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Clyde House Limited Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 6 December 2017

This was an unannounced inspection which took place on 26 and 28 September 2017, it was brought forward following the inspection of another of the registered provider’s services in the area. Heaton Lodge.

We had previously inspected the service in October 2015 when we identified five breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because medicines were not being safely managed, the premises were not always maintained securely, people were not protected against the risks associated with unsafe or unsuitable premises, there was poor infection control and lack of effective systems to regularly assess and monitor the quality of service people received.

During this inspection we checked if the required improvements had been made. We found the provider was still in breach of one of those regulations. We also found a further breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This related to the provider failing to provide information requested by the Care Quality Commission. You can see what action we told the provider to take at the back of the full report.

Clyde House is registered to provide personal care and accommodation for up to 17 adults with mental health conditions. There is a lounge, dining room and kitchen on the first floor and there are bedrooms and bathrooms on all three floors of the property. At the time of our inspection 10 people were living at the service.

Medicines were managed safely and people told us they received their medicines as prescribed.

To minimise the risk of people smoking in their bedrooms, a new smoking shelter had been purchased and placed at the front of the premises for easy access by people who used the service.

Staff we spoke with demonstrated a good understanding of the need for safeguarding procedures and their role in protecting vulnerable people.

People living in Clyde House told us they were happy with the care and support they received.

Staff had received the training they needed to carry out their job roles effectively.

People living in Clyde House told us they had been involved in making decisions about their care needs and had consented to the care and support that was being provided.

People who used the service were complimentary about the support staff provided them with.

The service promoted people’s independence and encouraged people to maintain contact with the local community, their relatives and friends.

People who used the service told us they were involved in reviewing their care plans and risk assessments.

Staff used daily logs in which they recorded the care and support that had been provided to the people who used the service. We found some of these logs lacked detail and reviews of care plans did not clearly indicate that people who used the service had been involved in those reviews. We recommend the service improves the way information is recorded in daily logs and that reviews of care plans indicate if the person had been involved.

At our last inspection of the service in October 2015 there was a lack of robust systems being in place to monitor the quality of service people received. Since that inspection, a new auditing system had been put in place but, at the time of our inspection was not fully operational.

The service is required to have a registered manager in place. 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 service did not have a registered manager. The last manager had left the service in May 2017. The provider was working at the service whilst a new manager was being recruited. The registered provider had also employed a quality consultant who was advising them on improvements that needed to be made and how those improvements could be made.

Inspection areas

Safe

Good

Updated 6 December 2017

The service was safe

Medicines were managed safely.

Suitable arrangements were in place to help safeguard people from potential abuse.

Appropriate window restrictors had been put in place to keep people safe.

People who used the service told us they thought enough staff were on duty at any one time to meet their needs.

Effective

Good

Updated 6 December 2017

The service was effective

Staff receiving appropriate training.

People we spoke with were complimentary about the food that was made available.

People told us they were involved in making decisions about their care needs.

Caring

Good

Updated 6 December 2017

The service was caring

People told us staff were very good and knew the type of help people needed.

Staff knew people well and positive relationships had been developed.

People's independence was supported and promoted.

Responsive

Requires improvement

Updated 6 December 2017

The service was not always responsive

Improvements were needed to the way in which information about the support provided to people was recorded in their daily logs.

There was a suitable complaints procedure in place and people were provided with contact details of other supporting agencies.

Well-led

Requires improvement

Updated 6 December 2017

The service was not always well-led

A new systems was in place to assess, monitor and improve the quality and safety of the service provided. However, no evidence was available to demonstrate that quality checks or audits had been carried out prior to September 2017.

We asked the provider to complete a Provider Information Return. They did not return the information we requested which is a legal requirement.

The service did not have a registered manager. The provider was working at the service whilst a new manager was being recruited. Staff were positive about working for the service and the changes since the provider had been managing the service.