Charlton Court Nursing Home

We found the following areas of good practice.

Staff were trained on how to keep people safe from the risk of infection. However, during the inspection not all staff wore their PPE in line with government guidance this was signposted at the time of inspection. The home was clean, tidy and cleaning records had been completed.

At the time of our inspection the home was allowing visitors and there were protocols in place to reduce the risk of infection.

The provider had appropriate arrangements to test people and staff for COVID- 19 and was following government guidance on testing.

People admitted to the service were supported following government guidelines on managing new admissions during the COVID-19 pandemic.

The home's infection prevention and control policy was up to date and in line with current guidance.

Charlton Court Nursing Home provides nursing and personal care for up to 64 people. At the time of this inspection there were 57 people using the service.

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

Medicines were managed well, so people received their medicines as prescribed. Staff meetings were held, and staff felt these were valuable. Staffing was appropriate to meet people’s needs and staff were visible at all times during the inspection. Robust recruitment procedures ensured suitable staff were employed. People were supported by staff who understood how to identify and report potential abuse. People told us they felt safe and risks to people’s health and safety were managed well by the home. When accidents or incidents occurred, trends and learning was identified to reduce the risk of them happening again.

There was strong leadership in the service. People and their relatives spoke highly of the staff and registered manager. Audits and monitoring procedures were in place and these reflected the good service.

People's care plans reflected person current needs. Staff said they read and followed care plans and knew people well. People's wishes regarding the end of their life were in place if and when required.

People had access to a good varied range of activities and told us they enjoyed these. The activity coordinator was very passionate about ensuring people were engaged. We observed this on inspection. People and relatives were confident to raise issues and concerns. Complaints procedures were effective.

People were supported to have 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. Staff received training and support which gave them the knowledge and skills needed to care for people safely and effectively.

People told us they enjoyed the food on offer at Charlton Court. We observed plenty of snacks and drinks throughout the day for people to access. People had the support they needed to maintain a balanced diet and good health

Staff built up very caring relationships with the people who lived at the service. Staff respected people’s privacy and dignity and promoted independence, equality and diversity throughout. People and their relatives were involved in the planning and delivery of their care. Relative’s told us they felt welcome and involved in the home.

Rating at last inspection

The last rating for this service was good (2 May 2018).

Why we inspected

This was a planned inspection based on the previous rating.

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

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

We last inspected the home on 16 November 2016 when the home was rated 'Requires Improvement' overall. We identified two breaches of regulations. These were;

Regulation 12 Safe care and Treatment as we found people's care plans were not person-centred.

Regulation 11 Need for consent as we found evidence of consent was not always available. Appropriate records to show people's capacity had been assessed were not completed.

Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions of safe, effective, caring responsive and well led to at least good. At this inspection, we found the provider had made all the required improvements and addressed the concerns highlighted last time we visited the service. The management team were also responsive to concerns we raised during our inspection.

Charlton Court Nursing Home is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission regulates both the premises and the care provided, and both were looked at during this inspection. This service provides nursing and personal care for up to 64 people. At the time of this inspection there were 58 people using the service.

There is a registered manager in post. A registered manager is a person who has registered with 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.

People's care plans and risk assessments did not always contain guidance for staff. The provider and the registered manager were aware of this and had already began to take appropriate action.

The registered manager ensured staff completed training on the Mental Capacity Act 2005 (MCA) and associated Deprivation of Liberty Safeguards (DoLS). Where people were deprived of their liberty to safeguard them, we found up-to-date records were in place to support decisions made by people. The registered manager and staff ensured good standards in obtaining and recording people's consent to their care.

Arrangements were in place to ensure people received their medicines safely.

People who used the service told us they felt safe. The staff we spoke with had a good understanding of safeguarding, whistleblowing and how to report any concerns.

Staff and people we spoke with said staffing levels were sufficient to meet their requirements. We looked at recruitment processes and found staff had been recruited safely. All staff received an induction when they started working at the home. Staff received regular supervision and appraisal. Staff also received all the necessary training relevant to their roles.

