufficient information available to staff to ensure people who were prescribed medicines as and when required (PRN), received them consistently and when needed.” from the report
Staff training and support
needs fixingSome staff had not received regular supervision or relevant refresher training. Inspectors also found that some nurses were not expected to complete training in important care areas unless a need was identified.
“Staff told us they did not feel well supported, and records confirmed they had not always received supervision or appraisals on a regular basis.” from the report
Management oversight
seriousThe home's audits did not identify all the concerns found by inspectors. There had also been several managers in a short period and no registered manager was in post.
“Although audits had identified areas that required improvement, and some of these issues had been acted upon, they did not highlight all of the concerns we raised during the inspection.” from the report
- 01What has changed to make sure falls checks, oral care, skin checks and personal care are recorded every time?
- 02How do you decide how many staff are needed, and how do you prevent people waiting for meals, washing or showers?
- 03How are medicines prescribed when needed recorded and given safely, and are homely remedies now available?
- 04What training, supervision and competency checks have staff completed since this inspection?
- 05Who is currently responsible for the home, and how are the Regulation 12 and Regulation 17 breaches being put right?
This was an unannounced inspection covering all five key questions and infection prevention and control; it was the first inspection under the new provider. This explanation was written from the published report of 24 May 2022 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
4 rated inspections over 6 years: the service has improved, from Requires improvement to Good.
- April 2023Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2022Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- February 2022Inspected but not ratedSafe: Inspected but not rated
- April 2021Inspected but not ratedSafe: Inspected but not rated
- June 2018Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2017Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- December 2020
Registered with the Care Quality Commission on 18 December 2020.
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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