Cliveden Manor Care Home

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs. This is the first full assessment for this service. This key question has been rated Good. This meant people’s needs were met through good organisation and delivery.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider made sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

People’s care records contained person-centred information about people's care and treatment, including documented contact with professionals’ advice received and actions taken, providing assurance that people's healthcare needs were being effectively monitored and managed.

People’s care records contained some information about their past lives, topics they enjoyed discussing and activities they liked to participate in, supporting staff to interact with people in a meaningful way. A professional partner told us, “Staff communicate in ways that meet people’s individual needs, consider cultural and personal preferences, maintain dignity and privacy, and adapt care plans when people’s needs or circumstances change.”

We saw examples of compassionate and person-centred care planning. One care plan contained detailed information about the person's relationship with their partner and clearly described the steps staff should take to support them to continue living together. The plan recognised the importance of maintaining the relationship while also identifying ways staff could provide discreet and unobtrusive support to reduce carer strain on both people.

Staff demonstrated they knew people well and regularly involved people’s relatives in their care choices at their request. A person’s relative told us, “My [relative] is well looked after, both my sibling and I are involved in their care.” Another person’s relative told us, “[I] discussed likes and dislikes and what support was needed [with staff]. There are regular reviews and updates of any changes [to person’s care needs].”

The provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

The service had supported people in partnership with external professionals, such as the local GP who visited the service on a weekly basis. Professionals told us, “When a person’s needs increase, staff take appropriate action to review care arrangements, update assessments, and seek additional support in a timely manner. Care and support are delivered in line with agreed care plans, with staff showing flexibility to respond to people’s changing needs and provide additional support where appropriate.” Records evidenced medical concerns were appropriately escalated and discussed with relevant specialists and healthcare professionals.

This meant people were supported to receive responsive care in a way which was accessible to them.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Aids and assistive technology such as telephones with enlarged numbers, large call buttons, audiobooks, and voice-assistant tools were present around the service to support people with their wellbeing and communication. The service provided information in enlarged text for people who required it. Staff also supported residents by reading documents aloud to them. Visual prompts, and signs were available to support people with cognition difficulties to make informed choices and encourage independence. Staff were directed to support people with sensory impairments in written form where necessary. This meant people had access to information that was aligned with their individual needs, in line with the Accessible Information Standard.

The provider had effective systems in place to enable people, relatives and staff to share feedback, raise concerns, make complaints and contribute ideas about the care, treatment and support provided. People were involved in decisions about their care and were informed of changes and improvements made in response to their feedback.

The provider maintained an up-to-date complaints policy and demonstrated a proactive approach to reviewing complaints, concerns and compliments. Records showed feedback was analysed, shared across the service and used to identify learning opportunities and drive improvements. The provider also sought feedback through annual satisfaction surveys distributed to people using the service, their relatives and staff, and communicated actions taken in response to the feedback received.

People living at the home were represented through a Residents' Council, which met monthly with staff to discuss suggestions and areas for improvement. Relatives were also provided with regular opportunities to attend meetings and contribute their views. Records showed these meetings were well attended and staff responded positively to suggestions raised. Meeting minutes were detailed, included updates on previous actions and showed how feedback had informed service developments.

For example, people had raised concerns about the quality of food provided within the home. The provider had listened to this feedback and taken steps to address the concerns, with improvements ongoing at the time of our assessment. This demonstrated a culture in which people felt able to speak up, were listened to, and could see that their views influenced changes within the service.

The provider made sure that people could access the care, support and treatment they needed when they needed it.

Care plans contained detailed information about people's health conditions and the impact these had on their daily lives. Records included clear guidance for staff on the support required, potential signs and symptoms of deterioration to monitor for, and the actions that should be taken in response to any concerns. The provider operated an on-call duty system for staff to gain support if they had concerns when management were not available. Staff were also able to contact a telehealth service for prompt access to medical care for people they supported. A professional told us, “It is a great service. Clinicians can prescribe [medicines] over the phone, allowing for earlier intervention.”

Staff and leaders did not always actively listen to information about people who are most likely to experience inequality in experience or outcomes. This meant people’s care was not always tailored in response to this.

Although care plans reflected people's interests, hobbies and preferences, they did not always provide clear guidance for staff on how these could be supported when risks or barriers were identified. For example, 1 person had chosen not to wear their sensory aids for a prolonged amount of time. Feedback from their family indicated they felt the person was experiencing increased social isolation as a result. While staff had been advised to communicate with the person in writing, there was no documented guidance outlining how staff should support them to access activities, maintain social engagement with other people in the home, or reduce the impact of their sensory impairment on their wellbeing.

Another person's care plan stated they enjoyed spending time outdoors but were unable to do so because of risks associated with their health condition. However, their care plan did not identify strategies to mitigate these risks, explore supervised access, consider alternative ways of achieving the person's desired outcomes, or evidence regular reviews of opportunities to support the person to access outdoor spaces safely. This meant that people were not consistently supported to achieve outcomes that mattered to them and maintain meaningful engagement in activities they enjoyed.

The service provided accessible routes into and throughout the building for wheelchair users. A hearing loop was available within the reception area to assist people with hearing loss. Staff were trained to effectively communicate with people who experienced difficulties in communicating verbally. A staff member shared an example of how they had supported a person to obtain assistive aids to help them communicate, and got to know their routines well, as well as their likes and dislikes.

People were given exceptional support to plan for important life changes, so they could make informed decisions about their future, including at the end of their life.

The service had achieved accreditation under the Gold Standards Framework (GSF), a nationally recognised, evidence‑based programme that strengthens end‑of‑life care in care homes. This accreditation reflected the provider’s commitment to ensuring people received the highest standard of compassionate, well‑coordinated support.

Through the GSF, staff were upskilled to deliver exceptional end‑of‑life care, developing strong communication skills and highly effective ways of working with healthcare teams to support people to plan for important life changes.

A staff member told us, “We arrange to meet the needs already expressed to us. We arrange a small drawer available with all the items that the person needs. This is detailed to their individual needs, for example, flowers, a prayer in the room, preferred music available.” Another staff member told us, “We form a ‘Guard of Honour’ when [the person is leaving the service], and their favourite music accompanies it.”

People and their relatives had been consistently involved in planning future care preferences. Discussions were clearly documented with a personalised and compassionate approach within people's care plans and advance care planning records. Staff supported open and compassionate conversations, ensuring people and their families understood available options regarding future care and treatment, preferred place of care, views on hospital admission, and relevant advance care planning documentation, including the presence and location of ReSPECT forms. Records reflected people's individual values, beliefs and priorities, with a focus on maintaining dignity, choice and independence for as long as possible.

This meant future care decisions had been considered, documented and communicated in a way that respected people's rights, promoted choice and supported staff to deliver care in accordance with their preferences.

A person’s relative shared their experience of the recent passing of their loved one. They shared that staff had spoken with the person about 1 of their favourite topics, and stayed with them until the end of their life. They told us, “Those words meant so much I won’t forget them.”