Carlton House Rest Home Limited

Updated 3 December 2022

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 Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was completed by one inspector and an Expert by Experience contacted relatives by telephone. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

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

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

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. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with five people who used the service about their experience of the care provided. We spoke with seven members of staff including the registered manager, deputy manager, provider, activities coordinator and three care staff.

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

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We received feedback from six relatives. We also received feedback from two health and care professionals.

Updated 3 December 2022

About the service

Carlton House Rest Home Limited is a residential home providing personal and nursing care to up to 40 people. The service provides support to older people some who may be living with dementia. At the time of our inspection there were 29 people using the service. Carlton House Rest Home Limited provides care in an adapted building close to a town centre. The home has bedrooms over three floors and shared living spaces on the ground with accessible outside areas.

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

People enjoyed living at the home and felt safe. However, improvements were required in some areas. The home was clean, and measures were in place for infection prevention and control. We were assured that most infection prevention and control practices were in line with current guidance. However, more robust procedures were required including staff not wearing nail polish and some areas of the home in need of refurbishment.

The risks to people were minimized through risk assessments. However, in some areas more detail will assist staff to keep people safe. There were plans in place for foreseeable emergencies and most fire safety checks were carried out.

Relevant recruitment checks were conducted before staff started working at the service to make sure they were of good character and had the necessary skills. However, we did find that more robust procedures for checking full employment histories were required.

Staff had received training in safeguarding adults and knew how to identify, prevent and report abuse. There were enough staff to keep people safe. Medicines were stored safely and securely, and procedures were in place to ensure people received their medicines as prescribed.

There were effective systems in place to monitor and improve the quality of the service provided. Staff felt supported by management and enjoyed working at the service. There was an open-door approach to management and staff could approach the management team to address concerns.

The provider had an open and honest approach to care delivery and reported accidents and incidents and informed those involved as necessary.

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 and update

The last rating for this service was good (published 08 July 2021).

Why we inspected

The inspection was prompted in part due to concerns received about a safeguarding review. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We looked at infection prevention and control measures under the safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe and well led sections of this report.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Carlton House Rest Home Limited on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.