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Clifford House Residential Care Home Good

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Inspection report

Date of Inspection: 30 June 2014
Date of Publication: 26 July 2014
Inspection Report published 26 July 2014 PDF

Overview

Inspection carried out on 30 June 2014

During an inspection looking at part of the service

Clifford House is a residential care home located in Andover in Hampshire. It is registered to provide accommodation and personal care for up to 21 people some of whom are living with dementia. At the time of our visit there were 19 people living at the home. Clifford house is an older style house that has been converted into residential care accommodation arranged over two floors. The home has a communal lounge and dining area, a kitchen and adapted bathing facilities. A walk in shower is currently being installed. There is access from the communal lounge to a small outdoor patio area.

The home has a registered manager who is also the registered provider of the service. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service and shares the legal responsibility of meeting the requirements of the law alongside the provider.

During the inspection we spoke with six people who use the service. Where people were unable to speak with us due to their complex needs, we used other methods to help us understand their experiences including observation of their support. We spoke with a number of staff including the registered manager, and three care workers. We reviewed 10 people�s care and support plans and other relevant records.

We had previously assessed that Clifford House Residential Care Home had not been meeting six of the essential standards. This inspection, reviewed whether they had taken action and made the required improvements to comply with these standards. In addition, we also reviewed whether the service was meeting the essential standards in relation to records and the management of medicines.

We gathered evidence against the outcomes we inspected to help us answer our five key questions.

Is the service safe?

Is the service effective?

Is the service caring?

Is the service responsive?

Is the service well led?

Below is a summary of what we found. If you want to see the evidence supporting our summary please read our full report.

Is the service safe?

People living at Clifford House told us that they felt safe. Safeguarding procedures were in place and staff understood how to safeguard the people they supported.

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. Whilst no-one living at the service was currently subject to a DoLS, we found that the manager understood when an application should be made and how to submit one and was aware of a recent Supreme Court Judgement which widened and clarified the definition of a deprivation of liberty.

We found that some people's care records contained incomplete monitoring charts which meant that accurate monitoring of their needs would be difficult. We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to the maintenance of accurate and appropriate records to ensure that people are fully protected against the risks of unsafe or inappropriate care.

Is the service effective?

Before people received care, they were asked for their consent and care staff acted in accordance with their wishes. The manager was knowledgeable about the Mental Capacity Act (MCA) 2005 and was able to demonstrate an understanding of assessing people's capacity to make decisions. Care staff displayed knowledge of the key principles of the MCA and we saw records which showed that all staff had completed training in the MCA.

People�s care plans included information about the care and support they needed. Staff we spoke with were informed about people�s needs and were able to tell us about the care they provided.

The provider had made arrangements to ensure that a programme of repair and on-going improvement was maintained within the service, which ensured that people were protected against the risks of unsafe premises and were cared for within a comfortable and pleasant environment.

The provider had put in place arrangements to provide staff with supervision and appraisals. Whilst we found that improvements had been made to the frequency of supervision, and staff told us that they felt well supported, these improvements will need to be embedded in practice and sustained to ensure that they were a fully effective tool in supporting the development of staff.

Is the service caring?

People we spoke with were positive about their care and the support they received from staff. One person said, �The staff are very kind, they always go out of their way, no-one could complain�. Another person said, �You come here, you come home, you belong�. A third person said, �They [staff] are kind and caring�.

People�s preferences, likes and dislikes had been recorded and we saw that support was provided in accordance with people�s wishes.

Is the service responsive?

The service had measures in place to review people�s needs on a regular basis. We saw that action was taken in response to any changes in people�s needs. For example, we saw that one person was referred to their GP when they developed signs or symptoms of a urine infection. Another person had been referred for a continence assessment and a GP had been consulted about a third person�s skin complaint. This meant that the service worked effectively with other providers to ensure that people received co-ordinated care, treatment and support.

Systems were in place to ensure that the service learnt from incidents and accidents, comments and complaints.

Is the service well led?

There were arrangements in place to ensure that people who use the service, their representatives and staff were asked their views about the care the service provided. We saw that where the need for improvement was identified, the service was taking action to address this.

The service had taken action to ensure that it had quality assurance systems in place to assess the quality of the service and identify where improvements could be made. However some of these needed to be further embedded to ensure that they provided an effective system for monitoring the quality and safety of the service people received. For example, some of the care records at the home were not clear or incomplete. These issues had not been identified through the audit process.