Clarendon House Care 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.

This is the first assessment for this service since registration. This key question has been rated Good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this

This service scored 71 (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 made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

Staff completed a comprehensive assessment of each person’s physical and mental health either on admission or soon after. People’s preferences were recorded and, where possible, taken into account. Care plans reflected a good understanding of people’s needs, including relevant assessments of people’s communication support and sensory needs.

People had care and support plans that were personalised, holistic, strengths-based and reflected their needs and aspirations, including their physical and mental health needs. People, including people important to them and staff, reviewed plans regularly together.

Nursing staff used nationally recognised assessment tools to identity risk, for instance when assessing skin integrity. Systems were in place to ensure assessment of needs were reviewed when people’s needs changed.

People were not routinely supported in an environment which promoted their wellbeing. People living with dementia on the first floor of the home would have benefitted from nationally recognised best practice guidance. Although we noted some interactive features such as wall murals of established shops from Buckingham high street and interactive displays of historical items, there was limited orientation opportunities for people living with dementia. The use of colour and contrast was not evident within bedrooms and communal spaces. In addition, no colour contrast was used in bathrooms. Bathroom fixings were the same colour and shape which made it difficult for people to identify the purpose of each. This could impact on their level of independence. We provided feedback to the provider about how improvements could be made to the environment in accordance with evidence-based care and treatment.

We observed some people would have benefitted from staff who understood and had skills in non-verbal communication. We provided examples to the registered manager where staff had failed to pick up on subtitle communication from people. Following our feedback the service had shared information with staff regarding respectful and inclusive language in health and social care from a referenced source.

Staff had received training on supporting people with modified diets and information was readily available in each kitchenette as a prompt for staff.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people their assessment of people’s needs when moving between different services.

People and their relatives told us they felt their care was co-ordinated and staff responded quickly to any changes in their condition. A relative told us their family member had been unwell during recent weeks, and the service had “gone above and beyond” to ensure the person’s medical needs were met.

External healthcare professionals told us they were confident information given to the service was shared and utilised to ensure continuity of care. They told us information was promptly shared with people’s representatives or families. External healthcare professionals told us when they visited people at the service, staff were well informed of where their support was required and staff “stay with people to help share information I need”.

Systems were in place for staff to share important information to the next shift. In addition to handover meetings, the registered manager met with the heads of departments each day to cascade important information. The service checked staff’s competency to ensure they understood and applied training and best practice. Staff received support in the form of continual supervision, appraisal and recognition of good practice.

Staff described morale as good. Comments from staff included, “Very happy staff who work hard and support each other”, “Generally positive and we work well as a team” and “We work as a team and support each other.”

Staff spoke about how they worked together to build respectful, supportive relationships with the people they cared for. They said they had access to personal histories, preferences and goals, which helped them to provide more personalised care.

Staff described a culture of dignity, inclusion and mutual respect. Staff said they were appreciated and supported by both colleagues and managers.

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

People were referred to health care professionals to support their wellbeing and help them to live healthy lives. Staff worked well with other services and professionals to prevent readmission or admission to hospital.

People and their relatives spoke positively about how the nursing staff had supported timely referrals to GP and other healthcare professionals. One person’s medicine had been changed which had significantly improved their wellbeing. One relative told us, “Our [person] enjoys chair exercises and staff ensure they are offered this opportunity weekly”. “Our [person] receives special podiatry services once per month, which the service arranges for them”.

We received positive feedback from external healthcare professionals who visit the home. They told us staff were knowledgeable about people's needs. Comments included, “staff are able to summarise key points about the individual’s wellbeing, any recent changes, and any risks or preferences I need to be aware of” and “The service makes referrals when required and communicates with external professionals appropriately. Whenever I attend the home, staff are proactive in informing me if any residents require attention or if there have been any changes that may affect their health.”

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

People were supported with their healthcare needs and had access to a GP. The registered manager told us “We have an excellent relationship with our nominated GP surgery, which provides regular scheduled visits carried out by a GP or an advanced practitioner. The surgery pharmacist completes annual medication reviews for each resident and offers ongoing advice throughout the year, ensuring medication remains safe, effective, and appropriate to residents’ changing needs.”

People were supported to maintain their level of mobility and gain access to social opportunities. A varied programme of structured activities was offered on a weekly basis and people were asked for their preferences for content of this.

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

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible.

We found mental capacity assessments were completed in line with the code of practice of the MCA. However, we found some MCA’s had been completed after we requested the person’s care planning documents. We have asked the provider to ensure the conclusion of the MCA’s are clearly recorded when the assessment has been completed.

Staff understood the principles of gaining valid consent and how it applied in day-to-day practice. They told us gaining consent from people before providing care and support was embedded within their working practices.

Where an MCA concluded a person was unable to consent to a decision, the service checked if a third party had legal authority to support decision making.