Archived: Cloverdale House

Cloverdale House is situated on a quiet residential road in Hove. Accommodation is provided over several floors; there were communal rooms on the ground floor.

Cloverdale House was last inspected on 24 May 2016. At that inspection, they were rated as requiring improvement. The provider was also not meeting the requirements of Regulation 12 of the HSCA 2008 (Regulated Activities) Regulations 2014. By this inspection, the provider had taken action and had fully addressed the Regulation.

A registered manager had been appointed since the last inspection. 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. The provider for Cloverdale House is Aitch Care Homes (London) Limited, who provide similar services across a range of areas in the south and east of England.

At the last inspection, people's medicines were not managed so that they received them properly and safely. The provider had addressed this. There were effective systems to ensure people received their medicines. Medicines were stored safely and full records kept. Staff understood their responsibilities for supporting people with taking their medicines.

People’s risk was assessed and where risk was identified, they had a care plan drawn up to reduce their risk. Staff followed care plans when supporting people. Staff followed procedures to protect people from risk in the general environment, including fire safety.

Staffing levels had improved and people told us the staff team was now stable. This meant people had improved opportunities to decide how they wanted to spend their days, as well as ensuring their safety. Newly appointed staff had been recruited appropriately to ensure they were safe to work with people.

Staff understood their responsibilities for safeguarding people from risk of abuse. Where people lacked mental capacity appropriate procedures were followed, in accordance with the Mental Capacity Act 2005 (MCA). Where people were subject to a Deprivation of Liberties (DoLS) safeguard, staff were aware of actions to take.

Staff showed a caring, respectful attitude to people. Staff encouraged people’s independence and helped them to make choices. People were supported in engaging with life in the home and the local area, as well as with their families. People were encouraged to choose what they wanted to eat and drink and were supported with healthy choices in eating and drinking.

People were involved in drawing up plans about their care. Staff followed these care plans. Staff supported the people who were living with behaviours which may challenge in an appropriate and supportive way. Where people had additional care needs, including medical needs, people had clear care plans and there was evidence of regular liaison with external healthcare professionals.

Staff were trained in meeting people’s needs. Staff said the registered manager had further developed ways of supporting them in their role, including by supervision.

People could raise concerns and complaints with managers. The provider’s quality audit systems ensured where matters were identified action was taken to ensure people’s safety and well-being.

Cloverdale House is registered to provide personal care and support for a maximum of 11 adults with learning disabilities and additional complex needs such as autism, epilepsy and behaviours that challenge. Accommodation is provided over three floors and consists of ten single rooms with ensuite facilities and one bed sitting room with an ensuite wet room. Cloverdale House is an older style building close to the seafront, town centre shops and amenities with transport links close by. On the day of our inspection there were 10 people living at the service with a variety of complex learning disability and physical needs requiring high levels of supervision and support in order to live full and active lives.

The service was last inspected on 24 April 2015 and some concerns were identified. We found one breach of the Health & Social Care Act 2008 (Regulated Activities) Regulations 2014 where staff did not have the required levels of skill and knowledge to assess or meet the needs of people. The provider was asked to submit an action plan to address this and we looked at the effectiveness of this action plan as part of this inspection. At this inspection We found that improvements had been made in the required area. However we identified a further breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

Cloverdale House requires a registered manager. 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. The service had not had a registered manager in post since February 2016, however, there was a newly appointed manager who had submitted their application to become registered manager and their application was in progress.

People did not always receive their medicines as prescribed. The safe management of medicines was not always consistent and there were times when there was no suitably trained staff available to administer ‘as required’ medicines. This was identified as a breach of regulation.

There were individual risk assessments in place and management plans to reduce risk had been reviewed. Support plans were personalised and there was detailed guidance for staff on how to support people. However, staff did not consistently follow the guidance given in the support plans which could put people at risk of harm and this is an area that needs improvement.

Staffing levels were not always maintained. The provider had calculated the number of staff required on a daily basis but rotas demonstrated, and staff told us, that these staffing levels were not always achieved and this is an area that needs improvement.

Staff had received training in safeguarding adults and had a good understanding of their role in keeping people safe, how to recognise abuse and report any concerns. Recruitment practices were robust and ensured that any staff employed were safe to work with people.

One person told us they had, “No problems with safety.” The environment and equipment were subject to regular checks, there was an emergency plan in place to include detailed Personal Emergency Evacuation Plans (PEEPs). Accidents and incidents reports were reviewed and there was a system in place to monitor and track actions taken to reduce risk of recurrence.

There was a training matrix in place and staff had received training specific to the needs of people for example catheter care and epilepsy awareness. Induction training had been subject to review and improved. Staff received regular supervision from senior members of the team.

People said they enjoyed the food and were involved in menu planning, shopping and the preparation of food and drink. Staff were aware of any allergies and individual preferences and support plans gave detailed guidance on these.

The service acted in accordance with the Mental Capacity Act (2005) (MCA) and the Deprivation of Liberty Safeguards (DoLS). The provisions of the MCA are used to protect people who might not be able to make informed decisions on their own about the support they receive. Consent was sought from people with regard to the support that was planned and delivered. Where people were unable to make decisions for themselves staff had considered the person’s capacity under the Mental Capacity Act 2005 and applied for DoLS authorisations where appropriate.

Peoples’ health was monitored and they were referred to health services in an appropriate and timely manner. Any recommendations made by health care professionals were acted upon and incorporated into people’s support plans. One person told us how they were supported through a long period of outpatient treatment and another was supported by staff during an admission to hospital.

Staff supported people gently and with kindness. One person said that they liked a member of staff because they knew and understood them well. Staff encouraged people to be independent and work towards personal goals. People were appropriately dressed according to their personal preferences and personalities. There were individual activity plans and people were busy throughout the day and were supported by staff to follow their chosen lifestyles

There was a complaints process in place and all complaints had been responded to appropriately and within a reasonable time frame. There were weekly resident meetings and an annual service user satisfaction survey. People said they felt listened to and that their opinions counted.

There was a quality assurance system in place and there were processes for gathering feedback from people and staff. Action plans were visible and monitored by the provider to ensure that any actions were completed in a timely manner.