Archived: Charlotte James Nursing Home

Updated 18 May 2017

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 visit took place on 29 March 2017 and was unannounced. The inspection team consisted of one inspector and an 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 checked the information we held about the service and the provider. This included notifications that the provider had sent to us about incidents at the service and information we had received from the public. We also spoke with the local authority who provided us with current monitoring information. We used this information to formulate our inspection plan.

On this occasion, we had not asked the provider to send us a provider Information return (PIR). A PIR is a form that asks the provider to give some key information about the service. This includes what the service does well and improvements they plan to make. However, we offered the provider the opportunity to share information they felt was relevant during our visit.

We spoke with eight people who used the service, six visiting relatives and friends, and two community professionals. We also spoke with five members of care staff, the cook, activities co-ordinator, nurse and the registered manager. Some people were unable to tell us their experience of their life in the home, so we observed how the staff interacted with people in communal areas.

We looked at the care plans of four people to see if they were accurate and up to date. We reviewed three staff files to see how staff were recruited and checked the training records to see how staff were trained and supported to deliver care appropriate to meet each person’s needs. We also looked at records that related to the management of the service. This included the systems the provider had in place to ensure the quality of the service was continuously monitored and reviewed to drive improvement.

Updated 18 May 2017

This inspection was unannounced and took place on 29 March 2017. Charlotte James Nursing Home is registered to provide accommodation and support for up to 28 people. People who used the service had physical health needs and/or were living with dementia. At the time of our inspection, 25 people were using the service.

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 our last inspection on 21 April 2016, we found that improvements were needed in relation to the staffing levels; assessing people’s capacity to make certain decisions; and the effectiveness of the audits to monitor the quality of the service. At this inspection, the required improvements had been made regarding the staffing available and the systems in place to make effective changes in the home.

However, further improvements were required. When people were unable to make specific decisions about their care, the provider had not assessed their capacity and could not demonstrate how decisions were made in people’s best interests. The provider did not always ensure the staff had the specific training they needed to deal with certain circumstances.

People were safe and protected from harm and abuse. They were supported in a safe manner and potential risks were monitored and reviewed. People’s medicines were administered as prescribed and the provider had safe recruitment processes in place.

People were supported to maintain a balanced diet and good health. They were supported by staff who knew them well and were kind and caring in their manner. Staff had positive relationships with the people who they supported. People were supported in a dignified manner and their privacy and independence was promoted. Visitors were made to feel welcome and there were no restrictions as to when they could call.

People were involved in the assessment and planning of their care. They received support that was individual to them and took their views into account. There were opportunities for people to participate in activities they enjoyed. People knew how to raise any concerns and these were responded to.

People were positive about living at the home and felt it was well managed. There was an open culture within the service and staff enjoyed working there.