Clarence House & The Granary

Updated 28 July 2021

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 Care Act 2014.

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

The inspection was carried out by one inspector.

Service and service type

Clarence House & The Granary is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave Clarence House & The Granary a short period notice of the inspection. This was due to the COVID-19 pandemic to ensure we had enough information prior to the inspection to promote safety.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service.

The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

During the inspection

We spoke with five people who lived at Clarence House & The Granary about their experience of the care provided. We also observed the care and support people received as some people were not able to share their experiences with us. We spoke with three members of care staff, a senior carer and the registered manager.

We looked at a range of records. This included three people’s care records and multiple medication records. We looked at three staff files in relation to recruitment and staff supervision.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked, for example, at quality assurance records, minutes of staff meetings and the provider’s policies.

Updated 28 July 2021

About the service

Clarence House & The Granary is a residential care home providing personal care for up to 21 people who live with learning disabilities. The accommodation consists of two houses situated in the same grounds. Clarence House can accommodate up to 12 people; The Granary can accommodate up to nine people. At the time of the inspection 16 people were living at the home.

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

Quality monitoring systems were in place; however they had failed to identify some of the shortfalls found at inspection. In addition, analysis and follow up of specific incidents had not been robustly documented.

Staff knew how to manage risks identified in relation to people’s care and support. However, care plans and risk management plans did not always reflect the knowledge staff had and applied in practice.

Staff knew how to keep people safe from abuse and were confident to raise concerns with the registered manager or external agencies.

There were enough staff to support people’s needs and wishes. Staff had received training for their roles. Safe recruitment procedures were in place for new staff.

Medicines were administered safely, and we were assured measures were in place to prevent the spread of infection to people, staff and visitors.

There was a positive and open culture in the home. People, their relatives and staff were encouraged to share their views about the services provided.

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.

This service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture such as choice, promotion of independence and inclusion.

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 24 January 2020).

Why we inspected

The inspection was prompted in part by notification of a specific incident. Following which a person using the service died. This incident is subject to a coronial investigation. As a result, this inspection did not examine the circumstances of the incident.

The information CQC received about the incident indicated concerns about the management of falls risks. This inspection examined those risks.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this report.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.