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Care Services

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Carter House, London.

Carter House in London is a Nursing home specialising in the provision of services relating to accommodation for persons who require nursing or personal care, caring for adults over 65 yrs, caring for adults under 65 yrs, dementia and treatment of disease, disorder or injury. The last inspection date here was 22nd February 2017

Carter House is managed by Country Court Care Homes 2 Limited who are also responsible for 15 other locations

Contact Details:

    Address:
      Carter House
      1-2 Farnham Gardens
      London
      SW20 0UE
      United Kingdom
    Telephone:
      0

Ratings:

For a guide to the ratings, click here.

Safe: Requires Improvement
Effective: Good
Caring: Good
Responsive: Good
Well-Led: Good
Overall: Good

Further Details:

Important Dates:

    Last Inspection 2017-02-22
    Last Published 0000-00-00

Local Authority:

    Merton

Link to this page:

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Inspection Reports:

Click the title bar on any of the report introductions below to read the full entry. If there is a PDF icon, click it to download the full report.

17th January 2017 - During a routine inspection pdf icon

Carter House is a care home that can provide nursing and personal care to up to 45 older people. The home is built over four floors and includes a residential, nursing, dementia and intermediate care units. The intermediate care unit with support from local NHS trusts’ community healthcare professionals provides short term care and rehabilitation for up to six weeks for people discharged from hospital. The aim of the unit is to help people to maintain their independent living skills and minimise the risk of them being readmitted to hospital. At the time of our inspection 40 people were using the service of whom approximately half were living with dementia.

The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have a legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.

At our last comprehensive inspection on 18 August 2015 the service was rated ‘Requires Improvement’ overall and for two key questions ‘Is the service caring?’ and ‘Is the service responsive?’ This was because care plans were not personalised and did not contain all the information staff required to meet people’s needs and wishes, and nor was people’s privacy and dignity always respected by staff. We asked the provider to take action to make improvements. At this inspection we found the provider had made the necessary improvements, most notably to the way staff respected the privacy and dignity of people they provided personal care to. We also found the provider had introduced a new care plan format that included more detailed and person centred information. Overall the service demonstrated they now met the regulations and fundamental standards.

However, given the layout of Carter House, we did not consider there were always enough staff suitably deployed in the home to meet people’s care and support needs. We asked the provider to review the staffing levels in relation to the current needs of people using the service as our findings showed that their needs might not have been effectively met. The provider increased the number of care staff working on the residential unit (top floor) during the day from one to two on the second day of our inspection.

There were robust procedures in place to safeguard people from harm and abuse. Staff were familiar with how to recognise and report abuse. The provider assessed and managed risks to people’s safety in a way that considered their individual needs. Recruitment procedures were designed to prevent people from being cared for by unsuitable staff. The premises and equipment were safe for people to use because staff routinely carried out health and safety checks. Medicines were managed safely and people received them as prescribed.

Staff received appropriate training and support to ensure they had the knowledge and skills needed to perform their roles effectively. People were supported to eat and drink enough to meet their dietary needs. They also received the support they needed to stay healthy and to access healthcare services.

Staff were caring and treated people with dignity and respect and ensured people’s privacy was maintained particularly when being supported with their personal care needs. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

People received personalised support that was responsive to their individual needs. Each person had an up to date, personalised care plan, which set out how their care and support needs should be met by staff. This meant people were supported by staff who knew them well and understood their needs, preferences and interests. Staff encouraged people to actively participate in leisure activities, pursue their social interests

18th August 2015 - During a routine inspection pdf icon

This inspection took place on 18 August 2015 and was unannounced. The last Care Quality Commission (CQC) inspection of the home was carried out on 1 October 2013, when we found the service was meeting all the regulations we looked at.

Carter House is a purpose built care home that is split over four floors which provides dementia, nursing, and personal care for up to 45 older people. At the time of our visit, there were 39 people using the service, the majority of whom were living with dementia.

The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have a legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.

Although people said they were happy with the care they received and spoke positively about the staff that cared for them, we observed an incident where staff had not respected a person's privacy and dignity when they had provided this individual with personal care. We also found that although the provider had created a more person centred care plan format, the new care plans had yet to be fully introduced at the time of our inspection. This meant some care plans did not contain all the current information staff needed to meet the needs of the people using the service.

People were safe living at the home. Staff knew what action to take to ensure people were protected if they suspected they were at risk of abuse or harm. There were appropriate plans in place to ensure identified risks to people were minimised. Managers ensured regular maintenance and service checks were carried out at the home to ensure the environment was safe.

There were no restrictions on visiting times and we saw staff made peoples’ guests feel welcome. Staff encouraged people to participate in meaningful social activities that interested them.

