Archived: Carlton House

Updated 2 May 2020

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

This inspection was carried out by two inspectors.

Service and service type

Carlton House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager in place however, they were not yet registered with the Care Quality Commission. Like registered providers, a registered manager is a 'registered person'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run. The manager was taking proactive steps to ensure registration was completed as soon as possible.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. This included statutory notifications sent to us by the manager about events that had occurred at the service. A notification is information about important events which the provider is required to tell us about by law.

We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps plan and support our inspections.

During the inspection

We were not always able to talk to people about their experiences of living at the service, so we spent time observing the interactions between people and staff, in order to help us understand people's experiences of living there. This is referred to as the Short Observational Framework for Inspection (SOFI). We spoke with two relatives and seven members of staff, including the manager, senior care workers, care workers and the housekeeper.

We reviewed a range of records. This included four people’s care records and medication records. We looked at three staff files in relation to recruitment and staff training. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the manager to validate evidence found. We looked at staffing rotas and surveys completed by people using the service, their relatives and visiting professionals. We spoke with health and social care professionals who visited the service regularly.

Updated 2 May 2020

About the service

Carlton House is registered to accommodate up to 25 people. It specialises in providing care and support for predominantly older people, many of whom were also living with dementia. Accommodation is provided over four floors in a quiet residential area. At the time of inspection there were 20 people living at the home. People had access to two communal lounges, a dining room and a garden area.

People’s experience of using this service and what we found

Whilst the manager had created an open and positive culture, we found not all discussions around people’s care and outcomes had been clearly documented. For example, it was not clear discussions had taken place with people and their relatives around DoLS applications. We have made recommendations about involving people in decisions about their care.

People were safe. A relative told us, “It’s very safe, because the staff are very conscientious, attentive and aware. I trust the staff that they look after mum well.” Systems supported people to stay safe and reduced the risks to them. Staff knew how to recognise signs of abuse and what action to take to keep people safe. There were enough staff to support people safely.

Staff were trained in administering medicines. People were protected by the prevention and control of infection. Appropriate Personal Protection Equipment (PPE) was available when needed while supporting people. People were supported to maintain their health and had support to access health care services when they needed to. The service had good relationships with external agencies, such as GPs and community mental health nurses.

Staff were responsive to people's individual needs and wishes and had an in-depth knowledge about each

person. Staff engaged with people very well and offered them choices on an ongoing basis. People's views and concerns were listened to and action was taken to improve the service as a result.

People received kind and compassionate care. The atmosphere within the home was friendly and welcoming and staff were warm and considerate towards the people they cared for. People's privacy was respected, and their dignity maintained. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection: Good (report published on 12 December 2017).

Why we inspected

This was a planned comprehensive inspection that was scheduled to take place in line with Care Quality Commission (CQC) scheduling guidelines for adult social care.

Follow up: We will continue to monitor the intelligence we receive about this service and plan to inspect in line with our re-inspection schedule for those services rated Good.