This inspection was unannounced and took place on 13 March 2018.

We last inspected the home on 16 November 2016 when the home was rated 'Requires Improvement' overall. We identified two breaches of regulations. These were;

Regulation 12 Safe care and Treatment as we found people's care plans were not person-centred.

Regulation 11 Need for consent as we found evidence of consent was not always available. Appropriate records to show people's capacity had been assessed were not completed.

Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions of safe, effective, caring responsive and well led to at least good. At this inspection, we found the provider had made all the required improvements and addressed the concerns highlighted last time we visited the service. The management team were also responsive to concerns we raised during our inspection.

Charlton Court Nursing Home is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission regulates both the premises and the care provided, and both were looked at during this inspection. This service provides nursing and personal care for up to 64 people. At the time of this inspection there were 58 people using the service.

There is a registered manager in post. A registered manager is a person who has registered with CQC 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.

People's care plans and risk assessments did not always contain guidance for staff. The provider and the registered manager were aware of this and had already began to take appropriate action.

The registered manager ensured staff completed training on the Mental Capacity Act 2005 (MCA) and associated Deprivation of Liberty Safeguards (DoLS). Where people were deprived of their liberty to safeguard them, we found up-to-date records were in place to support decisions made by people. The registered manager and staff ensured good standards in obtaining and recording people's consent to their care.

Arrangements were in place to ensure people received their medicines safely.

People who used the service told us they felt safe. The staff we spoke with had a good understanding of safeguarding, whistleblowing and how to report any concerns.

Staff and people we spoke with said staffing levels were sufficient to meet their requirements. We looked at recruitment processes and found staff had been recruited safely. All staff received an induction when they started working at the home. Staff received regular supervision and appraisal. Staff also received all the necessary training relevant to their roles.

All of the people we spoke with during the inspection made positive comments about the care and support provided. People told us they felt staff treated them with dignity and respect and promoted their independence where possible. People felt the staff were responsive to their needs. Each person had their own care plan, which was person centred and included their choices and personal preferences.

People were supported to express themselves and communicate through a range of different methods. They had individual communication support plans in place, which were followed by staff.

People had access to a range of activities and care staff spent time socialising with them. There was a happy atmosphere in the home and most people were relaxed and animated. People were supported to maintain relationships with relatives and friends.

People were offered a variety of meal options, such as three choices at lunch. They told us they enjoyed their meals and had ample portions. Risk assessments were completed regularly to monitor people

We inspected Charlton Court Nursing Home on 16 November 2016. The visit was unannounced. Our last inspection took place in July 2015 where we identified two breaches of legal requirements regarding staffing. The provider sent us an action plan telling us what they were going to do to ensure they were meeting the regulations and a clear time frame in which they would complete this. On this visit we checked and found improvements had been made in all of the required areas.

Charlton Court Nursing Home is a large, purpose built nursing home with accommodation for up to 60 people. It is located in a residential area of Leeds close to the boundary with Bradford. There are a number of communal areas including lounges, dining rooms and a garden.

At the time of our inspection the service had a manager who was going through the registered manager’s process. 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.

People who used the service and their relatives told us the service was safe. The home looked well maintained, clean and tidy, and checks were carried out to make sure the premises and equipment was safe.

There were sufficient staff with the right skills and experience; several staff told us the staffing arrangements had improved. Appropriate checks were carried out before staff were employed and medicines were managed safely.

People who used the service and their relatives told us they were happy with the staff that provided care and support. Staff we spoke with said they felt well supported and understood their role as they received training that made sure they knew how to do their job well. Staff we spoke with understood their responsibilities around how they should support people with decision making. People enjoyed the food, and had plenty to eat and drink.

People told us they were well cared for and visiting relatives told us the service was caring. We observed staff supported people in a calm, compassionate and caring way. Staff were cheerful and friendly. When staff assisted people to move and transfer they explained what was happening and reassured them throughout. Systems were in place that ensured people accessed healthcare services.

