Archived: Carrington House

Updated 9 October 2021

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 Care Act 2014.

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 three inspectors and an Expert by Experience who made phone calls to relatives. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service. One inspector carried out the first day of inspection. Two inspectors went to the home for days two and three.

Service and service type

Carrington House is a ‘care home’. 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.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced on the first and second days. The final day was announced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with 12 people who used the service and one relative about their experience of the care provided. We spoke with 13 members of staff including representatives of the provider, the registered manager, care staff and auxiliary staff. Throughout the inspection we carried out observations of the support people were receiving.

We reviewed a range of records. This included 11 people’s care records and medicine records. We looked at three staff files 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 continued to look at a variety of records including care plans, quality assurance records, training data and policies. An Expert by Experience spoke with 12 relatives on the telephone and we spoke with the local authority.

Updated 9 October 2021

About the service

Carrington House is a residential care home providing personal care without nursing for up to 44 older people. At the time of the inspection there were up to 33 people living in the home.

The home is purpose built and has a mixture of single bedrooms which were either en-suite or had access to communal bathrooms. It is spread over three floors with shared living spaces such as dining rooms and lounges.

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

People were not always receiving safe care. Concerns were found with risks such as pressure care and moving and handling. Care plans lacked details and guidance to support staff to follow best practice. Medicines were not always managed safely. Systems to manage safeguarding people from abuse were not effective. People were not supported by enough suitably qualified and experienced staff.

As part of the COVID-19 pandemic we look at the infection control practices in care homes. Staff did not understand how to safely use personal protective equipment (PPE) such as gloves, masks and aprons. Throughout the inspection we observed staff incorrectly wearing masks such as below their nose or under their chin. The registered manager had not accessed support from the local authority to help change the culture until we prompted them. During the inspection contact was made after prompting by the inspection team.

People were not always supported in a dignified and respectful way. This was not in line with the provider’s vision. Staff’s interactions with people were task based and a lack of social interaction was witnessed. The management were not always facilitating a positive culture.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

The service was not well led. The registered manager lacked understanding of their roles and responsibilities. Concerned found during the inspection had not always been identified by the management or provider. The provider’s policies and procedures were not always being followed. Quality assurance systems were not effective at driving safe and quality care. During and following the inspection the provider produced action plans to mitigate immediate risks to people.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Good (published 31 October 2018).

Why we inspected

We undertook this targeted inspection to follow up on specific concerns we had received about the service. The inspection was prompted in part due to concerns received about the management of risks. A decision was made for us to inspect and examine those risks.

We inspected and found there was a concern with the management of risks, eating and drinking and infection control, so we widened the scope of the inspection to become a focused inspection which included the key questions of safe, effective and well-led.

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.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to safe care and treatment, staffing, people being treated with dignity and respect, protecting people from abuse, capacity and consent and effective management at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.