Consent to care was sought by staff prior to any support being provided. People were involved in making decisions about the level of care and support they needed and how they wanted this to be provided. Where people's needs changed, the service responded by reviewing the care and support people received, which included their care plan.

People were supported to keep healthy and well. Staff ensured people were able to access community based health and social care services quickly when they needed them. Staff also worked closely with other health and social professionals to ensure people received the care and support they needed. People were encouraged to drink and eat sufficient amounts to reduce the risk to them of malnutrition and dehydration. People received their medicines as prescribed and staff knew how to manage medicines safely.

There were enough suitable staff to care for and support people. Managers continuously reviewed and planned staffing levels to ensure there were enough staff to meet the needs of people using the service.

Managers understood when a Deprivation of Liberty Safeguards (DoLS) authorisation application should be made and how to submit one. This helped to ensure people were safeguarded as required by the legislation. DoLS provides a process to make sure that people are only deprived of their liberty in a safe and correct way, when it is in their best interests and there is no other way to look after them.

The area and registered managers both demonstrated good leadership and used learning to drive improvement. There were arrangements in place to regularly seek the views of people and their relatives about how the service could be improved. The registered manager ensured staff were clear about their duties and responsibilities to the people they cared for and accountable for how they were meeting their needs.

They proactively sought the views of people, relatives, visitors, staff and external health care professionals about how the care and support people received could be improved. If people had concerns or complaints about the care and support they experienced, there were arrangements in place to deal with these appropriately.

Managers carried out regular checks of key aspects of the service to monitor and assess the safety and quality of the service that people experienced and took appropriate action to make changes and improvements when this was needed. Managers used learning from incidents and inspections to identify how the service could be improved. They also worked proactively with other health and social care professionals to share and learn best practice so that the quality of care and support people experienced continuously improved.

1st October 2013 - During a routine inspection pdf icon

At the last inspection in January 2013 we found that the provider was not meeting two of the essential standards of quality and safety. The provider sent us an action plan to show how they would become compliant with the regulations. We carried out this inspection to check that the action plan had been completed and as a routine inspection of other essential standards.

We spoke with some people at the service. Most people did not have the capacity to share their views regarding their care so we carried out a structured observation in order to make judgements about the care that individuals received. We observed interactions with staff and the care provided. We saw people were treated with respect and that staff were responsive to people’s needs.

We spoke afterwards to three relatives of people who used the service who visit regularly. They spoke positively of the service. One of them said “It has been fantastic for (my relative), I am always kept well informed.” Another told us "I cannot fault the care given."

At the last inspection we had found that care records were not always up to date and did not contain enough detailed information on how to deliver care. We found that this time the records were up to date and, although some were not personalised, most contained details of people’s preferences and the care to be provided.

People said they felt safe and well cared for. Staff were knowledgeable about safeguarding procedures and how to raise any concerns if needed. We saw that the service worked co-operatively with a range of other health professionals.

We saw evidence that regular checks were made of equipment at the service and that there was an adequate supply of hoists and wheelchairs.

At the last inspection we found that there were not enough qualified skilled and experienced staff on some floors at all times to meet people's needs. Since our last inspection the service had carried out an assessment of people’s needs and introduced additional staff on most of the floors. Staff told us they felt better able to respond to people’s needs than previously. While some people told us there were enough staff, three people said that staff were sometimes too busy to help them with small tasks of daily living.

29th January 2013 - During a routine inspection pdf icon

We spoke to people who used the service, a relative and health professionals who visited on the day of the inspection.

Most people we spoke to were happy with the care they received. They felt the staff looked after them well. One person said “the staff are very good you just have to ask if you want anything” another said “the staff are wonderful.” Most people felt they were consulted about their care and offered choices. We saw from records that their views about the home were sought through a variety of methods. Staff said they were trained and supported to do their work and we saw from records that regular induction and refresher training was being undertaken.

However we were concerned about the lack of daily activities for people who used the service and that their care records were not always updated or reviewed.

We observed the staff busy with the daily routine and noted that the staffing levels on some floors at some times were not always adequate to meet the variety of needs of the people who used the service.

6th December 2010 - During an inspection in response to concerns pdf icon

There are a number of people who live at Carter House who have a diagnosis of a dementia and people who live at the home have varied methods of communication. Some people were able to express their views clearly, others could not.

We spoke to one person who uses the service and two relatives about their experience of care at the home. Without hesitation all three were full of praise for the standard of care at the home. They could not list any issue that would lead them to request or expect improvements in the standard of care given or the environment.

The feedback we received from the people who use the service was in the main very positive. Typical comments about the food included, "very nice, and "its not bad". One person told us the lunchtime meal had been "perfect".

We spoke to a number of people who use the service and asked them if they liked the food. Typical comments included, "very nice, and "its not bad". One person told us the lunchtime meal had been "perfect".

 

 

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