Clifton Manor Nursing Home

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question good. At this assessment the rating has changed to outstanding.

This meant people’s outcomes were consistently better than expected compared to similar services. People’s feedback described it as exceptional and distinctive.

This service scored 96 (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 always made sure people’s care and treatment was effective by thoroughly assessing and reviewing their health, care, wellbeing and communication needs with them.

People's needs were assessed before they began using the service to ensure appropriate support was in place. Staff worked together with people to review care and ensure it reflected people's current needs, preferences and goals. Information was shared effectively across the team, and records were updated when people's needs changed. People told us staff regularly discussed their care with them. One relative told us, “We've been so happy with the communication, they always phone us with any changes.”

Staff demonstrated an exceptional understanding of people's individual needs and how these changed over time. They were able to describe how support had been adapted in response to changes in people's physical health, emotional wellbeing and life circumstances to ensure care remained effective and person centred.

We saw examples of the service taking a highly personalised and clinically informed approach to assessing people's needs. When a person's presentation changed significantly, the clinical team worked with healthcare professionals to develop a better understanding of the factors influencing their behaviour and wellbeing. Rather than relying on initial assumptions, staff explored a range of possible causes and adapted support accordingly. This resulted in a more person-centred approach to care, improved staff understanding of the person's needs, and positive outcomes for their wellbeing, dignity and quality of life.

The service continually sought to improve how people's needs were understood and met. Leaders encouraged staff to use research, specialist knowledge and clinical evidence to inform assessment and care planning. People benefited from assessments that recognised the complexity and individuality of their needs. This helped ensure support remained responsive to people's changing needs and reflected current understanding of good practice.

The provider always planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation. They worked to develop evidence-based good practice and standards.

The provider followed professional guidance and monitored people's health needs to support effective care and treatment. Care plans contained clear guidance for staff on how people should be supported and reflected people's preferences, wishes and life histories. Records showed care plans were regularly reviewed with people and updated when people's needs changed.

Leaders actively explored new ways of supporting people and evaluated the impact of interventions before embedding them into practice. For example, the service introduced a structured Cognitive Stimulation Therapy (CST). CST is a structured programme for people living with dementia that uses activities and discussion to improve thinking skills, confidence and social interaction. This resulted in people becoming more socially engaged, demonstrating improved confidence and mood, and developing stronger relationships with others. The programme had such a positive impact that it was incorporated into the home's ongoing activities programme.

Staff also introduced other evidence-informed approaches tailored to individual needs. For example, weighted doll therapy was used to support a person living with advanced dementia who experienced anxiety and distress. Doll therapy is a recognised therapeutic approach used in dementia care, where a lifelike doll is offered to provide comfort, reassurance and a sense of purpose. The intervention led to increased periods of calm, improved engagement and better sleep patterns. People's physical health and wellbeing were monitored closely. Outcomes from interventions were regularly reviewed and used to further develop care and support.

There was a strong emphasis on supporting people to eat and drink well. People had access to a wide choice of food and drinks throughout the day, and staff understood people's individual preferences and dietary needs. We observed positive dining experiences, with staff providing support where required whilst maintaining people's independence and involvement. Meals and refreshments were readily available throughout the day, helping to promote hydration, nutrition and wellbeing.

The provider always worked well across teams and services to support people. They shared thorough assessments of people’s needs when they moved between different services, so people only needed to tell their story once.

The service worked effectively with external partners to ensure people experienced coordinated care and support. When people required input from health or social care professionals, staff made timely referrals, shared relevant information and acted on recommendations which had helped achieve positive outcomes for people.

Staff worked exceptionally well together and understood their responsibilities in meeting people's assessed needs. Effective communication, regular information sharing and strong working relationships helped ensure people received consistent support from all members of the team. Staff told us this collaborative approach, alongside training and effective communication, enabled them to provide high-quality, person-centred care. One staff member told us, “The staff provide appropriate care, everybody here is different, they know who lives here extremely well, staff do go above and beyond, they take this job very personally.”

The provider promoted a collaborative culture where staff from different departments worked together to support people's wellbeing. Staff were encouraged to take part in activities and engagement opportunities regardless of their role, helping to ensure people benefited from a consistent and coordinated approach to support. Knowledge, skills and learning were shared across the service, enabling staff to respond effectively when people's needs changed and helping to achieve positive outcomes for people.

People benefited from a coordinated approach to care, with staff, managers and external professionals working together to ensure support was consistent, responsive and focused on what mattered most to them.

The provider always supported people to manage their health and wellbeing to fully maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

Staff were vigilant in monitoring people's health and wellbeing and sought timely input from healthcare professionals when required. The service maintained positive working relationships with health and social care professionals and acted on advice and recommendations to ensure people received effective support. People were supported to access services and opportunities that promoted positive health and wellbeing outcomes.

The provider took a proactive approach to promoting people's physical, emotional and cognitive wellbeing. People were consistently supported to take part in a wide range of meaningful opportunities, including dementia cafés, animal therapy, gardening activities, church groups, breakfast clubs and community outings. These opportunities were tailored to people's interests and encouraged independence, social connection and wellbeing.

The service continually looked for ways to improve people's quality of life through the use of research, therapeutic approaches and health promotion initiatives, as described elsewhere in this report. For example, the service achieved oral health accreditation and supported staff to develop their knowledge and skills in oral health care.

People's emotional wellbeing was also prioritised. We observed staff interacting with people in a caring and compassionate way, showing empathy, patience and encouragement.

People were supported to access community and outdoor opportunities, including spending time in the garden and participating in activities that reflected their interests and preferences. The provider worked creatively to ensure people could continue to participate in opportunities that promoted health and wellbeing, regardless of the complexity of their needs. We observed and were told about examples of how this helped people remain active, engaged and connected to their communities whilst enhancing their quality of life.

The provider monitored all people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they fully met both clinical expectations and the expectations of people themselves.

Records showed care plans and risk assessments were regularly reviewed. All staff had access to up-to-date information through the electronic care planning system. Effective monitoring processes helped staff recognise changes in people's health, wellbeing and behaviour and we saw that staff responded appropriately and in a timely way.

The provider used information from care records, behaviour monitoring and clinical reviews to understand people's changing needs and measure the impact of support. Detailed analysis identified trends, triggers and factors affecting people's wellbeing. The provider demonstrated how this allowed staff to introduce targeted interventions and adapt support when needed and in line with people’s individual circumstances. For example, behaviour monitoring identified patterns relating to physical health, family visits and environmental factors. The provider used this information to implement specific interventions, review outcomes and further adjust support where required. This helped reduce distress, improve engagement and ensure people received support that reflected their current needs.

Relatives told us staff knew people well and recognised when their needs changed. One relative told us, “[My relative] can no longer say what they need, but the staff just know. They're brilliant.”

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

Records showed mental capacity assessments and best interest decisions had been completed for individual decisions. Staff received training in relation to the Mental Capacity Act 2005 (MCA) and understood the importance of gaining consent from people. Mental capacity assessments included specific decisions and considered whether people could understand, retain and weigh up the information and communicate their decisions.