Clayton House

About the service

Clayton House is a small care home registered to provide care and support to 6 people who have a learning disability. There were 5 people living at the home at the time of the inspection. The home is a registered location of Outreach 3-Way, which is part of Dimensions.

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

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support:

People’s risks in relation to their care were well managed. 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.

There were sufficient staff deployed to meet people’s needs and people received their one-to-one support hours appropriately. Staff supported people to live as independently as possible and be in control of their daily lives.

Right Care:

People’s care plans reflected their needs. Staff had undertaken the training they needed to support people effectively. People’s right to privacy was respected and care provided was consistent and delivered by staff who knew people well. People appeared happy and looked well cared for.

We observed staff interacting in a kind and compassionate way with people who used the service and amongst themselves.

Right Culture:

The culture of the service was open, inclusive and empowered people to live confident lives. The service worked in partnership with other organisations to improve outcomes for people.

People were happy with the service and the leadership. A relative told us, “It all works very well. It’s been brilliant. [Name] has a really good life.” Management had undertaken regular audits and made appropriate improvements to the service.

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 the service was good, published on 31 May 2018.

Why we inspected

This inspection was prompted by a review of the information we held about this service and due to the time since it was last inspected.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has remained good.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

We found the following examples of good practice.

The service was clean and tidy. Cleaning tasks were consistently completed. Staff were wearing appropriate PPE in-line with government guidelines. Staff had completed infection prevention and control (IPC) training which included the safe use of PPE.

People were supported to maintain their relationships with friends and family where they wished to do so. At the time of our inspection the service was not accepting visitors due to the recent outbreak of coronavirus. There were systems in place for when visiting resumed. This included temperature checks prior to entry to the service. Personal protective equipment (PPE) was available throughout the service.

The registered manager completed risk assessments for people living at the service and staff to promote their safety. They worked with the Local Authority and Public Health England to control and manage the outbreak.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and on- going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

People felt safe at the service and staff and the registered manager were aware of their responsibilities for ensuring that people were kept safe and that any concerns were reported. Checks such as identity and criminal records checks were carried out on new staff as part of the recruitment process. Staffing levels were suitable to meet the needs of people who used the service. Medicines were managed safely and staff were assessed to ensure they were competent to support people to take their medicines.

At the last inspection, Mental Capacity Act (MCA) assessments were not clear in people’s records and the registered manager was in the process of applying for DoLS authorisations. The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to make particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible.

At this inspection we found clear MCA assessments to support people’s DoLS applications. People can only be deprived of their liberty so that they can receive care and treatment when this is in their best interests and legally authorised under the MCA. The authorisation procedures for this in care homes are called the Deprivation of Liberty Safeguards (DoLS).

People are 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 had their needs assessed and care was planned using best practice guidance. People said they were involved in reviewing their care and relatives were invited to attend reviews. People were observed making choices and were supported to maintain a healthy lifestyle. Staff received training and support which allowed them to provide care to people in a safe way.

Staff were observed being kind to people and respecting their dignity and independence. People’s views were collected and people were able to voice their opinions about the service. Staff were aware of how people communicated and were sensitive to how some people needed more time to communicate. People told us they liked the staff and got on well with them.

People’s preferences and choices were reflected in their care plans. The service took account of people’s individuality and supported them to maintain their individual interests. People knew how to raise concerns and were provided with information in a way they understood.

There is a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. People told us they liked the registered manager and staff and were comfortable at the service. Staff felt they were able to approach the manager and felt listened to. Governance structures had been put in place by the provider so that information could be shared and lessons learned in the service. People and their relatives were asked for their views and action plans were put in place to address any shortfalls in the quality of the service.

Further information is in the detailed findings below.

A relative told us, "The home is excellent. They really care and keep me well informed". We noted that the home provided a wide range of social, educational and work opportunities.

We saw that people's consent was sought, wherever possible, before care and support was provided. We found evidence that the care given was safe and appropriate and based on effective care planning and risk assessments. This meant that people's individual needs were met and their preferences were taken into account.

People were protected from the risks associated with poor medication management. We noted that medicines were properly handled and administered in line with the provider's policy. We found evidence that there were sufficient numbers of experienced staff to provide good care. We also found that systems were in place for people and relatives to make a complaint about the service if necessary.

Visitors told us that communication was excellent and that they had full involvement in the care of their relative.

We saw that people's privacy and independence were respected, people experienced safe and effective care based on detailed care plans and risk assessments that met individual needs.

People using the service were protected from abuse as they were supported by a staff team who had appropriate knowledge and training on safeguarding vulnerable adults.

We saw evidence that staff received ongoing training and supervision which provided them with the skills and knowledge to meet the needs of people.

The Provider had effective systems in place to monitor quality assurance and compliance.