Charles Court Care Home

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• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

We looked at 2 quality statements. This means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence. At our last inspection we rated this key question good. At this assessment we did not assess all quality statements within this key question. The overall rating for this key question remains good based on the findings at the last inspection.

This service scored 67 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Relatives were aware their loved ones had care plans in place. All of them told us they had discussed their family members care support needs, likes and dislikes, when they were first admitted to the home. However, most relatives spoken with told us they had not seen the care plans in place and had not been involved in any reviews.

Staff told us clinical staff carried out reviews and updates of care records, along with ensuring people’s clinical needs were met. We saw staff had failed to continue to monitor 2 people following them showing signs of being unwell. We raised this with the management team who investigated. Following this, a lessons learnt session was held with staff to ensure clinical observations were recorded at the time of a person causing concern. Observations would continue until either there is improvement in the condition or emergency medical assistance arrives and/or hospital transfer occurs. In addition, we found some repositioning records indicated people had not been repositioned according to their needs. For example, one person’s records showed they had not been repositioned every day or on a regular basis. The registered manager told us, and evidence was seen in staff meeting minutes, the management team were monitoring daily records and, had completed supervisions with all staff and provided additional training.

Prior to admission to the home an assessment of people’s individual needs was carried out to ensure they could be met safely and effectively. Information had been sought from people, relatives and professionals involved in people’s care, to ensure individualised, person-centred care could be provided. There were processes in place to involve family members in reviews. This involved inviting family members to get in touch to arrange a review at their convenience. However, this did not seem to be working effectively. The management team told us they would revisit this to ensure relatives were involved. A range of national assessment tools were used to understand people’s needs and how best to support them. For example, the malnutrition universal screening tool (MUST) was used for the management of weight loss and nutritional intake.

People and relatives spoken with mostly felt the service was meeting people’s needs. We received mixed feedback about some people’s mealtime experiences. Comments included, "Food is nice, have cooked breakfast every morning, get to choose what I have," “[Person’s name] likes the meals and has put on weight over the 2 years they have been a resident,” "Generally good food, not always a good choice, there's not always options for vegetarians,” “When it comes to mealtimes [family member] has never been asked what they would like, they just serve it up. There is no menu or choices to be had it’s just a cooked meal,” and “Food is excellent, and given a choice of what you want." People’s nutrition needs could be improved with further involvement and discussions with people as most spoken with said they had no choice and there was no menu. We saw a pictorial menu on the wall in the restaurant. Some relatives raised concerns about their family members weight loss. One relative said, “[Family member] has definitely lost weight and so has [family member].” Another relative told us, “[Family member] has lost weight due to loss of appetite and I don’t think their weight is being monitored.”

The registered manager told us menus are displayed on the menu board and alternatives are offered. For example, salads and jacket potatoes. Following our feedback to the management team they told us moving forwards they will ensure copies of the daily menus are provided to people. Staff had received training in food safety and nutrition and hydration.

Monitoring tools based on best practice standards, such as the International Dysphagia Diet Standardisation Initiative (IDDSI), were in place for staff to follow to ensure people were receiving the appropriate level of care, tailored to their needs. Malnutrition Universal Screening Tool (MUST) was used to identify people from risk of malnutrition. People’s care records contained details of health and social care professionals involved in their care. Staff meeting minutes showed the registered manager and senior management team had reminded staff about the importance of monitoring and recording. For example, people’s food and fluid intake to ensure a good nutritional intake for people was maintained. Any issues were reported to the nurses to escalate with the GP.

We did not look at How staff, teams and services work together during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Supporting people to live healthier lives during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Monitoring and improving outcomes during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Consent to care and treatment during this assessment. The score for this quality statement is based on the previous rating for Effective.