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Inspection carried out on 11 February 2020

During a routine inspection

About the service

Clarendon Grange is a residential care home that provides personal care and accommodation for up to 25 people. At the time of our inspection there were 24 people living at the home. Accommodation is over two floors and there is a lift for access.

People's experience of using this service and what we found

People told us they felt safe living at Clarendon Grange. The provider had suitable safeguarding systems in place to protect people from harm and abuse. The registered manager ensured that accidents and incidents were appropriately managed to lessen any future risk. There were enough staff available to support people as they wanted. The provider carried out checks when recruiting staff. Staff managed people’s medicines safely and kept the home clean and hygienic.

People were supported to live healthy lives by staff working collaboratively with external health and social care professionals. Staff assessed and worked with people to identify and meet their care and nutritional needs. A varied, nutritious diet and drinks were provided that reflected people’s needs and wishes. People were cared for by staff who were well supported and trained with the right skills and knowledge to meet people’s diverse needs effectively. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People were treated with kindness, courtesy and compassion by staff who respected their privacy and dignity and promoted inclusion. We were told by people, professionals and relatives that Clarendon Grange was a homely, welcoming and very caring place to live. We received very positive feedback about the caring and respectful approach of staff who knew them well and understood their personal histories, interests, likes and dislikes

The provider and staff worked consistently to provide outstanding standards of compassionate care at the end of life, that included families’ needs. This was confirmed by healthcare professionals who commended the teamwork approach taken. Staff involved people to develop detailed care plans and record personal wishes. People’s changing needs were quickly identified and responded to very quickly. People and their relatives told us about the good progress made and their improved well-being since living at the home. An excellent range of activities and opportunities were available to people inside and outside the home.

The service was being well-led and supported by the provider and registered manager and people felt management was very approachable and caring. People felt the care they received was of a high standard and liked living at the home. Everyone we spoke with said they would highly recommend the home. The culture was open and inclusive, if people were not happy about something, they were confident they could speak with staff to make improvements. The manager understood their responsibilities and monitored the quality of the service using a range of systems. People benefited from a well organised service that was very person-centred.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 17 August 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our inspection programme. If we receive any concerning information we may inspect sooner.

Inspection carried out on 7 July 2017

During a routine inspection

At the last inspection in February 2015 the service was rated good. At this inspection we found the service remained good overall but we identified some improvements needed in relation to good governance.

The home had a suitably qualified and experienced registered manager. She had created an open culture where both staff and people in the home felt they could be honest and open. Everyone we spoke with judged that the care of vulnerable people was the focus of the service.

We saw evidence to show that the registered manager audited aspects of the operation of the home and that the registered provider sent surveys to people in the home (and others) from time to time. We noted that although senior members of the company visited the service there was no in depth records of their visits and quality audits. There was no written plan in place to outline the future plans for the home. We made a recommendation about these matters.

Clarendon House is a residential care home which can accommodate up to twenty five older people, some of whom may be living with dementia. Accommodation is in single, ensuite rooms. The home has suitable shared spaces and a pleasant, enclosed garden.

Staff were trained to understand and report any potential or actual abuse. We had evidence to show that the manager made appropriate referrals, where necessary.

The service had suitable risk assessments in place and a plan for any foreseeable emergencies. Accidents and incidents were monitored and dealt with appropriately.

Staff were suitably recruited, inducted and trained. Staff received supervision. Staffing levels were suitable and the night staff levels were increased on the day of our inspection.

Medicines were appropriately managed.

The house was warm, safe, well decorated and well furnished. The home was clean and good infection control practice was in place.

The registered manager understood her responsibilities under the Mental Capacity Act 2005. 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. Restraint was not used and we had evidence that people were asked for consent for all interventions.

People ate well and told us the food was of a very high standard.

People had ready access to health care professionals. Staff supported and cared for people during times of ill health and at the end of life.

We observed caring and sensitive interactions between staff and people in the service. We learned that people were respected and treated with dignity and patience.

Each person had a care plan and these gave suitable guidance for staff. People were well groomed and told us that the care delivery was of a very high standard.

The home had an activities organiser and people enjoyed the activities and entertainments on offer.

We had evidence to show that complaints were suitably managed.

Further information is in the detailed findings below.

Inspection carried out on 12th February 2015

During a routine inspection

This was an unannounced inspection that took place on 12th February 2015.

Clarendon Grange is an older property that has been extended and adapted to provide accommodation for up to twenty five older people. It is situated near to the village amenities and is served by a regular bus service. Accommodation is in single occupancy rooms 24 out of 25 of which have en-suite toilet facilities. There is a well maintained garden and patio area for people to enjoy.

The home has 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 and associated Regulations about how the service is run.

We found the service to be safe because there are good arrangements in place to protect vulnerable people from harm and abuse. People told us they felt safe with the staff team and were secure in their environment. The home has suitable numbers of staff. Staff recruitment is done appropriately and new staff are suitably vetted. The company has good procedures in place to deal with staff disciplinary matters. Medicines are managed correctly in the home with good systems in place and staff training up to date. Infection control is being managed correctly.

People in the home judged the service to be effective because they were happy with the expertise of the staff group. No one felt they were being deprived of their liberty. Staff understand their responsibilities under the Mental Capacity Act 2005. People told us they enjoyed the food provided. We saw evidence to show that nutritional planning is well managed. The home is and older property that has been suitably designed and adapted for people with mobility issues.

We saw caring, discreet and sensitive care from the staff team. People told us they judged the staff to be caring. We saw that people are treated with dignity and respect and their needs kept confidential. Privacy is maintained by the approach of the staff. We spoke to the local community nurses who told us the staff managed end of life care very well.

We learned that the staff team put the needs of people first. We saw assessment and care planning in place. People told us they got the care they needed and wanted. People in the home said they had suitable activities and entertainments.

We judged the service to be well led. People told us they trusted the manager and her team. Staff are happy with the registered manager’s leadership style. We judged the management of the home to be open and transparent with the needs and wishes of people in the home at the centre of the operation. There is a focus on good quality care and services. We saw that all aspects of the operation are regularly monitored and audited.

Inspection carried out on 3 August 2013

During a routine inspection

People told us they were very happy living in Clarendon Grange and appreciated the support and care they received. Comments included,

�I can choose what to do and if I want to stay in my room and read I do just that�.

�I have lived here a long time and do not regret my decision to move in�.

�It is lovely here, we can do just what we like�.

Relatives were also happy with the care and felt their family members were very well supported. They said:

�I am very happy with the care my [relative] receives and do not need to worry about them�.

From our observations and conversations with people there we found they got the support they needed and were given choices about their care and their social activities. We saw that staff encouraged people to maintain their independence and control over their lives.

Staff working there had received appropriate training to support individual needs and to understand different conditions. The provider had effective recruitment procedures in place and had carried out relevant checks on the staff they employed. This helped to make sure that staff were suitable for working with the people living there.

Records and care documents were well maintained and held securely in locked facilities.

Inspection carried out on 24 April 2012

During a routine inspection

People who live in the home were keen to talk to us about the experience of living at Clarendon:

"I am so glad I decided to come here...I am very happy...it couldn't be better...".

"I like living here...the staff are very nice...".

"We all get on well here...we are friends and the staff look after us well...".

"I get everything I need...good food, nice room and kind carers".

"It is very good and I feel safe and well looked after...no complaints at all".

Reports under our old system of regulation (including those from before CQC was created)