Archived: Clarendon Gardens

Clarendon Gardens is a care home providing accommodation for persons who require nursing or personal care to up to 6 people. The service provides support to people who live with mental health conditions. At the time of our inspection there were 4 people living in the home.

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

The service was experiencing a staffing crisis. There were insufficient staff available to work including at manager and care worker level. The provider had not taken action to address this and the safeguards we found in place were inadequate.

The service did not follow safe recruitment procedures and staff were not sufficiently vetted to ensure they were suitable to support people who used the service. Staff lacked essential training and training records were not kept. Medicines were not always managed safely. Building and environmental checks were either out of date or non-existent.

Overall, the quality assurance monitoring system was not effective to ensure appropriate improvements were made to care for people who used the service. Risks to people were not always adequately assessed. The provider did not have effective systems in place to review care plans and risk assessments.

There were systems in place to protect against the spread of infection.

Staff worked with healthcare and social care professionals, to ensure people had a safe and effective service.

Staff were aware of their responsibilities to report allegations of abuse. People told us they felt safe using the service

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. People made decisions about their care, and about matters to do with the running of the service.

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 April 2021).

Why we inspected

We received concerns in relation to the lack of staff training, staffing levels and the provider managing the home without sufficient knowledge of people’s needs. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.

The overall rating for the service has changed from good to inadequate based on the findings of this inspection.

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.

Enforcement and Recommendations

We have identified breaches in relation to safe care and treatment, staff recruitment, person centred care and good governance at this inspection.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

Clarendon Gardens is a care home providing personal care to up to six people who live with mental health conditions. At the time of our inspection four people were living in the home.

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

We saw positive engagement between staff and people. Systems were in place to ensure people were protected from abuse and treated with respect and dignity. People and care staff were confident that allegations of abuse would be dealt with appropriately.

People told us that they felt safe living in the home. They knew who to speak with if they had a worry or concern about the care and support they received. Personalised risk assessments were in place. Staff were committed to supporting people to be as independent and as safe as possible.

People's care and support were personalised. They were supported to take part in activities of their choice. People's interests and preferences were known to staff.

Staff and people using the service participated in the regular COVID-19 testing and vaccination programme.

People who used the service received their medicines safely.

Care staff received the support and guidance they needed to carry out their role and responsibilities effectively.

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. People made decisions about their care, and about matters to do with the running of the service.

There were quality assurance systems in place to identify and address any shortfalls and make improvements to the service.

Staff worked with healthcare and social care professionals, to ensure that people received an effective and safe service. People were provided with a range of opportunities to feedback about their experience of the service they received.

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 October 2019).

Why we inspected

We received information about concerns in relation to the number of hours the director worked in the home, people’s one to one care and support, bland food and the use of closed circuit television (CCTV) in the home. As a result, we undertook a focused inspection to review the key questions of Safe, Effective, and Well-led.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect these. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service remains good. This is based on the findings at this inspection.

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.

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.

Clarendon Gardens is a care home providing personal care and accommodation for people who have mental health needs. There were five people using the service including one person who was receiving hospital care and treatment at the time of the inspection. The care home accommodates up to six people in a house similar looking to other houses within the area. Public transport services and a range of shops are located close to the home.

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

Staff knew people well and had a caring approach to their work. They engaged with people in a considerate and friendly way. People spoke in a positive way about the staff who supported them.

Each person had a care plan that was up to date and personalised. People were fully involved in the planning of their care and support.

Staff had the skills and knowledge to provide people with the care and support that they needed and wanted. They received a range of relevant training and had the support they needed to enable them to carry out their roles and responsibilities.

Staff respected people's privacy and dignity and understood and valued people’s differences.

People were protected from the risks of harm, abuse and discrimination. Staff knew what their responsibilities were in relation to keeping people safe.

Systems were in place to ensure that people received their prescribed medicines safely.

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 services supported this practice.

People had a choice of meals, snacks and drinks.

People received the support they needed to stay healthy and to access healthcare services.

Staff encouraged and supported people to participate in activities, pursue their interests and to maintain relationships with people that mattered to them.

The provider had systems in place to manage and resolve complaints.

Staff told us that the registered manager and chief executive officer were open and supportive.

Systems were in place to assess and monitor the quality and delivery of care to people. Improvements to the service were made when needed.

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 13 June 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.

At the last inspection, the service was rated Good. At this inspection we found the service remained Good

People told us that they felt safe living in the home. There were procedures for safeguarding people. Staff understood how to respond to complaints and possible abuse. They knew how to raise any concerns about people's safety so people were protected.

Arrangements were in place to make sure people received the service they required from sufficient numbers of appropriately recruited and suitably trained staff. Staff received the support they needed to carry out their roles and responsibilities in providing people with the care and support that they needed.

Staff demonstrated a caring attitude towards people who used the service and ensured their dignity and privacy was maintained. People were involved in planning their care, which was responsive and met their individual needs and preferences.

People's medicines were managed safely. People's dietary needs and preferences were supported, and they were encouraged to choose what they wanted to eat and drink.

Staff understood their responsibilities in relation to the Mental Capacity Act 2005 [MCA]. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Checks were carried out to monitor and improve the quality and safety of the service.