CQC report explained · a residential care home
What the CQC found at Charnley House
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, February 2024
Rated Requires Improvement; inspectors found risks with medicines, staffing, cleanliness, personal care and management, with warning notices issued.
Inspectors visited on three days in August 2023. The inspection was unannounced on the first and third days. They spoke with people, relatives and staff, observed care, and checked care, medicine, staff and management records.
They found some kind and positive interactions, and people generally said they felt safe. The home provided home-cooked food and usually involved healthcare professionals when needed. However, personal care and emotional support were not always sufficient, and activities were limited.
There were serious shortfalls in medicine records, risk monitoring, staffing, training, cleanliness and the safety of the building. Care plans were not always accurate or personal. All five areas were rated Requires Improvement. The previous overall rating was Good, published in March 2023.
The provider breached regulations about safe care and treatment, premises, staffing and governance. CQC issued warning notices for safe care and treatment and good governance. It will seek an action plan and monitor progress with the provider and local authority.
People felt safe
People told inspectors they felt safe in the home. Safeguarding concerns were monitored and reported to the local authority when needed.
“People told us they felt safe, and systems were in place to monitor allegations of abuse.” from the report
Home-cooked food
Meals were cooked in the home. The cook knew people's likes and dislikes, and alternatives and fortified diets were provided when needed.
“The cook had a good knowledge of people's likes and dislikes.” from the report
Kind relationships
Inspectors saw caring interactions between staff and people. Relatives and some people spoke positively about staff and the manager.
“We observed caring and positive interactions between people and staff; however, personal engagement was limited, and support was mostly task led.” from the report
Family contact
People were supported to keep friendships and important relationships. Relatives were seen visiting during the inspection.
“People were supported to maintain friendships and important relationships.” from the report
Medicines were not always safe
seriousRecords did not always show that medicines, creams, thickener or time-specific medicines were given correctly. Night-time medicine arrangements also created a risk that medicines would not be given when needed.
“Medicines were not managed safely. This placed people at risk of harm.” from the report
Risks were not consistently monitored
seriousCare plans and monitoring records were sometimes incomplete or contradictory. Inspectors found missed checks, equipment not being used and injuries without proper body maps or incident records.
“Individual risks to people were not always managed safely. This placed people at risk of harm.” from the report
Staffing and training shortfalls
seriousInspectors were not assured that there were enough staff, particularly at night. Training and supervision were not up to date for all staff, including training relevant to dementia, catheter care and end of life care.
“The provider had not ensured there was enough staff and not all staff had received training and supervision to safely meet the needs of people using the service at all times.” from the report
Cleanliness and building safety
seriousSome communal areas and bedrooms were unclean and had unpleasant smells. Inspectors also found unsafe or poorly maintained areas, unsecured wardrobes and uncovered radiators.
“The home was not always clean and safely maintained. This placed people at risk of harm.” from the report
Personal care and activities
needs fixingSome people were not well groomed and did not receive enough help with personal care. Daily activities were limited and were not always meaningful or suited to people's interests.
“People were not always supported to enable them to take part in inclusive and person-centred activities of their choice.” from the report
Weak management oversight
seriousAudits and improvement plans had not identified or resolved several problems. People's feedback and requests were not consistently acted on.
“The provider had not demonstrated continuous improvement and had not always ensured safe and effective governance of the service.” from the report
- 01What has changed to make sure all medicines, including creams, thickener and night-time medicines, are recorded and given safely?
- 02How many staff are now on each day and night shift, and how do you provide extra staff when someone has repeated falls or needs close monitoring?
- 03Which repairs and cleaning improvements have been completed, including the smells, flooring, wardrobes and radiators?
- 04How do you check that people receive enough personal care, clean clothing and clean bedding?
- 05What regular activities are now available for people with dementia, including people who spend time in their rooms, and how are their choices recorded?
