Charnley House

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Staff said they received enough training, supervision and appraisal to support them in their role. DoLS (Deprivation of Liberty Safeguards) applications were managed effectively, as were processes regarding the MCA (Mental Capacity Act). Initial assessments were completed when people first moved into the home. People said they received enough to eat and drink. Efforts had been made to make the environment more suitable for people living with dementia, although further improvements could be made.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People received care that was based on their needs and preferences. Several people we spoke with were unsure if they were involved in reviewing care plans, but relatives told us they had spoken with staff about how people needed their care to be delivered. One relative said, “I have power of attorney and was involved in (person’s) care plan initially when they came in.”

Staff appeared to know people well and we saw them supporting individuals in ways which reflected their assessed needs. For example, when people needed assistance with eating, staff sat with them and offered the support they needed at an appropriate pace, or assisting people with their mobility around the home.

Assessments of people’s care were undertaken when they first moved to Charnley House and people were involved with these if they were able to. Monthly reviews of care plans were undertaken, although it was unclear if people living at the home were involved in this process.

People told us staff provided them with all the care and support they needed.

Staff demonstrated an understanding about people’s care and the support they required. An electronic care planning system was used, which staff updated via hand held devices. Staff said this enabled them to establish the care people required.

At the last inspection, concerns were raised about the home environment not being suitable for people living with dementia. Decoration, signage and design layout had not promoted people's independence. People did not always have their name or photograph on their bedroom doors and the floors and walls of the ground floor corridors were painted a similar color. This didn’t allow people to be able to differentiate the different parts of the corridor.

At this inspection, we saw some improvements had been made. For example, hand rails had been painted in different colors to make them easier to see. There was also signage towards different parts of the home, such as lounge and the dining room.

Most rooms had a name and number on them, although some did not. There were no photographs of people on their door. The registered manager said this wasn’t necessarily what people wanted and these rooms were also vacant at the time of the assessment. We recommend these are added to all bedrooms when these become occupied.

We saw lots of good examples of how the home worked with other services with regards to people’s care. For example, being referred to dieticians and Speech and Language Therapy (SaLT) if there were concerns about a person. We also saw district nurses visiting the home during the assessment to provide input and advice about people’s skin.

Managers and staff told us they worked closely with various external health professionals and welcomed their views, advice, and best practice ideas. Staff spoke about how they had supported people in the home and liaised with healthcare professionals when they noticed some people’s mobility had deteriorated and when they had some unexpected weight loss.

We spoke with several visiting professionals throughout the assessment who told us staff followed their advice and were proactive in making new referrals when required.

People received timely support from doctor’s and GP’s (General Practitioner’s) when they needed it and we saw this was recorded within people’s care records. Referrals were made to other health professionals in a timely way, although some care plans were not always updated when people's needs changed, for example with regarding to nutritional intake.

People using the service told us they had access to health care professionals as required such as GP services. This enabled them to maintain good health and ensure the relevant people had oversight of their wellbeing.

Staff knew people well and worked in partnership with health professionals such as the GP. GP visits helped identify risks to people’s health and wellbeing early and supported staff to follow guidance to prevent and further deterioration.

Some staff received training in how to meet and appropriately manage people’s health care needs and conditions, for example oral health, seizures, diabetes and stroke awareness. Not all staff had completed this however according to the training matrix. We were told plans were in place for this to be completed.

We also found gaps in some people’s oral health care charts where they may need support from staff to clean their teeth. The registered manager told us further training was being explored in this area to ensure this was done correctly.

People received coordinated care and were treated well and as an individual. People were seen and treated as individuals each having their own needs assessed and reviewed.

Staff told us they met regularly to discuss any changes to people’s needs and the packages of care they received and we observed handovers and meetings amongst staff during the assessment.

The service people received was monitored by management through a range of different methods including care plan reviews and audits.

People said staff sought their consent before delivering any care.

Staff understood about how to seek consent where needed and also recognised how people may also want to do things for themselves.

Correct processes were followed where people didn’t have the capacity to consent to the care they received. We saw capacity assessments were completed and best interest decisions undertaken if people were unable to make their own choices and decisions.

DoLS (Deprivation of Liberty Safeguards) applications were completed where any restrictions were in place which could compromise people’s safety. These were re-applied for when they expired. Staff received MCA/DoLS training, although we noted some newer staff still need to complete this according to the training matrix.