Clifford House

There was a registered manager in place who was also the owner. 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.

At the last inspection on 01 May 2017 the service was rated Good. At this inspection we found the service remained Good.

Clifford House operated as a family home and the three people who lived there had done so for over 20 years as part of the family unit. One person who lived at the home said, “This is my home and family we are all so lucky here to be looked after [registered manager/owner].”

Relatives told us they were made welcome by a caring and compassionate person who supported their relatives. They told us they were happy with the care provided and had no concerns about their relatives safety. One relative said, “I would give [Registered manager/owner] 100% an absolutely wonderful person.”

Suitable arrangements were in place to protect people from abuse and unsafe care. People at Clifford house told us they felt safe.

The registered manager/owner with part time support from a family member provided care and guidance for the three people who lived at Clifford House. No staff had been recruited for many years.

We looked around the building and found it had been maintained, was clean and hygienic and a safe place for people to live. We found equipment had been serviced and maintained as required.

We found that medicines were managed well and in line with people’s needs.

We observed during the inspection visit warm and friendly interactions between the owner and people who lived at the home. We saw the owner was able to communicate well with the people they supported.

People had been 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.

People who lived at Clifford House told us they enjoyed the meals and choices made available to them and they supported the owner with cooking and cleaning of the kitchen area. One person who lived at the home said, “We make what we like each day, [owner] is a very good cook.”

We found people had access to healthcare professionals and records were kept of outcomes of visits and what action was taken to meet their healthcare needs.

The service had information with regards to support from an external advocate should this be required by them.

The service had a complaints procedure which was made available to people on their admission to the home and their relatives. The people we spoke with told us they were happy with the service and had no complaints

Monitoring of the quality of the service provided was done on an informal basis. For instance Informal discussions with people who lived at Clifford house and relatives.

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask;

This is a summary of what we found-

Is the service safe?

People told us they felt safe living in Clifford House. We saw that the manager and the member of staff had completed training in safeguarding vulnerable adults.

Records we looked at showed that risk assessments had been completed and covered the time people were in the home and out in the community. All risk assessments were reviewed and updated with the support plans. This ensured people were kept safe during their activities of daily living. Staff supervision was in place on an informal and formal basis.

Is the service effective?

People told us they were happy with the care and support they received. Support plans were in place and contained up to date information about the level of care required to meet peoples' assessed needs. Some people had complex needs and could challenge the service. Details were recorded on the support plans and evidenced the manager sought advice from external mental health care professionals in order to deal with any challenges.

Is the service caring?

During our inspection we saw caring interactions between the manager and the people living in Clifford House. People were relaxed in each other's company and told us, 'It is lovely living here and we are all well cared for'.

All the people had lived in the home for a number of years and the manager knew them very well. One person said, 'I love it here and wouldn't want to live anywhere else'.

Is the service responsive?

On the day of our visit we saw people being asked about their preferences and they told us they could choose what they wanted to do. One person told us, 'I do not go to work on a Tuesday so I am going to have a lie in tomorrow'. The home was run on family lines with decisions made only after all the people had voiced their opinion and said what they wanted. Holidays were only planned with the agreement of all those who used this service.

People we spoke to said they liked living in the home and that they were treated very well. They told us they could choose what they liked to do. One person told us, "I like to go out to the shops and to the caf' and we all enjoy going on holiday'. Another person told us, 'It is great here and we get to go out shopping and on holidays and have plenty of cups of tea'.

We were able to see that people were supported to lead active and full lives and access the local community. We observed people being supported by the provider to undertake meaningful tasks, like joining in household chores, and activities. We saw there was a relaxed and homely atmosphere with a friendly rapport between the provider and people living in Clifford House.

We saw that people's needs were continually re-assessed and care and treatment was planned and delivered in line with their individual plan of care. The home had developed good links with healthcare professionals to ensure that their health needs were being well met. Up to date risk assessments were in place to ensure people were safe at all times.