Charlotte House

Updated 8 April 2020

Inspection team

This inspection was carried out by two inspectors.

Service and service type

Charlotte House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and we looked at both during this inspection.

The service had a manager registered with the Care Quality Commission. Registered managers and providers have legal responsibilities for how they run the service and for the quality and safety of the care provided.

Notice of inspection

We gave 48 hours notice of the inspection because some of the people using it could not consent to a home visit from an inspector. This meant the service could appropriately prepare people for the inspection.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. For example, statutory notifications. A notification is information about important events which the provider is required to tell us about by law. We used the information the provider sent us in the provider information return. 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 of this information to plan our inspection.

During the inspection

We observed interactions between staff and people to help us understand the experience of people who could not talk with us. We spoke with six members of staff including the registered manager, home manager, three autism practitioners, a senior autism practitioner, quality and compliance manager, and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We reviewed a range of records. This included three people's care records and associated medication records. We looked at one staff file in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We spoke with three relatives of people who use the service. We requested feedback from six community professionals and received two responses.

Updated 8 April 2020

About the service

Charlotte House is an adapted residential building which delivers personal care and support for up to five people who have autism and associated conditions. At the time of inspection the service was supporting five people.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

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

People received care and support that was safe. People were protected from avoidable harm and abuse. The provider undertook appropriate recruitment checks on staff prior to their employment. People's medicines were managed in a safe way. There were safe systems in place to help ensure people received their medicines as prescribed. Staff received training on infection control and were provided with personal protective equipment such as disposable aprons and gloves.

People received care and support that was effective and based on detailed assessments and care plans which reflected their physical, mental and social needs. The service worked with other agencies to achieve good outcomes for people. People were supported to access appropriate healthcare services to ensure these needs were met. 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; however, the systems in the service did not always support this practice. We have made a recommendation that the provider reviews their systems to ensure they are working within the principles of the Mental Capacity Act 2005.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

There were caring relationships between people and staff. Staff were aware of and supported people's emotional needs. Staff respected and promoted people's privacy, dignity and independence, and encouraged people to be as independent as possible.

People received personalised care that was responsive to their needs. People were provided with information in a way they could understand which helped them make decisions about their care. There were effective systems in place to deal appropriately with complaints.

People were at the heart of the service. The registered manager and staff were passionate and continuously strived to achieve good, positive outcomes for people. Systems were operated effectively to maintain the quality and safety of the service.

For more information, please read the detailed findings section of this report. If you are reading this as a separate summary, the full report can be found on the Care Quality Commission (CQC) website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 13 March 2019).

At our last inspection we found breaches of the regulations in relation to medicines management and governance. The provider completed an action plan after the last inspection to tell us what they would do and by when to improve.

At this inspection we found the provider had made improvements and was no longer in breach of regulations.

Why we inspected

We carried out this inspection to follow up on action we told the provider to take at the last inspection.

Recommendations

We have made a recommendation in relation to working within the principles of the Mental Capacity Act 2005. We will check if the provider has acted on any recommendations at our next comprehensive inspection.

What happens next?

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.