Background to this inspection
Updated
28 April 2015
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
The inspection took place on 16 January 2015 and was unannounced. The inspection was carried out by an inspector and a specialist advisor in dementia and mental capacity. Before the inspection we reviewed information received from the local authority contracts team and information we held about the provider from statutory notifications about notifiable incidents and events.
We spoke with three of seven people who used the service and two relatives. Some people were unable to speak with us so we used observation to help us understand the experiences of those people. We spoke with four members of care staff, one support staff and a member of staff working on administrative systems. We also spoke with the deputy manager, registered manager and a temporary assistant manager. We reviewed the care plans for people living in the home and associated records. We looked at management records including audits, staff duty rosters, information about the premises and safety, training records, medicines records and four staff recruitment files.
We spoke with three community healthcare professionals and two representatives from the local authority social services.
Updated
28 April 2015
The inspection took place on 16 January 2015 and was unannounced. At the last inspection on 16 May 2014, we found the provider was not meeting standards relating to cleanliness and infection control, the management of medicines and in assessing and monitoring the quality of the service. We asked the provider to take action to address these areas and send us a plan telling us how and by when they would do this. At this inspection we found that this action had been taken and completed.
Clarondene Residential Home provides personal care and accommodation for up to 12 older people. At the time of inspection, seven people were living in the home. The home is based on the ground floor of the building. The building is situated on a residential street served by a front car park and gardens to the side, with office and residential accommodation upstairs.
There was a registered manager who was also the registered provider. 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.
At this inspection we found there had been improvements across a number of areas and we did not have concerns that the service was in breach of any regulations. However we found that some areas required improvement to ensure a consistent service was provided. Although there were some very stable elements of staffing, including the registered manager who was also the owner, there had been a relatively high staff turnover. This meant people had to get to know new faces regularly and family members commented that they thought this had affected their relative at times. One person told us they did not know the names of all staff. This was mitigated to some degree by the staff working closely together in a small home and being able to quickly get to know people and develop relationships with them. Although some staff felt they could influence decisions in the service, not all staff felt they could raise questions and this affected their confidence in approaching the registered manager.
People benefitted from living in a small home where people and staff quickly got to know each other. One person told us they would recommend the home to a friend. Two relatives told us they felt the home did much to keep them up to date with any changes in their loved one’s care needs and they felt involved. Most people had lived at the home for some time and their needs were well understood by the registered manager and senior staff. Care was responsive and changes in people’s needs were noticed and acted upon. Risky conditions were monitored and reviews were held with families and external professionals. The service sought and followed advice from experts where needed.
Within the home we observed warm interactions between staff and people who were encouraged to express themselves. Not all people could express themselves verbally; however staff adapted their communication to be able to connect with people. For example, getting down to their level if they were sitting down, using visual devices for communication and observing people’s facial expressions.
Staff demonstrated they understood people’s right to autonomy and respected people’s right to be consulted at all times about their care. Where people presented risks to themselves or others and were not fully aware due to their mental capacity, this had been formally considered. The registered manager and deputy manager demonstrated knowledge and understanding of the formal framework for protecting the rights of people who live in care homes. They consulted with families and relevant professionals to help to protect people’s rights.
Staff were trained either through induction or ongoing training which helped them to develop their knowledge. They had opportunities to shadow experienced staff if they were new. The leadership within the home had been boosted by a temporary additional management, brought in by the registered manager. This additional management support had helped to achieve improvements in the health, safety and cleanliness of the premises and in the systems and routines of care. This meant people benefited from a clean and safe environment where their needs were met effectively.