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Staff responded to people’s individual needs and delivered personalised care. People’s care plans and other records showed their needs had been initially assessed and care was usually planned, although there was inconsistency with the level of detail within the care plans and we saw examples where care plans had not been followed. Care plans did not contain appropriate records to show people’s capacity to make different decisions had been assessed. The manager had identified care plans as an area for improvement and action was also being taken to improve activities in the home.

People told us they would talk to staff and management if they had any concerns and complaints had been responded to in a way which resolved the issue where possible to the person’s satisfaction. Several written compliments had been received.

We received positive feedback from people about the manager. Resident and relative meetings and staff meetings were held. We saw from minutes of meetings that people had opportunities to discuss the service and were informed of planned events.

At the inspection we reviewed a wide range of audits which had been completed at the service which were used to monitor the quality and safety of service delivery.

We have identified breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 during this inspection. You can see what action we told the provider to take at the back of the full version of the report.

We inspected the service on 21 July 2015. The visit was unannounced. Our last inspection took place on 23 January 2014 and there were no identified breaches of legal requirements.

Charlton Court Nursing Home is a large, purpose built nursing home with accommodation for up to 60 people. Accommodation is based on two levels, with a small dementia unit on the first floor. The service is located in a residential area of Leeds close to the boundary with Bradford. There are a number of communal areas including lounges, dining rooms and a garden.

There was not 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.

We looked at staff personnel files and saw the recruitment processes in place were not robust enough to ensure staff were suitable to work with vulnerable adults.

There was not always sufficient numbers of staff deployed in order to meet the needs of people in the home.

During our visit we saw people looked well cared for. We observed staff speaking in a caring and respectful manner with people who lived in the home. Staff demonstrated they knew people’s individual characters, likes and dislikes.

We found the service was meeting the legal requirements relating to Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). People’s care records demonstrated that all relevant documentation was securely and clearly filed.

Staff we spoke with told us they were aware of their responsibilities with regard to safeguarding people who lived at the home. They were able to tell us about the signs and symptoms of possible abuse and how they would report this.

We saw the provider had a system in place for the purpose of assessing and monitoring the quality of the service. Records showed that the provider investigated and responded to people’s complaints, in line with the complaints procedure in place.

The home met people’s nutritional needs and most of the people told us the food was good and they had a choice of food.

People’s medicines were managed safely and people received appropriate healthcare support. We saw people were referred to relevant healthcare professionals in a timely manner.

There was an on-going training programme in place for staff to ensure they were kept up to date and aware of current good practice.

We found the home was in breach of Regulation 18 (1) (Staffing) and 19 (Fit and proper persons employed) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

We spoke with two people who used the service and they told us they enjoyed living at the home and were very complementary about the care and support provided by the staff. We saw staff were friendly and polite and offered choices to patients. We found people who used the service were treated with dignity and respect.

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

There were effective recruitment and selection processes in place.

We also found the provider had an accurate Statement of Purpose (SoP) and it contained the necessary information including aims and objectives, the kinds of services provided, names of key individuals working for the service, legal status of the provider and details of the office address.

There was an effective complaints system in place. The nurse in charge told us if complaints were made they would be responded to appropriately.

People told us they were happy with the care provided. People said they were able to choose what they wanted to do each day, decide if they wanted to join in with the activities and what clothes they wanted to wear. All three people we spoke with told us they could choose what time they got up, what time they went to bed and what they had to eat. Everyone told us there were plenty of activities and they enjoyed taking part. People told us that they could make decisions about their own care and how they were looked after.

People said they were happy with the care provided and were involved in planning their care and support needs. Everyone we spoke with told us their dignity was respected and confidentiality was always maintained. They said that staff encouraged them to be as independent as possible.

People who used the service told us they were happy living at the home and they were well looked after. They told us that they felt safe at the home and they would tell staff or the manager if they were worried about anything.

We spoke to people who live at Charlton Court Nursing Home. They told us that staff were kind and helpful.

One person said “I love music, it makes me happy inside, and I’m looking forward to dinner, its shepherd’s pie today, my favourite.”

Another person told us they had been very ill in hospital, and had been very well looked after at Charlton Court Nursing Home which felt very homely.