Clarence Gardens

Clarence Gardens is a registered care home providing 24 hour respite support for up to four adults with a learning disability and/or physical disability, for a maximum of 56 days in one calendar year. At the time of inspection, 30 people were accessing this service. On the first day of inspection, three people were accessing this service and on the second day, this number was four.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

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

Improvements were needed to managing risks to people and in the safe management of medicines. People and relatives told us they felt safe and steps were taken to protect people from harm. There were sufficiently numbers of suitably recruited staff to care for people. The home was a hygienic living environment.

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. However, Deprivation of Liberty Safeguards authorisations were not in place. People had access to healthcare services when this was needed. People received enough to eat and drink and where possible, people joined in with meal preparation. The home had been adapted to meet people’s care needs.

Staff were kind and caring and showed people respect in their interactions with them. Relatives feedback about staff was consistently positive. People’s privacy and dignity was maintained. People’s personal goals were discussed and several examples were seen where people had succeeded in these personal achievements. These achievements gave people new found confidence which transferred to other parts of their lives.

People’s care plans were personalised and sufficiently detailed. These were regularly reviewed. People’s communications needs were being met. The registered manager said they wanted to have easy read care plans for people to use. People were supported to access the local community.

Some improvements were needed in managing care records. Limited evidence of auditing was seen at the time of inspection. Staff said the registered manager was supportive and approachable. Staff meetings were used to recognise positive staff performance, to share learning outcomes and to engage staff in developing the service. The service worked in partnership with the local community.

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 5 April 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Clarence Gardens is a registered care home providing 24 hour respite support for up to four adults with a learning disability and/or physical disability, for a maximum of 56 days in one calendar year.

The service had a registered manager in post at the time of our inspection. 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.

People were protected from abuse and avoidable harm. We spoke with staff who knew the process for reporting any safeguarding concerns. They all felt the registered manager would take appropriate action without delay.

Risks associated with people’s care were identified and actions put in place to help minimise the risk from occurring. This was done in a way that maintained people’s independence.

We found that medicines were managed in a safe way and people received their medicines as prescribed. Staff were trained in the safe handling of medication and had annual competency checks to ensure their skills were kept up to date.

Through our observations and talking with relatives of people who used the service and the staff, we found there were enough staff to meet people’s needs. Staff had access to a manager who was on call out of hours.

Staff had the knowledge and skills to respond to people in an appropriate manner and ensured that people’s needs were met. Staff received training in a range of subjects including mandatory training and appropriate training to meet people's specific health needs. Staff felt fully supported to do their job well and received one to one sessions with their line manager on a regular basis.

We found the service to be meeting the requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). Staff confirmed that they had received training in this area and were knowledgeable about the subject. The registered manager knew the process for applying for DoLS.

We saw that meals were provided in line with people’s likes and dislikes. We saw fresh fruit and vegetables were on offer at the service.

We saw that guests had access to healthcare while staying at Clarence Gardens. We saw guests had access to district nurses, dieticians and attended pre-planned appointments.

Guest’s stays were based on the compatibility of others so that people stayed with guests who were interested in similar things. This also offered guests the correct environment to help them develop and maintain positive relationships.

Staff ensured that people’s privacy and dignity was maintained. They were able to talk with us about how they achieved this.

Staff engaged well with guests and gave opportunities for them to fulfil their dreams and wishes.

We looked at care records belonging to guests and found they reflected the support people required and the support staff were offering. Prior to guests using the service an admittance review was completed to ascertain if there were any changes to the care plan, risk assessment or medication.

We saw a range of in-depth care plans were in place for each guest in regard to personal care, mental capacity, communication, nutritional needs and health care. The care plans clearly set out how to support each guest.

The service had a procedure in place for dealing with complaints and we saw that these were effectively resolved in a timely way.

Staff we spoke with felt supported by the registered manager and the assistant managers and were complimentary about their leadership skills.