We carried out a review of the data available to us about The Clavadel on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about The Clavadel, you can give feedback on this service.
We found the following examples of good practice.
People continued to access the vital personal care and rehabilitation services in a COVID-19 secure way throughout the pandemic and were complimentary about the support they received. The management implemented robust plans to re-arrange the services in line with the national guidance to enable continued operation of the centre. For example, different care pathways were clearly assessed to include COVID-19 testing for people, social distancing and self-isolation plans. The physiotherapy support was individually tailored to people’s circumstances so they could regain their independence as quickly as possible and at the same time being protected from the spread of infections.
Staff received a range of COVID-19 specific in house training which was refreshed every three months. This included competency based direct observations, as well as remote support to regularly refresh their knowledge via skills-based questionnaires and video sessions. The range of subjects covered effective infection prevention and control (IPC), correct use of personal protective equipment (PPE) and good handwashing practices. Staff practice was also regularly monitored during IPC audits. Staff told us they felt supported in their roles and could clearly explain how they adhered to the COVID-19 national guidance, for example when supporting someone with COVID-19 infection.
The provider allocated a member of staff who completed a specific course in mental health and supported staff wellbeing on an individual basis. Staff were encouraged to access nationally available care workforce support resources and information was easily available in staff facilities. Where staff would be at higher risk of severe COVID-19, the provider risk assessed their individual circumstances and supported them to shield. The provider also reviewed their staffing and re-deployed staff where necessary to restrict movement of the workforce between the services as per the national guidance.
The service environment was reviewed and re-configured to ensure good IPC practice, zoning and cohorting and safety of the people receiving support as well as staff. For example, additional therapy rooms were arranged in all parts of the building so people did not need to walk across for their sessions. Where needed, disinfected physiotherapy equipment was provided for individual use in people’s rooms. The outside area was adapted for gait re-education and the hydrotherapy facilities were risk assessed for safe use in the pandemic. There was a spacious garden available to people with a dedicated outdoor visiting area. There was also an indoor visiting area accessible directly from the car park.
This inspection took place on 29 September 2017 and was unannounced.
There was a registered manager in post. 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. The registered manager helped us during our inspection.
We carried out this inspection because during our inspection in August 2016 we found the registered provider was in breach of three of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These related to recruitment processes, ensuring people’s individual needs were recorded and a lack of quality assurance checks within the service. Following that inspection the registered provider sent us an action plan telling us how they planned to address our concerns. We carried out this inspection to check that action had been taken in line with their action plan and found that it had.
People were cared for by staff who were well trained, professional, polite and friendly. Interactions on the day demonstrated staff respected people, gave them the privacy they wished and enabled and supported them to be as independently as possibly whilst living at the service. People using the service had the capacity to make their own decisions. However, staff were aware of the principals of the Mental Capacity Act in that they were able to tell us there were no restrictions at the service.
People lived in an environment that was well maintained and was safe. Staff carried out appropriate health and safety checks and there was information relating to people in the event of an emergency, such as a fire. People’s rooms were well presented and comfortable. There was a communal lounge area where people could meet with friends and relatives. People could make their own decisions on where they wished to spend their time or eat their meals. People were offered choice in what they ate and staff were aware of people’s individual dietary requirements.
Although the registered provider did not provide specific activities for people, they supported people with making suggestions in relation to how people could spend their time. Such as attending activities in one of the other of the provider’s services. People could come and go as they pleased and the registered manager told us people often went into town to meet friends for lunch, etc.
People were supported to regain their health and mobility. This involved sessions with the in-house physiotherapists and with the use of the hydro pool. The registered provider had good relationships with external health professionals and a doctor from the local GP practice visited the service twice a week. Risks to people had been identified and where accidents and incidents occurred these were reviewed for trends and appropriate action taken.
People were cared for by staff who told us they felt supported and who met with their line manager on a regular basis. We found the registered manager had good management oversight of the service and there was a good working relationship between them and staff. Staff received a good range of training and staff met together regularly as a team to discuss all aspects of the service.
There were a sufficient number of staff available for people. Staff were attentive to people and did not leave them waiting for support. Staff were aware of their role in keeping people safe so they would not be at risk of harm, either by an accident or from abuse. People told us they felt safe. People’s medicines were kept securely and regular audits of medicines were carried out and gaps identified were addressed.
The registered manager and other staff undertook quality assurance audits to ensure the care provided was of a standard people should expect. We found the registered manager had responded to any suggestions that had been made. Recruitment processes had improved to help ensure that there were only suitable staff working at the service.
Regular fire checks and fire drills were carried out to help ensure staff would know what to do in the event of an emergency.
Information was provided to people on all aspects of the service when they first arrived. This included information on how to make a complaint should they need to.
Pre-admission assessments were carried out and these were used to develop care plans (patient records). The records were detailed and included all the information necessary to help ensure people received the responsive care they required. Records were held in each person’s individual room and they told us they were aware that they had a patient record.
There was a registered manager in post and at the inspection. 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.
People were not always protected from being cared for by unsuitable staff because robust recruitment was not in place. There were documents missing in relation to pre-employment checks. On the day of the inspection there were not appropriate plans in plane in the event of an emergency and the building needed to be evacuated. However the registered manager did provide us with evidence of people’s personal evacuation plans.
There were no pre-admission assessments for people and the people’s records lacked any detailed around the planned care for the person. However the care that people received was effective and staff understood their needs. There was no activity provision for those people who had been at the service longer term.
Systems were not in place to make sure the service assessed and monitored its delivery of
care. However people and staff told us they were happy with the running of service.
People told us that they felt safe at the service. One person said “There are always staff around which helps me feel safe.” Staff had knowledge of safeguarding adults procedures. There were enough staff deployed at the service to meet the needs of people. Incidents and accidents were recorded and action taken to reduce the risks of incidents reoccurring.
People's medicines were managed safely and people understood the medicines that they received.
People received care from staff that had the training and experience to meet their needs. Staff's competencies were assessed regularly with staff and staff had support from senior members of staff.
People at the service had the capacity to make decisions we observed staff asking people for consent before they provided care.
People said that they enjoyed the food and were given choices. One person said, “The food is very good, if you don’t like what they have got they try their best to accommodate you.” Staff were all aware of people's dietary needs and preferences and those that required support to eat where provided this by staff. Health and social care professionals were involved with people’s care.
Without exception people said that the staff at the service were caring and respectful and people were involved in the decisions about their care. People were supported to be independent. Visitors were welcomed into the service.
People’s compliments and complaints were recorded and complaints addressed appropriately.
Staff understood the values of the service and said that they felt supported.
The registered manager had notified CQC about significant events and records were kept securely to protect people’s personal information.
We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.