Old Charlton House Residential Home

Old Charlton House is a residential care home. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The home is registered to provide accommodation and personal care for up to 32 people. At the time of the inspection there were 28 people living at the home.

People’s experience of using this service:

People’s needs were met in a personalised way by knowledgeable staff who were kind and caring. They supported people to lead happy, fulfilled lives.

Individual and environmental risks were managed appropriately, and people were protected from avoidable harm.

People received their medicines as prescribed and infection control risks were managed effectively.

There were enough staff to meet people’s needs and recruitment processes helped ensure only suitable staff were employed.

People’s rights were upheld. They were empowered to make their own choices and decisions and involved in the development of their care plans.

People knew how to raise concerns. They had confidence in the registered manager and told us they would recommend the service to others.

A quality assurance system was in place to continually assess, monitor and improve the service.

The service met the characteristics of Good in all areas. More information is in the full report which is on the CQC website at www.cqc.org.uk.

Rating at last inspection:

The service was rated Good overall at the last full comprehensive inspection, the report for which was published in October 2016.

Why we inspected:

This was a planned inspection based on the previous inspection rating.

Follow up:

There is no required follow up to this inspection. We will continue to monitor all information received about the service to understand any risks that may arise and to ensure the next inspection is scheduled accordingly.

There was an experienced registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the service is run.

People, relatives and healthcare professionals praised the quality of care delivered. Staff were skilled at meeting people’s needs in a personalised way. They were suitably trained and supported in their work by the registered manager and deputy manager. They responded promptly when people’s needs changed.

Staff sought consent from people before providing care and support. They followed legislation designed to protect people’s freedom and knew how to keep people safe in the least restrictive way. They also encouraged people to make choices about every aspect of their lives. People told us they could “please themselves” what they did and how they spent their day. They had access to a wide range of activities, run by staff and volunteers, including level access to the garden.

People were cared for with kindness and compassion. Staff created a calm atmosphere in the home by supporting people in a patient and unhurried way. They supported people to build and maintain relationships. They protected people’s privacy and dignity and involved them in planning the care and support they received.

People told us staff were always available to support them and their call bells were answered promptly. Safe recruitment processes were followed to help ensure only suitable staff were employed.

Individual and environmental risks to people were managed appropriately. People were supported to take risks that helped them retain their independence and avoid unnecessary restrictions. Suitable arrangements were in place for the safe management of medicines; people received their medicines as prescribed and when needed.

People were offered a choice of nutritious meals which were freshly prepared daily at the home. They received appropriate support to eat when needed and were encouraged to drink often.

People were able to access healthcare services when needed. Staff were working with healthcare professionals to develop plans to prevent people being admitted to hospital unnecessarily. There were plans in place to deal with foreseeable emergencies and staff knew what action to take in the event of a fire.

The sole director of the provider’s company was actively involved in running the home and there was a development plan in place to further enhance the service. Staff understood, and were committed to delivering, the vision of the director which aimed to provide high quality care in a relaxed, homely environment.

There was an open culture where visitors were welcomed at any time. Strong links with the community had been forged, to the benefit of people living at the home. Staff were happy in their work and this had led to a low level of staff turnover. An appropriate quality assurance system was in place that focused on continuous improvement.

The director sought and acted on feedback from people through the use of questionnaires, meetings and informal discussions. People knew how to complain and any concerns were addressed promptly.

We spoke with the manager and deputy manager, three care staff including one senior carer, a cleaner, the cook and the maintenance man. Staff told us 'We are a close working team' and 'We work hard to make things good for the people living here'. Another said 'We know people well. We pick it up quickly if there is something wrong'.

We also spoke with a volunteer from an independent art group, the activities coordinator and an assessor from a local college who told us 'There is a real commitment to training here.'

We reviewed care records for two people with diverse needs. We found that people experienced safe and effective care because their needs were assessed and reviewed.

People had a varied diet and were given the support encouragement they needed to eat and drink.

People were protected from the risk of abuse because staff understood their role and responsibilities in the event of a concern.

People using the service benefited from a staff team who were well trained and supported to do their job.

We also spent time observing care in communal areas. We found that people had positive experiences. We observed that staff were courteous and respectful of people's views. Choices were offered and where necessary informal consent was obtained. The staff knew what care and support people needed and they respected their wishes. The support we saw being given to people matched what their care plan said they needed.

We found that medication was correctly managed and appropriate staffing levels were provided. Care plans were relevant to people and records were well maintained and stored securely.