Archived: Charlotte Grange Care Home

Updated 26 January 2019

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 7 and 14 November 2018. The first day of the inspection was unannounced which meant the provider did not know we would be visiting. The second day of inspection was announced so the provider knew we would be returning. The inspection team was made up of one adult social care inspector and one expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

We reviewed information we held about the service, including the notifications we had received from the provider. Notifications are changes, events or incidents the provider is legally obliged to send us within required timescales.

The provider completed a provider information return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

We contacted the commissioners of the relevant local authorities, the local authority safeguarding team, and other professionals who worked with the service to gain their views of the care provided at Charlotte Grange.

During the inspection we spent time with people living at the service. We spoke with 10 people and eight relatives or visitors. We also spoke with the provider’s representatives (regional manager and head of compliance), the manager, the deputy manager, two senior care assistants, five care assistants, the administrator, one member of kitchen staff, a domestic and the maintenance person. We spoke with the local infection prevention and control nurse.

We reviewed three people's care records and three staff recruitment files. We reviewed medicine administration records for 12 people as well as records relating to staff training, supervisions and the management of the service.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

Updated 26 January 2019

This inspection took place on 7 November 2018 and was unannounced. A second day of inspection took place on 14 November and was announced.

Charlotte Grange 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. Charlotte Grange provides personal care for up to 46 people. At the time of our inspection there were 46 people living at the home who received personal care, some of whom were living with a dementia.

A registered manager was not in place at the time of our inspection. A new manager (who used to be the deputy manager) had taken over when the previous registered manager retired at the end of September 2018. The new manager had begun the process to apply to become the registered manager for this service. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

At our last inspection in November 2017 we awarded an overall rating of requires improvement. This was because communal bathrooms did not contain foot operated bins, menu information was confusing and best interest decisions had been recorded on incorrect documentation. We found that although legal requirements were met, some improvements were still required which needed to be sustained over a period of time.

At this inspection we found the improvements made at the last inspection had been sustained and further improvements had been made. We have awarded an overall rating of good due to the significant progress made at this service.

During this inspection people and relatives spoke positively about the service and said it was a safe place to live. Staff had received training in safeguarding and knew how to respond to any allegations of abuse. Safeguarding referrals had been made to the local authority appropriately and robust recruitment checks were in place.

Regular planned and preventative maintenance checks and repairs were carried out and other required inspections such as gas safety and servicing were up to date. Accidents and incidents were recorded accurately and analysed regularly. Each person had an up to date personal emergency evacuation plan should they need to be evacuated in the event of an emergency.

There were effective infection control measures in place and staff wore personal protective equipment when appropriate.

Staff received regular supervisions and told us they felt well supported by the manager. Staff training in key areas was up to date.

People had maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People told us staff were kind and caring. People said their choices were respected and their dignity was upheld. We saw lots of pleasant interactions between staff and people.

Each person who used the service was given information about how to make a complaint and how to access advocacy services. An advocate is someone who represents and acts on a person's behalf, and helps them make decisions.

Care records showed that people's needs were assessed before they started using the service and care plans were written in a person-centred way. Person-centred is about ensuring the person is at the centre of any care or support plans and their individual wishes, needs and choices are taken into account.

Activities were arranged for people who used the service based on their likes and interests and to help meet their social needs.

The provider had an effective complaints procedure. People who used the service and their relatives were aware of how to make a complaint.

The provider had an effective quality assurance process in place. Staff said they felt supported by the management team. People who used the service and relatives were regularly consulted about the quality of the service via meetings and surveys.

People who used the service spoke positively about the manager and said they would recommend Charlotte Grange to others.