Archived: Clifton Meadows

The service did not have a registered manager. 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. The registered manager left the service in December 2016. A new manager had been appointed but did not stay, they left in June 2017. The deputy manager has been covering this post from June 2017 and had applied to CQC become the registered manager.

Clifton Meadows is a care home for older people who require personal care. It also accommodates people who have a diagnosis of dementia. The service is two separate buildings one is called Wentworth and can accommodate up to 25 people with advanced dementia, the other unit is called Solway and can accommodate up to 41 people. At the time of our inspection there were 53 people using the service.

Staff we spoke with understood what it meant to safeguard vulnerable people from abuse, and they were confident management would take any concerns they had seriously and take appropriate action.

We found there were sufficient staff on duty to meet people’s needs, However, we observed on Wentworth unit that deployment of staff could be improved to ensure people were supported in communal areas at all times.

Risks to people had been identified but we found these were not always followed. Systems were in place for safe management of medicines. However, we identified a number of errors that meant systems had not always been followed to ensure people received medications as prescribed.

People were not always protected by the prevention and control of infection procedures. We found the service was not kept clean or hygienic to ensure people were protected from acquired infections.

We found procedures were followed for the recruitment of staff. Staff supervision took place and staff told us they felt supported by the new manager. Staff received training that ensured they had the competencies and skills to meet the needs of people who used the service.

We found the service did not always meet the requirements of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). Most staff we spoke with had a satisfactory understanding and knowledge of this, and people who used the service had been assessed to determine if a DoLS application was required. However, we found the conditions attached to people's authorised DoLS were not always met.

People received a well-balanced diet, and we saw people accessed health care services as and when required. Referrals were made quickly to health care professionals when people’s needs changed.

People and the relatives we spoke with all said the staff were kind and caring. People also said staff respected them and maintained their dignity.

Care plans identified people’s needs and had good detail of how to manage people’s needs. However, we identified that some documentation did not always reflect peoples changing needs.

People told us they were listened to and were confident any concerns would be dealt with. Activities took place, however, people told us more could be organised and there was out of date information displayed.

There were processes in place to monitor the quality and safety of the service. Some of the issues we had identified had been picked up and an action plan was in place to resolve the issues. However, these processes were not always effective as not all the issues we had identified had been picked up.

During our inspection, we found two breaches 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.

Is the service safe?

Through care planning and risk assessments, care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. People were protected from the risks of inadequate nutrition and dehydration.

People who use the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. The provider had taken steps to provide care in an environment that is suitably designed and adequately maintained. The property appeared to be well-maintained and clean.

Is the service effective?

People's needs were assessed and care and treatment was planned and delivered in line with their individual care plan. We checked eight care plans, and saw that each one contained assessments of people's care and support needs. These assessments described the steps staff should take to ensure each person's needs were met. Staff had received appropriate training to meet the needs of people living at the home. People contributed to the running of the home through residents meetings. One person who was using the service at the time of the inspection told us, 'I get involved in everything I can, it's my home after all.'

Is the service caring?

People were treated with respect and dignity by the staff. We saw that whenever staff helped people they ensured they discussed with people first what was going to happen. One person told us, 'It's not home but it's the next best thing, I like it here.' Another said, 'Good food and conversation, what more do you need?'

Is the service responsive?

The service supported people in accessing the community to pursue their interests and aspirations. Staff acted on people's needs and in accordance with their wishes. Where people's health needs changed, staff ensured that their support accommodated their changing needs. The service responded positively to feedback from customer surveys, for example we saw pictorial menus were in place in response to people's feedback..

Is the service well led?

People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard.

The provider had an effective system to regularly assess and monitor the quality of service that people received. The provider also had effective systems in place to identify, assess and manage risks to the health, safety and welfare of people who used the service and others. Staff told us that they felt supported and well led. They also said that regular auditing of

varying aspects of the home ensured they knew the standards to be achieved.

Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. One person who used the service told us: 'The staff are just wonderful.' Another person told us: 'It's not home but it's a great place to be.'

People were protected from unsafe or unsuitable equipment because the provider ensured that all equipment was regularly serviced, to ensure its safety.

People were cared for, or supported by, suitably qualified, skilled and experienced staff. We saw that before being employed by the provider, each staff member underwent a documented interview which examined their experience and understanding of the role.

There was an effective complaints system available. Comments and complaints people made were responded to appropriately. The provider had a comprehensive complaints system in place, and information was provided to people who use services, their relatives and representatives so that they understood how to make a complaint.

People were protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were maintained.

Regular checks were carried out to ensure that medicines were handled safely and appropriate action taken when concerns were identified

People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard.

The provider had an effective system to regularly assess and monitor the quality of service that people receive.

Staff were not supported to deliver care and treatment safely and to an appropriate standard.

The provider did not have an effective system to regularly assess and monitor the quality of service that people receive.

People were not protected from the risks of unsafe or inappropriate care and treatment.