Claremont Care Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people were safe and protected from avoidable harm.

This service scored 69 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had demonstrated a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events appropriately. Lessons were learned to continually identify and embed good practice.

Care plans, risk assessments, and daily records had been regularly reviewed and updated to reflect people’s changing needs and associated risks. Evidence showed that learning from monitoring, observations, and professional input was used to adapt care approaches. For example, changes in people’s mobility, health condition, behaviour, or ability to use call bells. These resulted in revised care plans, updated monitoring arrangements, and strengthened guidance for staff.

Accidents, incidents, and falls were accurately reported and reviewed, with clear analysis of trends and themes. Actions were taken in a timely manner following each event.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

Care pathways were responsive to people’s individual circumstances. There was clear evidence of ongoing involvement from healthcare professionals including GPs, district nurses, and nursing staff. Health conditions such as dementia, and the effects of stroke were clearly identified within care plans, alongside guidance on monitoring, escalation, and review.

Staff told us how they were supported involved prior to new people coming into the home as part of the pre-admission process. One staff member told us, "Anytime we have a new person, we read their care plan, body map, check for injuries, and learn how to support them safely." Another staff member told us, “We have a small meeting or the nurse in charge discusses this with us, and we are shown the care plan."

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes this can be done through a procedure called the Deprivation of Liberty Safeguards (DoLS), which is part of the Mental Capacity Act 2005 (MCA). We checked whether the service was working within the principles of the MCA and how they managed DoLS within the service.

Records demonstrated people were cared for in the least restrictive way, adhering to and promoting the principles of the Mental Capacity Act (MCA) 2005. Deprivation of Liberty Safeguards (DoLS) authorisations were sought when needed and any conditions imposed by them were followed.

Staff had completed safeguarding training and gave examples of how they incorporated this into their work. One staff member told us, “Serious concerns are investigated and reported to Local Authority Safeguarding, my line manager, and notified to CQC." Another told us, “If we notice anything that could put someone at risk, we report this immediately to the manager so assessments and preventative measures can be put in place."

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

People were supported to be actively involved in understanding and managing risks to their safety and wellbeing in ways that promote choice, independence, and dignity. This included supporting people to mobilise safely with appropriate equipment and maintaining clutter‑free environments. Records demonstrated that these checks were completed consistently and flexibly in response to individual need.

Where people may have experienced distress or agitation, staff were guided to use calm, patient approaches, allowing time for people to settle and re‑approaching care when appropriate. Staff told us they were aware of when to seek further clinical input to ensure emotional and physical risks are managed effectively. One member of staff told us, "Care plans are updated regularly as people’s conditions change, including mobility, nutrition, and end-of-life care needs."

People and their relatives told us they felt risks in the home overall were managed safely. People and their relatives gave examples of how risks had been identified and managed. One relative told us of a risk in relation to a person’s wheelchair. We discussed this with the management team who were already aware of this and action had been taken. One relative told us,” [Name] has equipment to support with their needs.”

The provider did not always detect and control potential risks in the care environment. They did not always make sure equipment, facilities and technology supported the delivery of safe care.

Some areas of the home required further improvement, including redecoration, replacement of worn carpets, and further external maintenance. Although a refurbishment plan was in place and some works had commenced, progress had been slow. This was discussed with the Registered Manager to ensure remedial actions were prioritised. On the second day of the inspection, additional work had commenced in the bathrooms. The Registered Manager confirmed this would be discussed with the provider to ensure refurbishment work continued across the home without delay.

Routine maintenance arrangements and safety checks were in place, including gas safety and equipment servicing. However, some wheelchair safety checks had not been completed on all required days. This was discussed with the Registered Manager to ensure appropriate oversight and timely completion. Personal Emergency Evacuation Plans (PEEPs) were in place within people’s care records to support safe evacuation in the event of an emergency.

The provider ensured there were sufficient qualified, skilled, and experienced staff in place, who received appropriate support, supervision, and development. Staff generally worked well together to deliver care that met people’s individual needs safely.

Staffing was planned using a dependency assessment tool, which informed rota planning and staffing deployment. Rotas reviewed for the previous four weeks demonstrated that staffing levels were consistently maintained, with no identified gaps. Where agency staff were used, this was to support one‑to‑one care needs. However, staff feedback about staffing levels was mixed. One staff member told us, “Staffing levels are sufficient. When numbers increase, more staff are added.” Another said, “Sometimes we need one extra staff member, but generally cover is arranged.” A third staff member commented that the service was “often short‑staffed,” which they felt placed pressure on both staff and people.

Some people and relatives told us there were sufficient staff on duty and that staff were visible and responsive. One person said, “The response to the buzzer is usually quick.” A relative told us, “There are staff popping in and out of her room all the time. You occasionally wait for the door to be answered but otherwise it is okay. There is always staff in the day room. People are not waiting for things.” Another relative said, “Staffing levels seem fine from what I see. Staff come and go when I am there. I get the impression it’s a stable team.”

During the inspection, we observed there were sufficient staff on duty to support people safely. Staff did not rush people when assisting with transfers or when supporting people to eat and took time to engage with people appropriately. This provided reassurance that staffing levels on the day of inspection were adequate to meet people’s immediate care and safety needs.

Recruitment processes were safe, and staff had the appropriate skills, to carry out their roles. Records relating to recruitment checks, including references and employment checks, were in place, alongside induction and training documentation. Staff received ongoing support through supervision and development opportunities, and staff told us they felt supported by the manager.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

Staff we spoke with had no concerns about Infection Prevention and Control (IPC) practices in the service. Processes were in place to ensure infection control risks were assessed and managed safely. Cleaning staff were operating around the home. We found the home was clean, hygienic, and good standards of cleanliness were maintained. One staff member told us, “We are provided with aprons, gloves, hair nets, and PPE is ordered as needed."

The provider did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff did not always involve people in planning.

Medicines were stored securely in locked cupboards, with internal and external medicines appropriately segregated. There were no missed medicinesidentifiedon the day of inspection, and sufficient stock was available to support safe administration.

People who were prescribed‘as and when required’ (PRN)medicineshad protocols in place, but these were not all in depth and person-centred so staff would know when to give these appropriately.

Liquid medicines did notalwayshave the date of opening recorded on their labels, which created a risk that medicines could be administered beyond their once‑opened expiry date.One person’s topical cream which should have been refrigerated wasalsofound in the drug trolley and not stored appropriately following manufacturer instructions.These issues were discussed with the registered manager on inspection and rectified straight away.

Body maps were in place for people prescribed topical creams to support staff in applying these medicines correctly.However, this was reliant on staff documenting on the electronic care system where these had been applied. Similarly, people who were prescribed patchesalso had to rely on staff documenting on the system where these had been applied.Although itwas notalways clear,there was evidence of patch rotation taking place.

We found one instance of time critical medicines being given late however, this was isolated as all other records reviewed showed these were given on time. When asked, the registered managerassured us this was being reviewed by the GP and Parkinsons’ nurse. The morning dose was alwaysgivenon time.

Controlled drugs, which require extra storage and documentation due to their potential for abuse and misuse, were checked weekly and stock levelswere correct with two staff signatures present for all entries.

Temperature monitoring was completed daily to ensure medicines were being kept in the correct environment. A drug waste disposal register was in placetoevidence thatstaff were documenting when a medicine was being destroyed.