CQC report explained · a residential care home
What the CQC found at Old Charlton House Residential Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and avoidable harm. Medicines, recruitment, cleaning and environmental risks were managed appropriately, although inspectors noted some delays in bathroom support and that staffing levels were not assessed using a systematic approach.
- Effective?
- Good
- People's needs were assessed and staff were trained to support them. Food, healthcare, moving support and consent arrangements were generally handled well, although some staff were not initially clear about which people had legal authorisations restricting their liberty.
- Caring?
- Good
- People were treated with kindness, dignity and respect. Staff knew people's preferences and supported independence, choice and involvement in care decisions.
- Responsive?
- Good
- Care plans were personalised and activities reflected people's interests. Inspectors found that daily records for people with catheters did not show that appropriate support had been given, but a new recording system was introduced during the inspection.
- Well-led?
- Good
- The home had an accessible management team and quality checks that had led to improvements. The manager responded promptly to issues found during the inspection and planned to make the quality checks more robust.
What inspectors found, May 2019
Old Charlton House Residential Home was rated Good; inspectors found kind, personalised care, with some records and staffing checks needing improvement.
Inspectors visited without notice on 11 and 12 April 2019. They spoke with people living at the home, relatives, staff and health and social care professionals. They reviewed care records, accident and complaint records, medicines information and quality checks.
The home supported 28 people, although it was registered for up to 32. Inspectors found people were safe, treated kindly and supported to make choices. Care was personalised, activities reflected people's interests, and staff helped people access healthcare and suitable food.
The overall rating was Good. All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. The home was also rated Good at its previous full inspection, published in October 2016. No follow-up inspection was required.
Kind and personalised care
People were treated with compassion and staff understood their individual needs, preferences and backgrounds.
“People's needs were met in a personalised way by knowledgeable staff who were kind and caring.” from the report
Good support with choices
People were involved in their care and supported to make everyday choices, including when to get up, what to eat and how to spend their time.
“People were empowered to make their own decisions and choices, including when they got up and went to bed, when and what they ate and how they spent their day.” from the report
Activities matched to individuals
The home offered varied activities and adapted them for people's abilities and interests, including gardening, music and dementia-friendly activities.
“The activities were tailored to people's individual interests and needs.” from the report
Responsive management
The management team listened to concerns and used audits, feedback and complaints to make changes.
“All issues identified during the inspection were responded to promptly.” from the report
Staffing checks were not fully structured
needs fixingSome people described delays with bathroom support. Inspectors found enough staff during their visit, but the home was not yet using dependency information and call bell response data to check staffing needs consistently.
“They did not assess people's levels of dependency or use the data available from the call bell system to analyse response times.” from the report
Some infection risks were not recorded
needs fixingInfection risks had been assessed and managed, but the assessments had not been documented as recommended. The manager said this would be completed.
“Infection risks had been assessed and appropriate action taken to reduce the risk, although these had not been documented” from the report
Catheter care records were incomplete
needs fixingDaily records did not show that people with catheters had received the required support. A new recording system was introduced by the end of the inspection.
“For people with catheters, their records did not show that they had received appropriate support.” from the report
Some staff needed clearer information
needs fixingStaff were not always clear about which people had legal authorisations affecting their freedom. The manager took immediate action to clarify this.
“Staff were not always clear about which people were subject to DoLS authorisations” from the report
- 01How do you now assess staffing levels during busy periods, and do you review call bell response times?
- 02How are catheter care tasks recorded and checked for each person?
- 03Have all infection risk assessments now been documented and kept up to date?
- 04How do staff know which people have legal authorisations affecting their freedom?
- 05What changes were made after the inspection to make quality checks more robust?
This was a planned comprehensive inspection covering the home, the care provided and all five CQC questions; all five ratings were given as Good. This explanation was written from the published report of 21 May 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, October 2016
Rated Good; inspectors found safe, kind and personalised care, with some records needing more detail.
This was an unannounced inspection on 12 and 16 August 2016. Inspectors spoke with people living at the home, relatives, staff and health professionals. They also observed care and checked care records, medicines, staff files, complaints and quality checks.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe medicine arrangements, suitable training and kind care. People had choices, activities and access to healthcare.
There were two areas for improvement. Capacity assessments did not always use the standard two-stage test. Some daily care plans did not give enough detail about the help each person needed. The manager took immediate action on the capacity assessments and agreed to review the care plans.
Kind, calm care
Staff were patient, respectful and unhurried. People were treated as individuals and their privacy and dignity were protected.
“Staff created a calm atmosphere in the home by supporting people in a patient and unhurried way.” from the report
Personalised support
Staff knew people's routines, preferences and changing needs, including how to support people living with dementia.
“Everyone is an individual and it affects them in different ways; they all have their own needs, which we get to know.” from the report
Safety and medicines
Risks were reviewed in ways that supported independence. Inspectors found that medicines were stored and given safely.
“Medication administration records (MAR) confirmed that people received their medicines as prescribed.” from the report
Choice and activities
People could choose when to get up, where to spend their day and whether to join activities. The home offered group activities, one-to-one time and access to the garden.
“People were supported and encouraged to make choices about every aspect of their lives, including when they got up and went to bed, and how and where they spent their day.” from the report
Open management
The manager and deputy manager were visible and approachable. Inspectors found that staff felt supported and that quality checks led to action.
“An appropriate quality assurance system was in place that focused on continuous improvement.” from the report
Capacity records
needs fixingManagers had not always used the standard two-stage test when recording whether people had capacity to make specific decisions. The manager took immediate action to improve this.
“Whilst the managers had assessed people's capacity to make the decisions in question, they had not always used the standard two-stage test recommended by the MCA.” from the report
- 01How were the capacity assessments updated after inspectors raised the issue with the standard two-stage test?
- 02How do you now make sure daily care plans explain exactly what personal care support each person needs?
- 03How do you decide staffing levels when people need one-to-one or end-of-life care?
- 04How are changes in people's health, mobility or mood recorded and passed to the next shift?
- 05How do you involve families in care plan reviews and decisions about changing needs?
This was an unannounced comprehensive inspection covering all five CQC questions and the overall quality of the home. This explanation was written from the published report of 12 October 2016 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 Old Charlton House Residential Home
2 rated inspections over 3 years: the service has held its Good rating throughout.
- May 2019Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
Read what inspectors found at Old Charlton House Residential Home →
- October 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
Read what inspectors found at Old Charlton House Residential Home →
- February 2014
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- January 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 26 January 2011.
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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