CQC report explained · a nursing home, run by Welltower

Charlotte House

Snowy Fielder Waye, Isleworth, TW7 6AE

Goodpublished 25 November 2023, 2 years ago

Rated Good: inspectors found the service performing well and meeting their expectations.

The five questions inspectors ask

Safe?: Requires improvement; Inspectors found medicines were not always stored or given safely. They also found unsecured cleaning products, a choking risk that was not properly supervised and some cleaning shortfalls, although the provider took action after the visit.
Effective?: Good; People's needs and choices were assessed and reviewed. Staff were trained and supported, people had enough to eat and drink, and they could access healthcare services.
Caring?: Good; People and relatives described staff as kind and caring. Inspectors saw staff treating people politely, respecting privacy and involving them in decisions.
Responsive?: Good; Care was personalised and reflected people's preferences. The home supported communication, activities, family contact and end-of-life wishes, and complaints were investigated.
Well-led?: Good; Managers had systems for audits, feedback and learning from incidents. Inspectors found a positive culture, although some safety monitoring systems had not worked effectively.

The latest report, explained

What inspectors found, November 2023

Rated Good overall, but inspectors found medicines, some safety risks and cleaning needed improvement.

Inspectors visited without notice on 17 and 25 October 2023. They spoke with people living at the home, relatives and staff. They observed care and checked care records, medicines, recruitment records, audits, equipment and the environment.

People and relatives generally said they felt safe and well cared for. Inspectors found kind staff, personalised care, good support with food, health needs, activities and end-of-life care. The home was also found to be effective, caring, responsive and well-led.

The main concerns were about medicines, unsecured cleaning products, a person at risk of choking being left with food and drink, and some areas not being properly cleaned. The provider took action after the inspection to reduce these risks and improve monitoring.

The overall rating is Good, but Safe is Requires Improvement. This means most aspects of care were good, but there was limited assurance that people were always protected from avoidable harm.

What inspectors praised

Kind and respectful staff
People and relatives spoke positively about staff. Inspectors saw staff treating people kindly, knowing them well and respecting their privacy.
“We saw staff were kind and caring when they were supporting them. They knew people well and spoke with them politely.” from the report
Personalised care
Care plans included detailed information about people's needs and preferences. People and relatives were involved in reviewing their care.
“People received care which met their needs and reflected their preferences.” from the report
Activities and family contact
People could take part in group and individual activities, outings and celebrations. Visitors were welcome and staff supported people to keep in touch with family and friends.
“People were supported to take part in a range of different activities.” from the report
End-of-life support
Staff had training in end-of-life care and worked with specialist teams. Care plans recorded people's wishes and families could stay with their loved ones.
“The staff worked closely with the palliative care teams to help support people to have comfortable and pain free care.” from the report
Good staff support
Staff received induction, regular training and meetings with managers. The provider checked that new staff were suitable and competent.
“New staff completed inductions which involved a range of training, shadowing experienced workers and assessments of their skills and knowledge.” from the report

What inspectors were concerned about

Medicines were not always managed safely
serious
Some medicines were stored at the wrong temperature, one person received the wrong formulation and an expired medicine was found. The provider acted after inspectors identified these issues.
“Medicines were not always safely managed.” from the report
Cleaning products and chemicals were not always secure
serious
Some cleaning products were accessible, and a sluice room containing equipment and chemicals was not locked. Managers secured the items during the inspection.
“Some cleaning products were not stored securely.” from the report
Choking risk was not properly managed on one occasion
serious
A person whose care plan said they were at risk of choking was left alone with food and drink. Managers agreed to investigate and improve supervision.
“A person whose care plan stated they were at risk of choking, had been left in a room with food and drink.” from the report
Some areas needed better cleaning
needs fixing
Inspectors found that some kitchenette areas in the main dining rooms were not properly cleaned. The provider said it had introduced stronger checks.
“On the day of the inspection, some areas of the environment were not properly cleaned.” from the report
Call bell access and delays
needs fixing
Some people said they could not reach their call bells and that staff sometimes took a while to respond. Most responses were prompt according to the provider's audit, but managers agreed staff should explain delays.
“Some people told us they could not reach their call bells.” from the report

Questions to ask them, based on this report

01What changes have been made to medicines storage, expiry-date checks and checking that people receive the correct formulation?
02How do you now make sure cleaning products, chemicals and sluice rooms are secure at all times?
03How will you make sure people at risk of choking are supervised whenever they eat and drink?
04How do you check that all areas, including dining-room kitchenettes, are cleaned properly?
05How do you make sure people can reach their call bells and understand what happens if there is a delay?

This was an unannounced inspection of all five key questions, with the 25 October visit specifically checking medicines management; infection prevention and control was also considered. This explanation was written from the published report of 25 November 2023 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.

The story over the years

Every inspection of Charlotte House

5 rated inspections over 8 years: the service has improved, from Inadequate to Good.

November 2023Goodcurrent rating
Safe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
Read what inspectors found at Charlotte House →
February 2022Inspected but not rated
Safe: Inspected but not rated
We are reading this report · the original is on cqc.org.uk
May 2018Goodstayed Good
Safe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
Read this report on cqc.org.uk
July 2016Goodup from Requires improvement
Safe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
Read this report on cqc.org.uk
March 2016Requires improvementup from Inadequate
Safe: GoodEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
Read this report on cqc.org.uk
December 2015Inadequate
Safe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: InadequateWell-led: Inadequate
Read this report on cqc.org.uk
October 2014
Report published without a new overall rating.
Read this report on cqc.org.uk
July 2014
Report published without a new overall rating.
Read this report on cqc.org.uk
March 2014
Report published without a new overall rating.
Read this report on cqc.org.uk
October 2013
Report published without a new overall rating.
Read this report on cqc.org.uk
January 2013
Report published without a new overall rating.
Read this report on cqc.org.uk
October 2012
Report published without a new overall rating.
Read this report on cqc.org.uk
January 2011
Registered with the Care Quality Commission on 11 January 2011.

Ratings and report dates from the Care Quality Commission. A service can also be visited without a new rating being published, so the timeline shows published inspections, not every contact the CQC has had with the service.

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