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Clifford House Residential Care Home Good

All reports

Inspection report

Date of Inspection: 27 November 2013
Date of Publication: 4 January 2014
Inspection Report published 04 January 2014 PDF

Staff should be properly trained and supervised, and have the chance to develop and improve their skills (outcome 14)

Not met this standard

We checked that people who use this service

  • Are safe and their health and welfare needs are met by competent staff.

How this check was done

We looked at the personal care or treatment records of people who use the service, carried out a visit on 27 November 2013, observed how people were being cared for and checked how people were cared for at each stage of their treatment and care. We talked with people who use the service, talked with staff and reviewed information given to us by the provider.

Our judgement

The provider had failed to ensure that staff received appropriate training and supervision.

Reasons for our judgement

We spoke with five people who lived at Clifford House. They were all positive about the skills of the staff and felt their care was managed effectively and in a timely manner. Each shift was led by either the manager of the service, or a supervisor or senior carer. This provided support to staff in the day to day delivery of care.

We noted that all staff held a National Vocational Qualification (NVQ) in health and social care. The manager had a NVQ at level 4, six staff had NVQ at level 3 and seven staff had NVQ at level 2. Training records showed fire safety, first aid and moving and handling training as up to date and in line with the frequency determined by the service. Nine staff have completed end of life training. This included learning about how to work alongside the community nursing teams to deliver sensitive health care to people who were dying whilst also ensuring that their spiritual and emotional needs were met.

We saw records that showed a new member of staff had been provided with an induction using the Skills for Care Common Induction Standards. However, one care worker who had been employed by the service for two months had not completed their moving and handling training. This meant that staff might not have all the training they needed and were not properly equipped to provide care and support to people using the service. The manager told us they were trying to make arrangements for this care worker to access appropriate training. In the interim, the manager told us the worker was supervised to ensure that they were not required to manage any moving and handling tasks.

During our visit we spoke with staff who told us that training could be more comprehensive and tailored to their roles and the needs of people who use the service. One member of staff told us they felt staff did not always have adequate skills in, and knowledge of dementia care and that this meant they lacked understanding of how this condition impacted on a person's abilities to undertake some tasks. Training records highlighted that whilst nine of the permanent staff had completed training in dementia care, five staff had still to undertake this.

Staff we spoke with did not demonstrate a detailed understanding of, and knowledge about the Mental Capacity Act (MCA) (2005) and its implications for their role within the service. For example, one care worker said ‘…mental capacity was being able to make a decision’. Another care worker told us that mental capacity meant identifying ‘what a person could or could not do’. This care worker also told us she was not familiar with the term best interest’s decision making. Both staff said they had not received training in the MCA (2005). The failure to provide staff with training on how to use the MCA (2005) meant they might not be clear about how to protect people, who had been identified as lacking capacity to give valid consent. This placed people who used the service at risk of receiving inappropriate care and treatment, particularly where this related to more complex decisions.

Training records we saw showed that no permanent members of staff had completed safeguarding training within the last two years as per the organisation’s stated frequency. Only three staff had completed this training within the last five years and five staff had not undertaken any safeguarding training. We spoke with the manager about this and he explained that he had identified additional training was needed in this area and he was taking steps to arrange this.

We found that there were inadequate arrangements for ensuring staff receive regular supervision. Staff told us supervision was provided but that this was not regular. One care worker told us that her supervision was adequate, but another care worker told us that she did not feel that supervision looked at her training needs effectively. We saw that the service had a supervision policy that stated that there would be three 30 minute super