Archived: Clare House Care Home

On the day of our visit there was a registered manager. A registered manager is a person who has registered with the Care Quality Commission 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. We were also assisted by the deputy manager, who was also the clinical lead.

People said that they felt safe. Relatives of people felt their family members were safe. One person said, “I feel safe because if I needed help at night there is always staff available.” Staff had knowledge of safeguarding adults procedures and what to do if they suspected any type of abuse.

There were enough staff deployed at the service. We saw that people’s needs were met by staff when they needed help. People told us that there were enough staff. One person said, “There is an abundance of staff.”

Risks to people’s safety were identified and appropriately managed. Staff were aware of the risks to people and what actions they should be taking that included risks around their care. Incidents and accidents were recorded and action taken to reduce the risks of these occurring. There were robust recruitment processes in place before staff started work.

People's medicines were managed safely and medicines were stored securely and in an appropriate environment.

People and relatives told us that they felt staff were competent in their roles. One person said, “I feel confident with them (staff)” with their clinical care.” Staff had the training and experience they needed to meet people’s needs. Staff’s competencies were assessed regularly in one to one meetings with their manager.

People’s human rights were protected because the requirements of the Mental Capacity Act (MCA) and Deprivation of Liberty (DoLS) was being followed. Where gaps had been identified around MCA assessments these were being addressed by the registered manager.

People had mixed views about the quality of the food at the service.although we found people were provided with adequate nutritious food to maintain their health. Comments included, “The food is quite good and tasty” and “The food is acceptable but not exciting.” People at risk of dehydration or malnutrition had effective systems in place to support them including being regularly weighed and food and fluid charts being put in place if needed.

People had access to a range of health care professionals. Advice given by health care professionals was followed by staff.

People and relatives felt that staff were kind and caring. One person said “The carers are just brilliant.”

Staff interacted with people in a kind and compassionate manner and treated with people with dignity and respect. It was clear that staff understood people’s needs and how to communicate with people. People and relatives were involved in decisions about their care.

People were cared for in a compassionate and dignified way at their end of life. The registered manager told us that more work was being undertaken to ensure that people’s wishes about end of life care was obtained.

Detailed assessments of people’s needs were undertaken and people felt they were getting good, responsive care. One person told us “My health has improved (since moving in) I am much more mobile because of the care I am getting.” The registered manager confirmed that where there was information missing around the particular needs of people that this was would be addressed.

There was a lack of social interaction for people who were being cared for in their rooms and activities were not always person centred. However there were other activities that people participated in including, poetry, music, pet therapy, bingo, drawing, move and groove, donkey visit and church services. The registered manager told us that more work was being done to address the personalised activities. We have made a recommendation that this aspect of peoples care is improved.

People and relatives were aware of the complaints process and people were supported to make complaints if they needed to. Complaints were responded to appropriately.

People, relatives and staff said they were happy with the management and running of service. One person said, “I find (the manager) to be very approachable, pleasant, friendly and takes on board what you are saying.” We saw during the inspection that the registered manager engaged with people positively and had a good amount of knowledge about the people living at the service.

There were systems in place that ensured that people and staff were involved in the running of the service and staff felt valued and appreciated.

There were a number of systems in place to make sure the provider assessed and monitored its delivery of care including audits, surveys and meetings with staff. Records were kept securely.

Services that provide health and social care to people are required to inform the Care Quality Commission (CQC) of important events that happen in the service. The registered manager had informed the CQC of significant events in a timely way. This meant we could check that appropriate action had been taken.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, their relatives, and the staff supporting them and from looking at records.

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

Is the service safe?

People are treated with respect and dignity by the staff. People told us that they felt safe living at the service. One person told us, 'Staff here are very good, I cannot think of anything bad to say about them.'

The registered manager sets the staff rotas to show they take people's care needs into account when making decisions about the numbers, qualifications, skills and experience required. This helps to ensure that people's needs are always met. Some people told us that they believed another member of staff should be employed for the later shift, especially around bed times.

We saw that two care records we looked at had not been reviewed on a monthly basis as required by the provider.

Is the service effective?

People's health and care needs were assessed and they and their relatives were involved in annual reviews of care plans. Records showed that people had access to all the healthcare professionals as and when required.

The registered manager and staff work with other care agencies when transferring a person to another service.

Is the service caring?

People were supported by kind and attentive staff. We saw that staff were patient and gave encouragement when they supported people. People told us, 'Staff always help me, and they listen to what I have to say.' People told us that the staff were very, very good.

The registered manager and staff told us that people who use the service, their relatives and associated professionals completed annual satisfaction surveys. One person who used the service told us they had completed a questionnaire.

People's likes, dislikes and religious needs had been recorded and care and support had been provided in accordance with people's wishes.

Is the service responsive?

People completed a range of activities in and outside the service regularly. People said they could make choices about the activities they wanted to do.

Is the service well-led?

The service has a system in place to monitor the quality of the service provided. We saw that the service maintained records of accidents and incidents. We saw that the registered manager had a book to record complaints received at the service and the outcomes of complaints were recorded.

People who used the service told us that they were very happy about the care they received from staff. They told us that consent about their care and treatment had been sought by staff. They gave us examples of how staff did this. For example, one person told us, 'Staff would always ask me if I was ready for them to help me with my personal care before they began.' Another person told us, 'Staff ask me if I am ready to get out of bed and get dressed. If I want a little longer in bed I tell them and they would come back later.'

People we spoke with told us they had an assessment of their needs undertaken. One person told us, 'I was asked lots of questions about myself.' They told us that they had a care plan and these were reviewed every month with them and with their relatives.

People told us that they saw the General Practitioner and other healthcare professionals when they needed to.People who used the service told us that the food was very good. One person told us, 'They give me what I ask for and I can have a snack during the night if I want one.'

All the people we spoke with told us they knew how to make a complaint. They told us they had never had to make a formal complaint.

People who used the service told us that they make choices every day that included choosing their bedtimes, the food they would like to eat and the clothes they would like to wear. They said they could eat their meals anywhere, for example, one person told us 'I am having my lunch in my bedroom today because I want to.' Another person told us 'I make choices every day.' A relative we spoke to confirmed that staff asked their relative what they would like to do each day. People told us that they had an assessment of their needs undertaken. One person said 'I was asked lots of questions about myself.'

People told us they had a care plan and they had seen this. One person told us 'I have a care plan but I do not need to see it as all the staff know what they are doing when they help me.' People also told us that they felt safe living at the service.

We observed staff interacting with people who used the service in a polite and respectful manner, calling people by their preferred names and listening to what people had to say before responding to them.