Claybourne

We found the following examples of good practice.

• The visiting policy and procedure had been shared with relatives. This included the booking system to be followed, health screening checks and the Personal Protective Equipment (PPE) to be worn by all visitors. This meant people were protected when they had visits from relatives.

• When visits had been restricted other methods were used to ensure people continued to have contact with their loved ones such as, video/telephone calls and letter writing. The registered manager kept in regular contact with relatives to provide updates on their relatives’ wellbeing and government guidance.

• The environment was well maintained and clean. Additional cleaning had been implemented to lower the risk of cross transmission of infection.

• Zoning of areas within the home had been implemented and staff were assigned to specific areas of the home to reduce the risk of cross infection.

• Staff were supported by the registered manager and provider during periods of anxiety. There were internal wellbeing services for staff to access if needed.

• Infection Prevention and Control (IPC) policies and procedures were in place and were regularly reviewed to ensure they contained up to date guidance for staff.

• The registered manager had completed a route cause analysis to ensure any learning was taken to reduce IPC risks.

Claybourne is a residential care home providing accommodation for persons who require nursing or personal care to 45 people aged 65 and over at the time of the inspection. The service can support up to 46 people.

Claybourne accommodates 46 people across three separate units, each of which has separate adapted facilities.

People’s experience of using this service and what we found

People were kept safe and protected from abuse. Staff understood how to protect people and report their concerns.

Risks to people were assessed and plans were put in place to mitigate these. If accidents or incidents occurred, action was taken to reduce the risk of similar incidents happening again.

There were enough staff to meet people's needs and the provider had recruitment procedures in place which helped ensure only suitable staff were employed.

Medicines were managed safely, and staff maintained appropriate standards of hygiene and infection control.

People’s need were assessed and plans were put in place to meet them. The home was purpose built and had adaptations to meet individual needs. Staff received an induction, training and support to carry out their roles.

People received consistent support from staff and others involved in their care. People had their health needs met and had access to support from health professionals when needed.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People were communicated with effectively and were involved in decisions about their care. Staff encouraged people to make choices and be independent. Staff treated people with respect and maintained their dignity and privacy when supporting them.

People received support which was person-centred and were engaged in social activity including accessing the community. There was a complaint process in place which people understood how to use. Peoples future wishes were considered for when they reached the end of their life.

The registered manager knew people well. People, relatives and staff found the registered manager approachable and there was a positive attitude towards making improvements in people's lives. The quality of the service was checked regularly and the provider sought ways to learn and make changes and improvements.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 15 March 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

This inspection took place on 21 December 2016 and was unannounced. Claybourne is a care service for people who have a variety of support needs, such as older people and people with dementia. There were 44 people receiving a service at the time of the inspection.

There was a Registered Manager in post at the time of our 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.

People told us they felt safe and we saw risk assessments and plans had been put in place to keep people safe. When an incident had occurred, action had been taken to protect the person and to reduce the likelihood of another incident occurring. Appropriate moving and handling techniques were being used to help people mobilise.

Medicines were stored and managed safely. There was clear guidance available for staff to follow and checks were made to ensure people were receiving their medicine as prescribed. PRN protocols were also in place for people that needed their medicine ‘as and when required’.

There were appropriate amounts of staff to care for people and people did not have to wait for support. Staff were aware of their responsibilities to safeguard people from abuse and referrals had been made if there had been an incident.

Safe recruitment practices were in place and staff had appropriate checks prior to starting work to ensure they were suitable to work with people who use the service.

Checks were made on the building itself to ensure it remained safe for people to live there.

The principles of the Mental Capacity Act 2005 were being followed. Mental capacity assessments were being carried out and when people did not have capacity decisions were made and recorded in their best interest. Evidence had been sought to verify that representatives had Lasting Power of Attorney.

Appropriate Deprivation of Liberty Safeguarding referrals had been made to ensure people were not being unlawfully deprived.

Staff had sufficient training to support people effectively and staff were able to refresh this training when required.

People had access to other health professionals in order to maintain their health and wellbeing.

People were supported to have food and drinks of their choice that were appropriate for their needs.

People felt staff were caring and that they were treated with dignity and respect, and people were encouraged to maintain as much independence as possible. People were offered choices and these choices were respected. Visitors were able to visit at a time convenient for them and people could decorate their rooms so they could have personalised space.

Care plans contained good personal detail so that staff could get to know the people they supported and people had their preferences documented and catered for where possible. People and family were involved in reviews and when people’s needs had changed plans had been updated.

People were encouraged to partake in activities that interested them and staff were able to support people with this. People’s spiritual needs were taken into consideration and people were able to access spiritual support.

People and relatives were encouraged to provide feedback or complain if they needed to and it was recorded that this feedback was acted upon. We saw that complaints were recorded, investigated and responded to.

Effective quality monitoring systems were in place. Care files and associated documentation was audited and action was taken when omissions had been identified.

Staff all felt they could approach the registered manager and management team. There was an open door policy and staff all said they could raise things if necessary.

The registered manager felt supported by the provider and had submitted notifications about the service, which they are required to do by law.

Plans of care identified the support people needed. They gave information about the way people expressed their wishes and the help people needed to make decisions about their care. Assessments were completed when potential risks to people were identified. The action needed to reduce the risk being clearly documented.

The staff we spoke with had a good knowledge of the people's needs and the support they required. We saw staff recognised people's rights and were respectful to people that required assistance.

We observed that interaction between people who used the service and staff was very good. Conversations were initiated by people who used the service in many cases, all of whom appeared to recognise and feel comfortable talking with members of staff and management.

Relatives we spoke with told us the care and support provided was 'very good'. One person said: "The staff here are great, I've been very impressed. They have a 'can-do' attitude'.

We saw the service had systems in place to effectively monitor, assess and improve the quality and safety of the service provided.

We observed that staff were aware of people's individual needs and were attentive and caring. Staff were also aware of how each person communicated and their choices and preferences. Staff felt supported with their training needs. One person said, "It's very good here with training."

People received care as individuals and their choices and preferences were taken into account.

There was a good programme of entertainment within the home and people were enabled to participate in activities and events. This created a friendly atmosphere where visitors felt welcome and included. One person told us, "I love coming here you always feel welcome and get involved."

The service was supported by various health care professionals and we met with a visiting doctor and district nurse. People received good health care and support and were able to stay at the home until the end of their lives.

We were informed about a recent inspection by a local involvement network group. This had been a positive inspection with just a few points of recommendation.

The registered manager was in the process of leaving and moving on to another home for the same provider. The peripatetic manager was present throughout the inspection and she was taking over management of the home until a new permanent manager could be employed.