CQC report explained · a nursing home
What the CQC found at The Queen Charlotte
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People felt safe, staff understood safeguarding and individual risks, and staffing levels had increased. The home had recruited nurses after a period of high nurse turnover.
- Effective?
- Good
- People’s needs were assessed and staff supported their health, nutrition and choices. However, some care records did not reflect current needs, and oral care was not always provided as planned.
- Caring?
- Good
- Staff were kind, compassionate and respectful. People valued relationships with regular staff, but some found unfamiliar agency staff unsettling.
- Responsive?
- Good
- Care was personalised and people’s needs and preferences were recorded. Activities were available, but they were not always provided when the activities coordinator was unavailable.
- Well-led?
- Requires improvement
- Leadership had been unsettled, with five managers in four years and high nurse turnover. A new senior team had an improvement plan, but inspectors could not yet tell whether the arrangements would last.
What inspectors found, January 2020
Rated Good overall; inspectors found safe, kind care, but leadership and some care records needed improvement.
This was an unannounced inspection on 26 November and 9 December 2019. Inspectors spoke with people living in the home, relatives, staff and managers. They also observed care and checked care records, medicines records, staff files, training and safety records.
People were generally safe and received kind, respectful care. Staffing had improved, medicines were managed safely, and people’s health, food, communication and personal preferences were supported. The home also provided activities and helped people keep in touch with family and friends.
The main weakness was leadership. The home had experienced frequent manager changes and high nurse turnover. Some care records were incomplete or inaccurate, and oral care and activities were not always provided as recorded or expected.
The overall rating was Good. Safe, Effective, Caring and Responsive were rated Good. Well-led was rated Requires Improvement, which means management and leadership were not yet consistent enough.
Kind and respectful staff
Inspectors saw staff treating people with kindness, humour and compassion. People said staff were kind and that they felt respected.
“Staff were observed engaging with people with kindness, humour and compassion.” from the report
Improving staffing
Staffing levels had increased and recruitment had filled nursing vacancies. Inspectors found staff were not rushed and could respond to people’s requests.
“The provider had developed a recruitment plan in response to the specific challenges of the home.” from the report
Safe care arrangements
Risks such as falls, skin damage and eating and drinking were assessed. Medicines, equipment, infection control and emergency arrangements were also checked and found to be safe.
“People were protected from the risk of abuse and avoidable harm.” from the report
Improved responsiveness
The Responsive rating improved from Requires Improvement to Good. Care planning reflected people’s preferences, interests and communication needs.
“At this inspection this key question has now improved to Good.” from the report
Unsettled leadership
needs fixingThere had been frequent changes in managers and high nurse turnover. Staff were sometimes unsure what was expected of them, and inspectors could not yet judge whether the new leadership arrangements would last.
“The home had been through a sustained period of unsettled leadership with regular changes in the manager role and high turnover of nursing staff.” from the report
Incomplete care records
needs fixingSome records did not accurately or consistently show the care people received or their current needs. This made it harder to review whether care had been delivered properly.
“The recording of some care was not accurate or consistent.” from the report
Oral care was not always provided
needs fixingOral care did not always happen as described in care plans. The senior team said it would review and address this.
“Oral care was not always provided as described in people's care plans.” from the report
Activities were not always available
minorPeople had access to activities and outings, but these were not always available when the activities coordinator was away. Feedback from people and visitors was mixed.
“these were not always available if the activities coordinator was not available.” from the report
- 01Who is currently responsible for managing the home, and how has leadership been kept stable since the inspection?
- 02How do you check that care records accurately show each person’s current needs and the care they receive?
- 03How is oral care planned, recorded and checked for each person?
- 04What activities are available when the activities coordinator is not working?
- 05How much agency staff is currently being used, and how do you ensure unfamiliar staff know each person’s needs?
This was an unannounced inspection covering all five CQC questions, with the home, care and records examined. This explanation was written from the published report of 22 January 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.
