Archived: Clearview

Clearview provides care and accommodation for up to seven people with learning disabilities. On the days of our inspection there were seven people living at the care home. In relation to Registering the Right Support we found this service was doing all the right things, ensuring choice and maximum control. Registering the Right Support (RRS) sets out CQC’s policy registration, variations to registration and inspecting services supporting people with a learning disability and/or autism.

People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service did not currently have a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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. However, a new manager had started work this week who had plans to apply for registration with the CQC.

The Provider Information Return (PIR), where we ask providers to tell us what they do well and what they would so better, said; “Our Director (provider) has owned the business for nearly 20 years and has always promoted a positive culture that is open and person centred.”

At the last inspection on the 5 December 2015, the service was rated Good. At this inspection we found the service remained Good.

Why the service is rated good:

People were not able to verbalise their views and staff used other methods of communication, for example pictures or sign language. We met and spoke to all the people during our visit and observed the interaction between them and the staff.

People remained safe at the service. People were protected by safe recruitment process which helped to ensure only staff suitable to work with vulnerable people where employed. Staff said there were sufficient staff employed to meet the needs of people and support them with any activities or trips out. One staff said people were safe because; “We all work together to keep people safe.”

People’s risks were assessed, monitored and managed by staff to help ensure they remained safe. Risk assessments had been completed to enable people to retain as much independence as possible. People received their medicines safely by suitably trained staff.

People continued to receive care from staff who had the skills and knowledge required to effectively support them. All staff had completed a range of training such as safeguarding training and new staff completed the Care Certificate (a nationally recognised training course for staff new to care). The new manager confirmed that the Care Certificate training included a section on the Equality and Diversity needs of people.

People were 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’s end of life wishes were not currently documented, however the new manager had plans to discuss this issue with relatives, advocates and involve people as much as possible. People's health was monitored by the staff and they had access to a variety of healthcare professionals. This helped ensure people’s healthcare needs were met.

People’s care and support was based on legislation and best practice guidelines; helping to ensure the best outcomes for people. People’s legal rights were up held and consent to care was sought as much as possible. Care records were person centred and held full details on how people liked their needs to be met; taking into account people’s preferences and wishes. Information recorded included people’s previous medical and social history and people’s cultural, religious and spiritual needs.

People were observed to be treated with kindness and compassion by all the staff who valued them. The staff, had worked for the company for some time and built strong relationships with people who lived there. Staff respected people’s privacy. People, or their representatives, were involved in decisions about the care and support people received.

The service remained responsive to people's individual needs and provided personalised care and support. People had complex communication needs and these were individually assessed and met. People were able to make choices about their day to day lives. The provider had a complaints policy in place and the new manager said any complaints received would be fully investigated and responded to in line with the company’s policy. Staff knew people well and used this to gauge how people were feeling. The policy was not provided in an accessible format for people. However, the provider and staff demonstrated they would always act on changes in people’s presentation.

The service continued to be well led. People lived in a service where the provider’s values and vision were embedded into the service, staff and culture. Staff told us the provider, who had been overseeing the service in the absence of a registered manager, was very approachable and made themselves available. The provider had monitoring systems which enabled them to identify good practices and areas of improvement.

People lived in a service which had been designed and adapted to meet their needs. The service was monitored by the provider to help ensure its ongoing quality and safety. The provider’s governance framework, helped monitor the management and leadership of the service, as well as the ongoing quality and safety of the care people were receiving.

Below is a summary of what we found. The summary describes what the staff told us, what we observed and the records we looked at.

If you want to see the evidence that supports our summary please read the full report.

This is a summary of what we found:

Is the service safe?

We found that overall the service was safe. There were proper procedures in place to record what medicines people were prescribed and when they had taken them.

We noted that all medicine was kept under lock and key according to regulations and the home had systems in place to ensure that it would be difficult for the people who lived at the home to gain unauthorised access to the medicines. We saw that only staff who had been trained were allowed to administer medicines.

Below is a summary of what we found. The summary describes what we observed and the records we looked at.

If you want to see the evidence that supports our summary please read the full report.

We inspected this service because at a previous inspection we found that improvements were needed to the way medication was managed. A senior member of care staff assisted throughout the inspection.

Is the service safe?

We saw that medication was generally managed well and in a safe manner. For example, staff had received training in administering medication. We also saw that medication was stored securely.

However, we identified some improvements were needed. Not all policies had been recently reviewed, issues identified through audits had not always been followed up, and recordings on Medication Administration Record (MAR) charts were not always accurate. A compliance action has been set for this and the provider must tell us how they plan to improve.

We saw that people were relaxed and happy in their home. One person was having a lie in. Staff said that they respected this person's choice and would support them to get up when they were ready.

Care plans were detailed and included information about how people wanted and preferred to be supported.

We saw a folder containing photographs of one person and important aspects of their life. This ensured that the person was able to understand and be involved in issues concerning their care and lifestyle.

We saw that people had a well- balanced and varied diet. Any special dietary needs had been catered for and guidelines were in place when any risks had been identified.

A health professional we spoke to said that people's health needs were well met. They said ' Staff are good at considering preventative care, and make appropriate, prompt referrals when they have any concerns'

Staff had been provided with updated, clear information about procedures to safeguard people who used the service.

We saw that the recording of incidents had been improved to include more detail. These changes ensured that the provider could have an overview of incidents and consider any lessons for future practice.