Background to this inspection
Updated
6 December 2023
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 carried out by 2 inspectors and 1 other CQC staff member who was observing the inspection process.
Service and service type
Carlton House is a care home registered to provide care to up to 24 older people. There were 22 people living at the home, the majority of whom were living with dementia. 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.
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 in person with the manager. We also spoke with 6 people using the service, 5 relatives and 4 staff to get their experience and views about the care provided. We reviewed a range of records. They included staff files containing recruitment, training and supervision information, and peoples' files containing care and medicine records, risk assessments, care plans and reviews. We checked a variety of records relating to the management of the service, including audits, quality assurance, policies and procedures. We continued to seek clarification from the provider to validate evidence found. We requested additional evidence to be sent to us after our inspection.
Updated
6 December 2023
About the service
Carlton House is a care home registered to provide care for up to 24 older people The home is a converted building on a residential street in Hatch End. The service provides support to people living with various health conditions and including people living with dementia. At the time of our inspection, 23 people were using the service.
People’s experience of using this service and what we found
Food hygiene practice was not always carried out in a safe way. Quality assurance audits were not robust enough to identify when actions were required to make improvements around food hygiene.
People were well cared for and received personalised care and support. They were happy living at the home, had good relationships with staff and were given choices about their care. Their relatives were also happy. People were supported to stay safe. The risks to their wellbeing were assessed and planned for. They received their medicines safely and as prescribed. People were supported to access healthcare services. They had enough to eat and drink and they were offered chances to participate in a range of activities.
Policies and systems were in place to help protect people from the risk of harm, abuse, and improper treatment. Risks had been identified to both those people who used the service, and staff. Medicines were administered following best practice.
There were enough suitable staff. There were systems for selecting and recruiting staff, as well as good training opportunities. Staff felt supported and worked well as a team.
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 was good (published 15 November 2018).
At our last inspection we recommended that the provider sought advice and guidance from a reputable source regarding activities for people with dementia. At this inspection we found had made improvements in this area including recruiting an activity coordinator, people and their relatives were happy with the daily activities provided by the home.
Why we inspected
This inspection was prompted by a review of the information we held about this service.
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.
You can see what action we have asked the provider to take at the end of this full report.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect. We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress.