CQC report explained · a residential care home
What the CQC found at Charnwood
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- People were generally kept safe, medicines were administered correctly and infection control procedures were followed. However, some care plans lacked enough detail and staffing was not always sufficient, especially later in the day.
- Effective?
- Good
- This key question was not inspected during this focused visit. The previous comprehensive inspection rating was used in calculating the overall rating.
- Caring?
- Good
- This key question was not inspected during this focused visit. The previous comprehensive inspection rating was used in calculating the overall rating.
- Responsive?
- Good
- This key question was not inspected during this focused visit. The previous comprehensive inspection rating was used in calculating the overall rating.
- Well-led?
- Requires improvement
- The manager had introduced improvements, but governance checks were not consistently effective. Problems with care plans and medicines stock were not always identified or dealt with, and there was no registered manager in post.
What inspectors found, February 2021
Rated Requires Improvement; inspectors found improvements in medicines and infection control, but staffing and management checks were not reliable enough.
This was a focused inspection on 19 January 2021. One inspector spoke with people living at the home, relatives and staff, and checked care records, medicines records and management documents. The inspection looked only at Safe and Well-led.
People and relatives said they felt safe and staff understood how to reduce risks. Medicines were given as prescribed, infection control arrangements were effective, and accidents were reviewed. However, care plans did not always give enough detail, and staffing was sometimes stretched in the afternoons and early evenings.
Management systems had improved but were still not consistently effective. Audits did not always identify or correct problems with care plans and medicines stock checks. The home remains Requires Improvement, as it was at the previous inspection and for the third consecutive inspection.
Medicines
Inspectors found that medicines were given as prescribed. Records, storage, staff training and stock counts were checked and found to be accurate.
“Medicines were stored safely, and medicines administration records were completed accurately.” from the report
Infection control
The home had suitable arrangements for preventing and managing infection, including using protective equipment, testing and updated policies.
“We were assured that the provider was using PPE effectively and safely.” from the report
People felt safe
People and relatives told inspectors they felt safe. Staff could explain how they supported people with risks such as falls, skin damage and poor food or fluid intake.
“People and Relatives told us they felt the home kept people safe.” from the report
Supportive management
People, relatives and staff described the manager as approachable and supportive. Staff also had access to training and updates.
“The manager is very supportive, always available to us.” from the report
Afternoon and evening staffing
needs fixingStaffing had improved in the mornings, but inspectors saw staff were busy at teatime. The provider was asked to review whether staffing matched people's needs later in the day.
“People were not consistently supported by enough staff.” from the report
Care plan detail
needs fixingSome risk assessments and care plans did not explain clearly enough how people should be supported. The manager updated some records after the inspection.
“People had risk assessments and care plans in place to give guidance to staff. However, these were not always sufficiently detailed.” from the report
Weak governance checks
seriousAudits did not always identify problems with care plans or medicines stock. CQC said the systems were not robust enough to show that people's safety was consistently protected.
“This was a continued breach of regulation 17 (Governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.” from the report
- 01What staffing levels are now in place in the afternoons and early evenings, and how are they matched to people's needs?
- 02How do you check that each person's risk assessment and care plan contains enough detail for staff to provide safe support?
- 03How do you check medicines stock so that medicines are consistently available?
- 04Who is currently responsible for management while there is no registered manager, and when will an application be made?
- 05What actions were included in the improvement plan requested by CQC, and what progress has been made since this inspection?
This was a focused inspection of Safe and Well-led only; the other key question ratings from the previous comprehensive inspection were used to calculate the overall rating. This explanation was written from the published report of 26 February 2021 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, October 2020
Charnwood rated Requires Improvement; inspectors found risks with staffing, medicines, infection control and management oversight.
Inspectors visited on 12 and 18 August 2020. They spoke with people, a relative, staff and two visiting professionals. They reviewed care records, medicine records, training information and management records.
People were not always supported quickly enough. Some waited for meals or continence support, and staff did not always have time for meaningful conversation. Records and care plans were not consistently up to date, and staff did not always follow professional guidance about fluids and pressure relief.
Inspectors found serious weaknesses in infection control during the COVID-19 pandemic. Some new residents were not isolated as guidance required, staff were not routinely wearing masks at first, and social distancing and cleaning guidance was not always followed. The manager took some immediate action during the inspection.
The overall rating was Requires Improvement. Safe and Well-led were both rated Requires Improvement. This was a focused inspection of those two areas, so the other ratings came from the previous comprehensive inspection. The home had been rated Requires Improvement at the previous inspection and has held that rating for two consecutive inspections.
Staff understood safeguarding
Staff knew how to recognise possible abuse and what to do about concerns.
“Staff knew how to recognise the signs of potential abuse and how to report and record their concerns.” from the report
Regular medicines
Inspectors saw that regular medicines were given by trained staff as prescribed, although problems remained with some medicines given only when needed.
“Despite this, we saw people received their regular medicines by trained staff as they were prescribed.” from the report
Immediate infection action
The manager responded during the inspection by making sure staff wore masks and had designated areas for putting on and removing protective equipment.
“The manager responded immediately during and after the inspection.” from the report
Manager approachable
People and staff found the manager approachable. The provider also sought feedback from people and families during the pandemic.
“Staff gave positive feedback about the manager and told us they were approachable.” from the report
Not enough staff
seriousPeople sometimes waited for care, meals and continence support. Staff also had little time for conversation or activities outside direct care tasks.
“We saw people had to wait for 40 minutes from being supported by staff to the dining table to receiving their lunch.” from the report
Infection control
seriousSeven people were admitted without isolation in line with government guidance. Staff were not always wearing masks, distancing, using suitable PPE areas or following cleaning guidance.
“We saw seven people had been admitted to the care home without being isolated as per government guidance.” from the report
Care records not reliable
seriousCare plans and daily notes were not consistently updated or clear. This meant staff might not have the right guidance about diet, fluids, mobility or pressure relief.
“People's care files did not consistently contain clear and up to date guidance to enable to staff to meet their needs.” from the report
Medicines when needed
seriousSome people did not have clear instructions for medicines prescribed only when needed. Medicine records were not checked through a reliable review system.
“People did not always have protocols in place for as required medicines to ensure staff had an understanding of the circumstances these medicines should be given in.” from the report
Weak quality checks
seriousThe provider's monitoring systems did not identify or sustain improvements. The report says this left people at risk of harm.
“Systems were not in place to effectively monitor and assess the quality of the service, to drive and sustain improvements and to ensure compliance with the regulations.” from the report
- 01What changes have been made to staffing levels and how do you now assess whether there are enough staff for people's care and emotional needs?
- 02How do you now make sure new residents are isolated when required and that staff follow current infection control guidance?
- 03How are care plans and daily notes checked to make sure professional advice about fluids, diet and pressure relief is being followed?
- 04What instructions are now in place for medicines prescribed only when needed, and how often are medicine records reviewed?
- 05What action plan did you send to CQC, and what evidence can you show that improvements have been sustained?
This was a focused inspection of Safe and Well-led only, prompted partly by an infection control review; the other ratings carried over from the previous comprehensive inspection. This explanation was written from the published report of 7 October 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.
Every inspection of Charnwood
4 rated inspections over 4 years: the service has slipped, from Good to Requires improvement.
- February 2021Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- October 2020Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
- July 2019Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- November 2016GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- August 2013
Report published without a new overall rating.
- October 2012
Report published without a new overall rating.
- June 2011
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 3 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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