Clarence House

Updated 18 November 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

This inspection was carried out by 2 inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Clarence House is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under 1 contractual agreement dependent on their registration with us. Clarence House is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

Before the inspection, we reviewed all the information we held about the service including the previous inspection report and notifications received by the CQC. A notification is information about important events which the service is required to tell us about by law. We requested feedback from other stakeholders. These included Healthwatch Kirklees, the local authority safeguarding team and commissioners. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

During the inspection, we spoke with 3 people using the service and 2 relatives of people using the service. We requested feedback from 1 healthcare professional who regularly visited the service. We spent time observing care in the communal lounges.

We spoke with 4 staff members; this included the registered manager and care workers. We looked at the care records for 2 people living at the home and 4 medication records. We looked at training for staff. We also reviewed various policies and procedures and the quality assurance and monitoring systems of the service.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We reviewed additional evidence requested.

Updated 18 November 2022

About the service

Clarence House provides accommodation and personal care for up to 11 people who have a learning disability and complex behavioural or mental health related support needs. At the time of this inspection, there were 9 people living at the service.

People’s experience of using this service and what we found

Right Support:

People were positive about the support they received and told us staff listened to them. People were engaged in varied activities of their interest, including activities to enhance their skills and learning.

Risks to people’s care were assessed and managed well. Medication was managed safely. The service followed safe recruitment practices and we found enough staff were available to support people. At the time of our inspection, there was an outbreak of COVID – 19 at the service. We found the provider was following current guidelines in relation to infection prevention and control and visiting, although some staff had to be reminded at times by the registered manager to wear their personal protective equipment appropriately.

Right Care:

People had to request staff’s support to access some areas at the home. We discussed with the registered manager if people’s movements were being restricted and what measures were in place to prevent this happening unnecessarily. We were reassured by the evidence reviewed and feedback gathered from people, relatives and staff this was not an issue and appropriate measures were in place. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

The provider completed person-centred assessments and care plans were updated when required. We found some areas of people’s care plans were not always written from people’s point of view. We discussed this with the registered manager and saw evidence of this being immediately reviewed.

Right Culture:

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture. There was a person-centred culture at the service. Support provided promoted people’s choice and control. Communication plans had been developed to ensure staff communicated well with people. We observed positive interactions between people and staff. People told us they were able to lead fulfilling lives and develop their interests.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 7 June 2018).

Why we inspected

The inspection was prompted in part due to concerns received about how risks to people’s care were managed. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

We found no evidence during this inspection that people were at risk of harm from this concern. Please see safe and well-led sections of this full report.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.