This inspection covered all five key questions and infection prevention and control, and was prompted by concerns about moving and handling, risk management, personal care and staffing. This explanation was written from the published report of 7 February 2024 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 2023
Rated Good overall; inspectors found safe care had improved, but the home remained Requires Improvement for being well-led.
This was an unannounced focused inspection on 21 and 22 February 2023. Inspectors observed care, spoke with people, visitors, staff and health professionals, toured the building, and checked care, medicines, staff and management records.
The home was rated Good for Safe. Inspectors found enough staff, safer medicines systems, suitable safeguarding arrangements and risk information in care plans. Some environmental risk assessments were out of date, and improvements to the building were still in progress.
The home was rated Requires Improvement for Well-led. People had limited chances to give feedback or help shape the service. The home had not always sent required notifications to the CQC. The overall rating was Good because the other areas were not inspected at this visit and their previous ratings were carried forward.
Medicines were safer
The home had improved its medicines systems since the previous inspection. Records, staff training and checks were in place.
“The staff maintained appropriate records for the receipt, administration and disposal of medicines.” from the report
Enough staff
Inspectors found sufficient staff working in the home during the inspection. The manager was using dependency assessments to monitor staffing levels.
“There were sufficient staff deployed in the home at the time of the inspection.” from the report
People felt safe
People told inspectors they felt safe. Staff had safeguarding training and understood how to report concerns.
“People told us they felt safe in the home.” from the report
Learning from incidents
The management team reviewed accidents and incidents regularly to look for patterns and discuss learning with staff.
“The management team had carried out a detailed analysis of the accident and incident data on a weekly and monthly basis to identify any patterns or trends.” from the report
Limited involvement
needs fixingPeople had few opportunities to comment on or help develop the service. No satisfaction survey had been offered during 2022, and activities and communication were raised as issues.
“People were not always provided with opportunities to be engaged and involved in the operation of the service.” from the report
Notifications were not always sent
needs fixingThe manager had not always submitted statutory notifications to the CQC. The notifications were sent immediately after the inspection, but the home was asked to strengthen its procedures.
“However, the registered manager had not always submitted statutory notifications to the Care Quality Commission.” from the report
Some risk checks were out of date
minorSome environmental risk assessments had not been reviewed since 2021. The manager agreed to review them and consider new risks.
“The registered manager had carried out environmental risk assessments, however some had not been reviewed since 2021.” from the report
Building work was ongoing
minorThe home had a premises improvement plan, including bathroom refurbishment and changes to furnishings and bedding management. Inspectors also noticed odours in several areas, which were addressed during the inspection.
“However, whilst the home had a satisfactory standard of cleanliness, we noted there were odours in several areas of the home.” from the report
- 01How are residents and relatives now being invited to complete satisfaction surveys and attend residents' meetings?
- 02What activities are available, and how are people's preferences being used to plan them?
- 03Have all environmental risk assessments now been reviewed, including those that had not been updated since 2021?
- 04What changes have been made to ensure all statutory notifications are submitted to the CQC on time?
- 05What progress has been made with the bathroom refurbishment, furnishings and bedding management?
This was a focused inspection of Safe and Well-led only; the ratings for Effective, Caring and Responsive were carried forward from the previous inspection. This explanation was written from the published report of 10 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.
Every inspection of Charnley House
8 rated inspections over 7 years: the service has improved, from Inadequate to Requires improvement.
- February 2024Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- March 2023Goodup from Requires improvementSafe: GoodWell-led: Requires improvement
- April 2022Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodWell-led: Requires improvement
- February 2021Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- February 2019Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- January 2018Requires improvementup from InadequateSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- June 2017Inadequatestayed InadequateSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- November 2016InadequateSafe: InadequateEffective: InadequateCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- May 2014
Report published without a new overall rating.
- November 2013
Report published without a new overall rating.
- October 2012
Report published without a new overall rating.
- February 2012
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 13 December 2010.
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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