All of the people we spoke with during the inspection made positive comments about the care and support provided. People told us they felt staff treated them with dignity and respect and promoted their independence where possible. People felt the staff were responsive to their needs. Each person had their own care plan, which was person centred and included their choices and personal preferences.

People were supported to express themselves and communicate through a range of different methods. They had individual communication support plans in place, which were followed by staff.

People had access to a range of activities and care staff spent time socialising with them. There was a happy atmosphere in the home and most people were relaxed and animated. People were supported to maintain relationships with relatives and friends.

People were offered a variety of meal options, such as three choices at lunch. They told us they enjoyed their meals and had ample portions. Risk assessments were completed regularly to monitor people against the risks of malnutrition. People had access to health and social care professionals when required.

The service provided appropriate care and support to people at the end of their lives. People's needs were reviewed and monitored on a regular basis. People were provided with information on how to make a complaint.

The service worked with health and social care professionals to ensure people's needs were met. There were systems and processes in place to monitor and evaluate the service provided. People's views about the service were sought and considered through residents meetings and satisfaction surveys.

The registered manager and the staff were all striving to achieve the highest possible CQC rating and to provide the best possible service to people using the service.

Charlton Court Nursing Home is a large, purpose built nursing home with accommodation for up to 60 people. It is located in a residential area of Leeds close to the boundary with Bradford. There are a number of communal areas including lounges, dining rooms and a garden.

At the time of our inspection the service had a manager who was going through the registered manager’s process. 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.

People who used the service and their relatives told us the service was safe. The home looked well maintained, clean and tidy, and checks were carried out to make sure the premises and equipment was safe.

There were sufficient staff with the right skills and experience; several staff told us the staffing arrangements had improved. Appropriate checks were carried out before staff were employed and medicines were managed safely.

People who used the service and their relatives told us they were happy with the staff that provided care and support. Staff we spoke with said they felt well supported and understood their role as they received training that made sure they knew how to do their job well. Staff we spoke with understood their responsibilities around how they should support people with decision making. People enjoyed the food, and had plenty to eat and drink.

People told us they were well cared for and visiting relatives told us the service was caring. We observed staff supported people in a calm, compassionate and caring way. Staff were cheerful and friendly. When staff assisted people to move and transfer they explained what was happening and reassured them throughout. Systems were in place that ensured people accessed healthcare services.

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Staff responded to people’s individual needs and delivered personalised care. People’s care plans and other records showed their needs had been initially assessed and care was usually planned, although there was inconsistency with the level of detail within the care plans and we saw examples where care plans had not been followed. Care plans did not contain appropriate records to show people’s capacity to make different decisions had been assessed. The manager had identified care plans as an area for improvement and action was also being taken to improve activities in the home.

People told us they would talk to staff and management if they had any concerns and complaints had been responded to in a way which resolved the issue where possible to the person’s satisfaction. Several written compliments had been received.

We received positive feedback from people about the manager. Resident and relative meetings and staff meetings were held. We saw from minutes of meetings that people had opportunities to discuss the service and were informed of planned events.

At the inspection we reviewed a wide range of audits which had been completed at the service which were used to monitor the quality and safety of service delivery.

We have identified breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 during this inspection. You can see what action we told the provider to take at the back of the full version of the report.

We spoke with two people who used the service and they told us they enjoyed living at the home and were very complementary about the care and support provided by the staff. We saw staff were friendly and polite and offered choices to patients. We found people who used the service were treated with dignity and respect.

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

There were effective recruitment and selection processes in place.

We also found the provider had an accurate Statement of Purpose (SoP) and it contained the necessary information including aims and objectives, the kinds of services provided, names of key individuals working for the service, legal status of the provider and details of the office address.

There was an effective complaints system in place. The nurse in charge told us if complaints were made they would be responded to appropriately.