This inspection was undertaken on 14 September 2015, and was unannounced. The service was last inspected on 28 January 2014 the service was compliant with the regulations that we looked at.
Carlton House is registered with the Care Quality Commission [CQC] to provide care and accommodation for up to ten people who may be living with dementia. Accommodation is provided over two floors with a secure garden at the rear of the service and situated close to local amenities. There is a car park, but this is not in use, street parking is available for visitors.
The registered provider is the registered manager for this service. 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 the legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
Staff had a clear understanding about their duty to protect people from abuse. Staff knew they must report concerns or potential abuse to the management team, local authority or to the Care Quality Commission [CQC]. This helped to protect people.
There were enough staff on duty to support people during our visit. Staff understood people’s needs and were aware of potential risks to people’s health and wellbeing. Staff received training in a variety of subjects, this was updated, as required to maintain the staff’s skills and knowledge.
People’s nutritional needs were assessed and monitored. Food provided was home cooked and
people’s preferences and special dietary needs were catered for. Staff assisted and encouraged people to eat and drink with patience and kindness. Advice was sought from relevant health care professionals to ensure people’s nutritional needs were met.
A visiting health care professional confirmed that the staff sought their advice, reported issues and followed their guidance to help maintain people’s wellbeing.
People who used the service were supported to make their own decisions about aspects of their daily lives. Staff followed the principles of the Mental Capacity Act 2005 when there were concerns people lacked capacity and important decisions needed to be made.
The service was undergoing a programme of refurbishment and internal redecoration. People’s bedrooms were personalised. The pictorial signage was down where painting was taking place and this was to be replaced to help people find their way around. Staff helped guide people to where they wished to go. Service contracts were in place to maintain equipment so it remained safe to use.
Staff respected people’s individuality, privacy and dignity. People made decisions about what they wanted to do and how they wanted to spend their time. Staff reworded questions or information to help people understand what was being said so people could respond.
A complaints procedure was in place for people, relatives and visitors to use to raise concerns. This information was provided to people in a format that met their needs. Staff asked for people’s views and they acted upon what was said. This helped to ensure people remained satisfied with the service they received.
The registered provider and senior staff undertook regular audits to help them monitor, maintain or improve the service provided. However, we found there were some issues to be addressed during our inspection; two fire doors were held open by inappropriate means and light cords required cleaning to maintain infection control. Night checks undertaken to help maintain people’s wellbeing needed to be recorded in more detail by staff.