What inspectors found, October 2017
Rated Good overall; inspectors found safe, effective and caring support, but activities and some improvement systems required improvement.
The inspection took place on 31 August and 1 September 2017. The first day was unannounced and the second was announced. Inspectors spoke with people, relatives, staff and health professionals. They observed care and checked care plans, staff files, medicines, training and management records.
The home was rated Good for being safe, effective, caring and well-led. Inspectors found enough staff, safe medicines arrangements, suitable training and good access to healthcare. People were treated respectfully, supported to make choices and cared for by staff who knew them well.
The responsive rating was Requires Improvement. Group activities were available, but there were limited meaningful one-to-one activities for people who stayed in bed or did not want to join groups. Quality checks were regular, but the information was not always turned into clear actions. The report also identified gaps involving one expired DoLS authorisation, some recruitment records and oversight of medicines that must be given at specific times.
Safe staffing and risk support
Inspectors found enough staff and said staff knew people's individual risks and how to manage them.
“There were enough staff to support people and the operations manager showed us the tool they used to determine whether there were sufficient staff to meet people's needs.” from the report
Kind and respectful care
People appeared relaxed with staff. Staff respected privacy and dignity and supported people to make choices.
“People were supported to maintain their privacy and dignity.” from the report
Good health support
The home had regular links with healthcare professionals and people could receive healthcare input promptly when needed.
“People had access to healthcare promptly when required.” from the report
Person-centred care plans
Care plans included people's history, preferences and the support they needed. Reviews were carried out regularly.
“People had care plans which were person centred and included details about how they wished to be supported.” from the report
Limited meaningful activities
needs fixingActivities were often provided in groups. People who stayed in bed or did not want to join groups had few regular activities that were meaningful to them.
“This meant that people who stayed in their rooms did not have opportunities for regular activities which were meaningful for them.” from the report
Quality checks did not always lead to action
needs fixingAudits were completed, but some only recorded information without analysing it or identifying what needed to improve.
“However other audits consisted of the information gathered but did not have any analysis to determine whether any learning or actions were required.” from the report
DoLS conditions were not met
needs fixingOne person's expired DoLS authorisation had conditions that were not recorded in the care plan or met. The home said it would improve how these conditions were recorded and monitored.
“Although a new application has been submitted, the conditions to which the authorisation had been subject had not been recorded in the person's care plan and had not been met.” from the report
Medicine timing oversight
needs fixingThe electronic medicines system alerted staff if medicines were more than two hours late. Inspectors said this was not robust enough for medicines that had to be given at exact times.
“The two hour window would not be sufficient where people required medicines which were time specific.” from the report
Some recruitment records incomplete
needs fixingMost recruitment checks were in place, but one file lacked enough information about previous conduct and another did not have employment gaps checked.
“We saw one file which did not have sufficient information about an applicant's previous conduct and another file where employment gaps had not been checked.” from the report
- 01What one-to-one activities are now available for people who stay in bed or do not want to join group activities?
- 02How do you make sure that any conditions attached to a DoLS authorisation are recorded, followed and reviewed?
- 03How do you check that medicines needing exact timings are given on time?
- 04What changes have been made to ensure recruitment records include previous conduct and explanations for employment gaps?
- 05How are audit findings now analysed and turned into clear improvement actions?
This was a comprehensive inspection covering all five key questions and providing ratings for the overall service and each question. This explanation was written from the published report of 10 October 2017 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 The Queen Charlotte
5 rated inspections over 4 years: the service has improved, from Inadequate to Good.
- January 2020Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- October 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Good
- August 2016Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- May 2016Inadequatestayed InadequateSafe: Requires improvementWell-led: Requires improvement
- December 2015InadequateSafe: InadequateEffective: InadequateCaring: InadequateResponsive: InadequateWell-led: Inadequate
- March 2014
Report published without a new overall rating.
- August 2013
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 24 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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These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
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