CQC report explained · a nursing home
What the CQC found at Charters Court Nursing and Residential Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and avoidable harm. Inspectors found safer medicines systems, improved staffing, suitable risk assessments and effective infection control arrangements.
- Effective?
- Good
- People's consent and best-interest records had improved, and staff understood the Mental Capacity Act. Staff training, food, healthcare support and individual assessments were also found to be effective.
- Caring?
- Good
- This key question was not assessed during this focused inspection. Its previous rating was used in the overall rating.
- Responsive?
- Requires improvement
- This key question was not assessed during this focused inspection. Its previous rating was used in the overall rating.
- Well-led?
- Good
- Management systems had improved, including audits, handovers, meetings and checks. People, relatives and staff described the manager as supportive and approachable.
What inspectors found, June 2021
Charters Court Nursing and Residential Home was rated Good; inspectors found safer care, better staffing and stronger management after previous problems.
This was an unannounced focused inspection on 13 May 2021. Inspectors checked whether the home had acted on its improvement plan. They spoke with people, relatives, staff and a professional, and reviewed care, medicines, staffing and management records.
The home was rated Good for Safe, Effective and Well-led. Inspectors found that people were protected from avoidable harm, medicines were managed safely, staffing had improved and staff understood people's needs. Consent records and best-interest decisions had also improved.
This inspection did not assess Caring or Responsive. The ratings for those areas from the previous comprehensive inspection were carried forward when calculating the overall Good rating.
The home had previously been rated Requires Improvement, with breaches relating to consent and governance. Inspectors found enough improvement had been made and the home was no longer in breach.
Safer medicines
Medicines records gave clearer instructions, including for medicines used when needed. Staff recorded support properly and monitored risks.
“People's medicines were managed safely. Senior staff had an effective oversight of the management of medicines and individual risks.” from the report
Improved staffing
The home had reduced its use of temporary staff and increased permanent staffing. People and staff said care was timely and staff were not rushed.
“The provider reduced the use of temporary staff and employed more permanent staff.” from the report
Consent and choice
Records showed better mental capacity assessments and best-interest decisions. Staff supported people to make choices and used the least restrictive approaches.
“People were supported in the least restrictive ways.” from the report
Stronger management
The management team introduced better handovers, daily meetings, audits and checks. Inspectors found these changes improved communication and continuity of care.
“The home manager implemented a range of improvements to the service governance which addressed the previous breach of regulations” from the report
Listening to people
People, relatives and staff said they felt listened to and involved. The home made improvements to food, staffing and the general atmosphere.
“People, their relatives and staff told us the home did improve since the appointment of the new manager.” from the report
Manager registration
minorThere was no manager registered with the CQC at the time of the inspection. The home manager was applying for registration.
“The service did not have a manager registered with the Care Quality Commission.” from the report
- 01What is the current position on the home manager's CQC registration?
- 02How are medicines errors and 'when required' medicines checked now?
- 03How do you make sure there are enough permanent staff with the right mix of skills on each suite?
- 04What changes were made after the falls that resulted in fractures, and how are falls monitored now?
- 05How are relatives kept informed about accidents, incidents and changes to care?
This was a focused inspection of Safe, Effective and Well-led only; Caring and Responsive were not assessed and their previous ratings carried forward. This explanation was written from the published report of 11 June 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, July 2019
Requires Improvement; inspectors found kind care and better staffing, but ongoing problems with medicines, consent, care records and management oversight.
Inspectors visited without notice on 23 May 2019. They spoke with people, relatives and staff, watched care, checked medicines and reviewed care plans, risk assessments, complaints, recruitment records and quality checks.
People generally felt safe and said staff were kind, respectful and caring. Staffing had improved, the home was clean, people received food and healthcare support, and staff had better training and supervision.
However, some risks were not recorded clearly. There were errors or missing instructions in some medicines records. Mental Capacity Act decisions and Deprivation of Liberty Safeguards reviews were not consistently recorded. Some care plans did not contain enough detail, and activities were not always suitable or delivered as planned.
The overall rating was Requires Improvement. Safe, Effective, Responsive and Well-led were rated Requires Improvement, while Caring was rated Good. The home had improved since August 2018, when Well-led was rated Inadequate, but two regulations were still breached.
Kind and respectful staff
People were treated with kindness, dignity and respect. Staff helped people express their wishes and supported independence.
“People were supported and treated with dignity and respect; and involved as partners in their care.” from the report
Improved staffing
The home had recruited more care staff, reduced its reliance on agency staff and responded promptly to call bells. Nursing hours were covered, although recruitment of nurses was still needed.
“People were cared for by sufficient numbers of staff to meet their needs.” from the report
Clean environment
Inspectors found good hygiene and cleanliness, with suitable equipment and staffing for cleaning and laundry.
“Good hygiene and cleanliness were evident in the home.” from the report
Food and healthcare support
People were supported with nutrition and hydration, and the home worked with dietitians, therapists, doctors and other healthcare professionals.
“People were supported to eat and drink well.” from the report
Improved staff training
Training records had improved, mandatory training was up to date, and staff were receiving regular supervision.
“This was a big improvement since the last inspection and the provider had good records to keep track of staff training and when it was undertaken.” from the report
Medicines instructions were incomplete
seriousSome creams had no opening dates. Other records lacked a dose, clear eye-drop instructions or clear guidance about maximum doses and reviews.
“There were not clear instructions in place for two people who needed eyedrops, for example, which eye to apply them to or both and when.” from the report
Risks were not always recorded
seriousInspectors found missing or inconsistent records about risks linked to smoking and flammable creams, food advice and going out of the home.
“There were, however, inconsistencies about how some risks were documented.” from the report
Mental capacity decisions were unclear
seriousSome best-interest decisions and decision-specific capacity assessments were missing or unclear. Deprivation of Liberty Safeguards records were not regularly reviewed.
“The service was still not meeting the legal requirements of the Mental Capacity Act 2005 consistently.” from the report
Care plans lacked detail
needs fixingOne newer resident still had only a short interim plan, and some plans did not explain medical conditions, health history or personal interests in enough detail.
“Some people's care plans lacked detail on their medical needs and health history or diagnosis.” from the report
Activities were uneven
needs fixingOne quiz confused and frustrated people, and another planned event did not happen. The report also records generally positive views about other activities.
“In the afternoon, people waited a long time for an event that did not take place.” from the report
Management checks were not effective enough
seriousThere had been several changes in managers, and quality checks had not found all the problems identified by inspectors. Provider oversight needed to improve.
“The provider not being able to ensure that all requirements and care regulations were met was a breach of Regulation 17” from the report
- 01How are you now checking that every person's medicines record has clear doses, eye-drop instructions, opening dates and maximum daily amounts?
- 02How do you record and review best-interest decisions, decision-specific capacity assessments and Deprivation of Liberty Safeguards?
- 03How quickly are full care plans completed for new residents, and how do you make sure medical conditions and personal preferences are included?
- 04What has changed in the provider's quality checks so that risks, medicines and care-record problems are found before they affect people?
- 05How do you make sure activities are suitable for the people attending and that planned activities take place?
This was an unannounced inspection of the overall service and all five CQC questions, including care, premises, medicines, records, staffing, complaints and management systems. This explanation was written from the published report of 26 July 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 Charters Court Nursing and Residential Home
3 rated inspections over 3 years: the service has improved, from Requires improvement to Good.
- June 2021Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Good
Read what inspectors found at Charters Court Nursing and Residential Home →
- July 2019Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
Read what inspectors found at Charters Court Nursing and Residential Home →
- October 2018Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- August 2017
Registered with the Care Quality Commission on 25 August 2017.
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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