The inspection team was made up of an inspector and an expert by experience. The focus of the inspection was to check if the provider had taken sufficient action to meet the compliance actions set at our visit in August 2013. We considered our inspection findings to answer questions we always ask: Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?Below is a summary of what we found. The summary is based on our observations during the inspection, discussions with 10 people using the service, two relatives and seven of the staff supporting them. We also looked at records including three care plans and three staff recruitment files.
If you wish to see the evidence supporting our summary please read the full report.
Is the service safe?
The provider had reviewed the staffing level in the home and increased the numbers of staff on duty. People that we spoke with were complimentary about the staff. We observed that staff responded quickly to meet people's needs and ensure their safety.
We looked at the recruitment processes and found them to be safe and thorough. The home had carried out relevant checks to ensure that staff had the necessary skills and aptitudes to work with people living at Clemsfold House.
Systems were in place to make sure that the manager and staff learnt from events such as accidents, incidents and complaints. This reduced the risks to people and helped the home to continually improve.
CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While no applications had needed to be submitted, the manager demonstrated knowledge of their responsibilities in respect of this.
Is the service effective?
We found that care plans were detailed and provided up-to-date information about people's care needs and preferences. This meant that people were sure that their individual care needs and wishes were known and planned for.
We found, however, that appropriate monitoring was not always in place to ensure that people's needs were met. Where people had been assessed as at risk of constipation appropriate bowel monitoring was not in place. We have asked the provider to tell us what improvements they are going to make to ensure that people's assessed needs are managed appropriately.
People expressed satisfaction with the food at Clemsfold House. One said, 'The food here is very good'. We saw that they were offered a choice and that staff supported them to eat and drink in accordance with their needs. During lunchtime, we observed that the mealtime was well paced and allowed people the time they needed to eat their meal.
Many of the people who lived at the home had reduced memory or a dementia. We noted that the manager had taken steps to follow relevant research and guidance in order to support people in their care. For example the home had clear signage and individual bedrooms could be identified by brightly coloured doors.
Is the service caring?
People were supported by kind and attentive staff. We saw that staff were patient and gave encouragement when supporting people. People that we spoke with were largely satisfied with the care that they received. One said, 'They are very kind to us'. Another told us, 'I don't have any complaints'.
Staff told us that they had time to deliver good care to people and that they were able to spend time with them. We observed that staff were quick to respond to people's needs and clearly knew them well. One member of staff told us, 'You can't do this job if you don't love them'.
Is the service responsive?
People, their relatives and staff told us that they were able to raise suggestions or concerns. One person told us, 'I can talk to any of the staff'. Where issues or concerns were identified we noted that the home had taken appropriate action. One of the two relatives we spoke with explained that they had regular discussions with the manager. They told us, 'The door is always open and she delivers what she says she will'. We found that the home listened and responded to feedback received from people, their representatives and from staff.
Is the service well-led?
Since our last inspection we found that improvements had been made in relation to staffing levels. This was also confirmed by people and staff that we spoke with and by examining records.
We saw there were systems for monitoring the quality of services provided. The manager demonstrated a commitment to making improvements to the quality of service provided to people. One member of staff told us, 'I tell the manager and she will take action'.