30 March 2015
During a routine inspection
This inspection took place on the 30 March 2015 and was unannounced.
Clarendon Mews provides residential care for up to 45 people many of whom are living with dementia. At the time of our inspection there were 40 people in residence. Accommodation is provided over three floors with access via a stairwell or passenger lift. The majority of communal living areas are located on the ground floor, with smaller seating areas located on the first and second floor. There is a garden which is accessible and provides areas of interest.
Clarendon Mews had a registered manager in post at the service at the time of our inspection. 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.
People who used the service and visiting relatives told us they felt safe and were well cared for. People were supported by staff in a timely and sensitive manner, which meant people’s needs were met and that there were sufficient staff on duty.
Staff were able to tell us what action they would take should they believe somebody was being abused and were aware of the provider’s policies and procedures, which included whistleblowing. Records showed staff had received training to support them in recognising potential abuse and this provided them with guidance as to their role in promoting people’s welfare.
Potential risks to people were assessed and measures put into place to reduce risk, which included the use of equipment and the provision of personal care which were reflected within people’s plans of care.
People received their medication as prescribed and their medication was stored safely. We found that the principles of the Mental Capacity Act (MCA) 2005 had been correctly followed with regards to the administration of medication covertly (without the person’s knowledge).
People we spoke with told us that staff provided the care and support they required and had a good understanding as to the needs of people living with dementia. Records showed staff had undertaken training which enabled them to meet people’s needs.
People were protected under the Mental Capacity Act 2005 Deprivation of Liberty Safeguards (MCA 2005 DoLS). We found that appropriate referrals had been made to supervisory bodies where people were thought to not have capacity to make decisions themselves about receiving personal care and leaving the service without support.
People we spoke with were complimentary about the meals provided at the service. Where people were at risk of poor nutrition, advice from health care professionals was sought and their recommendations followed. This meant people were supported to eat and drink enough and maintain a balanced diet. The dining experience for people did not meet everyone’s needs in a timely manner. Following our inspection the registered manager advised us they had reviewed how staff supported people and had made changes to improve the service people received.
People we spoke with and their visitors told us they had good access to healthcare. Records showed people were referred to the appropriate health care professionals when necessary and that their advice was acted upon. This meant people were supported to maintain good health.
There were open and positive relationships between people who use the service, their relatives who visited and staff. This created a friendly, calm and welcoming environment for people to live in and visit. People were supported by staff who sought to provide companionship and social interaction in a caring manner. Where people became distressed or anxious staff offered reassurance.
People we spoke with told us they were involved in the development and review of plans of care and that staff kept them up to date with any change to people’s needs and health. Visitors said they were encouraged to be involved in decisions about their relative’s needs and were provided with opportunities to comment on and influence the care provided.
Staff had a good understanding as to the needs of people and told us how they supported people in making day to day decisions about their lives. We observed staff supporting people in a way that respected their privacy and dignity.
People’s needs were assessed prior to them moving into the service. The registered manager met with people to ensure their needs could be met by the service and spoke with them about the care they needed. People who used the service, visitors and staff spoke to us about the care and support within the service and how this was personalised and reflective of people’s individual needs and choices.
The environment was decorated and adapted to meet the needs of people living with dementia. The environment was interactive and enabled and encouraged people to take part in activities and perform tasks which provided them with reassurance and a sense of purpose. The garden was accessible and provided areas of stimulation and was used by people who wished to have a cigarette.
People were encouraged to take part in activities and events which promoted their well-being individually and with staff support. The service had a range of animals which people who used the service interacted with and helped care for, which included walking the dog.
People who had expressed concerns told us these had been responded to quickly and well. Information about the providers’ complaints procedure was accessible. The service had not received any complaints within the last twelve months.
The registered manager and staff had a clear view as to the service they wished to provide which focused on promoting people’s rights and choices, and the provision of a stimulating lifestyle. Staff were complimentary about the supported they received from the management team and commented that they led by example.
The registered manager undertook effective audits to check the quality and safety of the service. The service had strong links with health and social care professionals who helped to ensure people were in receipt of quality care.
People and staff had the opportunity to influence the service by attending meetings and sharing their views through one to one discussions that were both formal and informal, which enabled the provider to review and develop the service.