All inspections: Clifton Court - Care Quality Commission

Clifton Court is a residential care home for up to 15 people with a mental health problem such as depression or schizophrenia. There were 14 people living in the home with an age range of 43 to 73 years of age. At the last inspection, the service was rated Good. At this inspection we found the service remained Good.

There was a registered manager in post. 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’s needs were effectively met because staff had the skills they needed to do so. Staff were well supported with induction, training, supervision and appraisal. There was enough staff on duty to keep people safe and care workers were flexible so people could do what they wanted, when they wanted. Recruitment practices were good.

People’s medicines were managed safely and staff understood when they needed to give people medicines on an ‘as and when basis’, and how to support people with self administration, if this is what they wanted.

Staff knew how to safeguard people from abuse and what they should do if they thought someone was at risk. Risks to individuals were well managed and people were able to stay safe without having their freedoms restricted. People’s independence was well promoted. Incidents and accidents were well managed.

Although everyone living in the home had capacity to make their own decisions about their care, the registered manager and staff had a good understanding of the Mental Capacity Act (2015) and made sure they gained consent from people in line with legislation.

People were well supported to eat and drink enough. Food was homemade and nutritious and people were involved in making decisions about menus. Everyone was supported to maintain good physical and mental health and appropriate referrals were made to health care professionals when required.

People were treated with dignity and respect by kind and caring staff. Staff had a good understanding of the care and support needs of every person living in the home. People had developed positive relationships with staff and there was a friendly and relaxed atmosphere in the home. People were well supported to do the things that were important to them, such as going to church or out for a meal. People’s social and spiritual needs were met.

Person centred care was important to the service and staff made sure people were at the centre of their practice. Care plans focused on the whole person, and assessments and plans were regularly updated. There was an open culture in the home, and staff felt confident to discuss any concerns they might have and said the registered manager would act on them. Staff said they were well supported and were well motivated to provide good care. The registered manager knew all of the people who lived in the home very well and ensured care was person centred.

The service has met all of the fundamental standards and the registered manager and staff have maintained a consistently good service. Further information is in the detailed findings below.

Clifton Court provided accommodation for up to 15 people with mental health problems such as depression and schizophrenia. There were 14 people living at the home on the day of our inspection. The age group of the people currently living at the home ranged from 21 years to 65 years old.

This inspection took place on the 21 October 2014 and was an unannounced. There was a registered manager at Clifton Court. ‘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 and associated Regulations about how the service is run.’

People told us they felt safe living at the home. All staff had received safeguarding adults at risk training and staff were able to tell us what they would do if they had any concerns.

CQC is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS). Staff had received training on the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). Staff also had access to an organisational policy which related to the MCA 2005 and DoLS.

The service provided a safe environment for people, giving them freedom to make everyday choices, such as accessing the community for classes, shopping and meeting friends and family. Care plans contained individual risk assessments in order to help keep people safe. People commented they felt safe and respected, and there were no obvious safety risks.

People told us there were always enough staff to support them in their life choices, such as trips out and hospital appointments. As well as supporting them in the home. People told us, “I have never had a problem with getting help or support when I need it, “and “Could not wish to live anywhere better.” Staff told us they felt there were enough staff on duty each day to provide safe care. One staff member said, “We are well staffed and there are always staff available if we need extra staff.” Another staff member said, “We have enough staff, if someone has an appointment or wants to go out we arrange extra staff beforehand so we don’t let people down.” On the day of the inspection there were enough staff available to provide support and keep people safe.

Staff were encouraged to progress professionally and attend training appropriate for their role. Staff training included management of mental health disorders, managing risk, medication competencies and training, and physical health disorders such as diabetes. Staff received annual appraisals and had regular group and individual supervision sessions with their manager. Staff told us they felt supported to deliver safe and effective care.

People were cared for by kind and caring staff. Staff demonstrated they knew people well. We were told “They are kind, so very kind.” Another said, “Just wonderful, everything I could want is here.” Everyone we spoke with told us they felt staff treated them with respect and dignity and that they could have privacy whenever they needed it.

People told us that they were involved in reviewing the support and treatment they received. They told us, “Asks me about how I feel and if I am happy with the care.” The staff we spoke with said, “We always ask people for their input, thoughts and agreement.” The service clearly involved people in designing their own care.

Care plans showed us people had access to other health care professionals as and when required. This included diabetic nurse, chiropodists and opticians. The care plans confirmed that staff followed guidance from health professionals and people told us they were supported in hospital visits and managing their health and welfare needs.

There was detailed information regarding people’s personal preferences for life choices and how staff supported them to achieve them. We were told, “As long as I don’t put myself in a risky position, I am supported to live my life in the way I want.”

People were given information on how to make a complaint on admission to the home. We also saw the complaint procedure displayed on notice boards in the dining area. The manager told us that there had been no complaints received in the last 12 months. The home operated an open door policy which meant people knew they could talk to staff at any time about problems or concerns.

There was a central code of ‘care’ which staff had contributed ideas to. This included to maintaining people’s self-respect and dignity, treat people how they’d like to be treated themselves, show compassion and treat people all in the same way.

People told us the registered manager was approachable and supportive. One person told us, “If I had any concerns I would go straight to the manager.” Another told us, “I go to the office or speak to the care staff.” Staff said, “We have an open culture which allows us to discuss anything and everything.”

Staff carried out regular audits of the service which included a monthly provider’s visit. The monthly providers visit was part of the quality assurance system used by the service. People received care and treatment in an appropriate and safe way.

The service held an accident and incident log which recorded details of the incident, together with the outcome and action taken.

We spoke with three people who used the service, seven staff and two relatives. We looked at staff files including the training records. We looked at three care files and all the medication records. We saw training records, supervision reports and appraisal schedules both past and future.

We observed that staff engaged with people in a respectful, compassionate manner which preserved their dignity. The location had a very relaxed atmosphere and the people who used the service appeared to be at ease with the staff. We found that the staff received regular training and support.

People's opinions were sought about their care, their preferences documented in the care records and the care provided was reviewed regularly. One relative told that 'The home shows a true dedication to the quality of the care they provide'.

Medications were supplied and administered safely and staff were trained in the safe administration and effective record keeping. There were no errors or missing signatures on the medication records. They told us that their medication was reviewed regularly and that if there was a problem, the staff responded quickly and the issue was resolved with the GP.

There was a complaints policy that clearly set out the process of making and investigating a complaint. People who used the service told us 'if I'm not happy I can talk to any of the staff. I know the manager will sort things out' and 'It's very good here, the staff are very helpful'

People were very anxious about having a person in their home who was unfamiliar to them. Three people did speak with us. Other people living in the home preferred not to. One person told us, 'It's lovely here.' Another said they had no problems and someone else told us, 'I'm happy here.'

The atmosphere at the home was calm and relaxed. During the day we observed that people were taking part in activities or carrying out independent tasks. We looked at care records that showed people were involved in planning their care and treatment. We saw that people's choices were respected and supported by the staff.

We saw that there were processes in place to recruit, train and support staff working in the home.

We saw evidence that services were monitored and reviewed to ensure that people were kept safe and quality standards were maintained.

Archived: Clifton Court

All Inspections

23 March 2017

During a routine inspection

21 October 2014

During a routine inspection

12 December 2013

During a routine inspection

19 November 2012

During a routine inspection