Archived: Carleton House Care Home

Carleton House Care Home is a service that provides accommodation and personal care to older people and is registered for up to 27 people. It is not registered to provide nursing care. The care home is a former rectory and accommodation is provided over two floors, accessed via a lift or stairs. On the days of our inspection there were 17 people living in the home.

There was a registered manager in post. 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.

At this inspection we found two breaches of the Health and Social Care Act 2008.You can see what action we told the provider to take at the back of the full version of the report.

People told us they felt safe in the home. Staff understood and knew how to identify and report harm. Staff understood people’s individual care needs and took action to prevent people from coming to harm. Premises and equipment were assessed, reviewed, and maintained. Appropriate actions were taken to deal with accidents and incidents, although these were not always robustly investigated and documented. Safe recruitment practices were being followed. Medication was administered and stored safely.

Staff had the knowledge and skills to meet people’s needs, preferences and choices. Staff had training and support from the service that equipped them to carry out their roles. Knowledge about the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards was variable. Assessments of mental capacity and best interests were not being made. This meant the home was not following the requirements of the MCA.

People were supported to eat and drink enough. There was sufficient staff to support people who needed assistance to eat. People were assisted to eat and drink independently if possible. Where there were concerns people’s weight, fluid and food intake was monitored and reviewed. People were supported to access external health care services when needed.

Staff showed kindness, compassion, and respect towards people living in the home. Staff demonstrated that they knew the people living in the home. People were supported to express their views and make decisions. Relationships with friends and family were supported by the service. People were supported to be independent and their dignity was protected.

The care provided met people’s needs and preferences. Staff knew people well including their personal preferences. However, people were not routinely involved in planning and reviewing their care.

An activities co-ordinator was in post. Feedback about activities was mixed. There was no regular activities timetable however there was some planned regular entertainment provided externally.

Staff felt they were listened to and supported by the registered manager. However, they did not feel supported by the provider. Care records did not provide sufficient guidance and were not effective. The service promoted a culture of openness and a desire to learn and improve. Systems were in place for people to raise concerns and provide feedback.

People told us that staff respected and acted on the decisions they made about the care and support they agreed to.

Our observations showed us that staff members were responsive to the needs of people and that they were given the support and attention they needed. We saw that people had a positive experience of being included in conversations, decision making and activities.

We found that plans of care contained the information staff members needed to promote and protect the health and safety of people.

People spoken with and their relatives told us that people were safe, provided with the care and support they needed and that the staff were, 'Wonderful and kind.'

Medication was administered, recorded and stored accurately and safely.

There were effective recruitment and selection processes in place and appropriate checks were undertaken before staff began work.

The records held ensure that people are protected against the risks associated with unsafe or inappropriate care and treatment.

We found that people were cared for in an environment that was well maintained, safe, accessible and that promoted people's dignity.

We found that people using the service had their care needs assessed and planned in detail, and that care was delivered in line with what was planned. In each of the six records we looked at, we found a personalised risk assessment, which put in place steps to reduce the risk of harm to the person using the service.

We found that the service had in place processes for obtaining the consent of those using the service. We saw that people using the service signed a document which explained to them their rights, care and treatment.

We found that people were provided with adequate nutrition and hydration. We saw that people were supported to make choices from a wide range of food and drink, and that people's preferences with regard to food and drinks were documented. We spoke with one person and asked them what they liked about living at Carleton House. They told us, "The food is good."