The Care Quality Commission
  • Care Home
  • Care home

Archived: Clarondene Residential Care Home

Overall: Good read more about inspection ratings

View Road, Lyme Regis, Dorset, DT7 3AA (01297) 442876

Provided and run by:
Ms Mary Alison Curtis

All Inspections

16 January 2015

During a routine inspection

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.

16 May 2014

During a routine inspection

A single inspector carried out this inspection. The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well-led? Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at. If you want to see the evidence that supports our summary please read the full report.

Is the service safe?

There were no people being deprived of their liberty. The registered manager demonstrated understanding of the changes following the recent legal judgement about people's ability to consent to care and treatment where they do not have mental capacity. They had contacted the relevant professionals for advice about this. Staff adapted the care routine to meet individual needs and we observed that staff worked with people's consent. One member of staff told us, 'I have time to spend with people here and get to know them."

At the last inspection of 20 May 2013, we found that medicines were not always recorded accurately and that not enough staff were trained. At this inspection we found that although there had been improvement, some changes were required for the provider to meet this standard.

We found that the home was not clean in places and that staff had insufficient guidance about cleaning and infection control. We have asked the provider to write to us telling us how they will address this.

Is the service effective?

The care plans were up to date and contained the right information to guide staff about people's care needs. Monitoring of each person's care and any changes was kept up to date. The registered manager and staff worked effectively with other agencies to provide timely care to people and ensure individual risks were managed. There were sufficient staff to meet the needs of people.

Is the service caring?

People reacted positively to staff and we saw people were treated with respect, consideration and kindness by staff. One relative we spoke with told us, "My relative does not like to be alone and they always have company." There were activities provided every day and tailored to suit people's individual ability.

Is the service responsive?

Care plans had been reviewed and we staff showed they understood people's needs. We saw staff following detailed instructions provided in the care plans and responding to changes in need.

Is the service well led?

There were systems in place to monitor and check the quality of the service however, these were not always effective. Whilst the service was regularly checked for quality there were gaps in identifying risks around infection control and medicines. This put people at risk of harm. People's views were sought and relatives told us they could approach the registered manager if they had any concerns. We have asked the provider to tell us what they are going to do meet the requirements of this standard. Records were found to be fit for purpose.

20 May 2013

During an inspection in response to concerns

During our inspection people spoke positively about the staff within the home. We saw people's individual needs and risks were assessed, however people's risk assessments were not regularly reviewed and people were not protected from risks such as the risk of malnutrition or the development of pressure sores.

Medicines were not always stored securely and administration records and controlled drugs registers were not always accurate. Staff competency in the administration of medicines was not recorded.

The provider undertook appropriate pre employment checks and staff were supported through regular training, however we found that there was not always a sufficient number of staff on duty.

The home had systems to monitor the quality of service provided but this was not always effective and areas of concern were not acted upon.

People's personal records, including medical records, were not always current and accurate.

16 January 2013

During an inspection in response to concerns

We spoke with people in the home who told us 'The staff do everything they can to help you' and another told us 'I'm very happy, I have everything I need.' One person's relative told us 'The staff here provide genuine care to people.' People's needs were assessed and care was delivered in line with their wishes. People told us that their needs were met and that the home would meet any changes that they had in their daily living, for example, changing a meal location.

The home was clean and there were procedures to prevent and control the risk of health care associated infections.

The provider had not completed all pre-employment checks for new members of staff and this may place people at risk of harm.

The home had effective systems to monitor the quality of the service provided and to assess and manage risks to the health, safety and welfare of people using the service and others.

24 July 2012

During an inspection in response to concerns

We visited the home unannounced on 24 July 2012 following concerns about the management of medicines and recruitment of staff. There were eight people living in the home. We spoke with and observed the care of seven of the eight people.

We observed medicines being given to people during our visit. The member of staff focused on the task, ensured the medicines trolley was locked each time they left it unattended. The person explained the medicines to people, answered their questions and ensured they had taken their medicine before moving on to support someone else.

People we spoke with did not express a view on how staff were recruited. We observed staff supporting people. They knew people well and were knowledgeable about their care needs. One person told us staff were very caring and you could joke with them.

25 April 2012

During an inspection looking at part of the service

We visited the home unannounced in October 2011. We issued a warning notice because we had concerns about the way staff were recruited to work with vulnerable people. We also made two compliance actions because of concerns about how incidents of alleged abuse were reported and how medicines were being managed.

We returned to the home in January 2012 to check the provider had complied with the warning notice. They had.

We returned to the home unannounced on 25 April 2012 to follow up on the two compliance actions we made in October 2011.

During our visit people were being supported in a variety of activities by a member of staff. Several people participated in a game, encouraging each other and chatting with the member of staff.

Staff were seen following guidance in care plans on how people need to be supported. For example one person needed staff to assist them when walking but to enable them to be as independent as possible.

One person we spoke with told us "staff sit with me while I take my medicine".

27 October 2011

During an inspection in response to concerns

People were supported to make choices by staff who knew them well and understood their preferences.

People thought staff were good and looked after them when they were unwell.

People are supported to take their medicines.

We found that when staff are supporting people they take time to explain what they are doing and there are enough staff on duty to assist people living in the home. Staff support people to take their medicines but the medicines are not always returned to the pharmacy when they are no longer needed.

Staff did not have an effective recruitment procedure to ensure people were protected.