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Archived: Clinton House Nursing Home Inadequate

Inspection Summary


Overall summary & rating

Inadequate

Updated 25 November 2016

Clinton House is a care home which offers care and support for up to 46 predominantly older people. At the time of the inspection there were 28 people living at the service. Some of these people were living with dementia. The building is a detached house over two floors with a recently added extension on the ground floor comprising of five new en suite rooms. Clinton House is part of the Morleigh Group of care homes.

The service is required to have a registered manager and there was one in place. However, the registered manager had been on maternity leave since August 2016. A temporary manager had covered the role for the first six weeks and another manager had been appointed nine days before our inspection. A registered manager is a person who has registered with the 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 and associated Regulations about how the service is run.

We carried out this unannounced comprehensive inspection of Clinton House Nursing Home on 1 November 2016. We brought forward the planned comprehensive inspection due to concerns that had been raised with us. These concerns related to the premises and equipment, the quality of the food, lack of activities, poor care practices, staff working without the relevant recruitment checks, staff training and medicines. At this inspection we also checked to see if the service had made the required improvements identified at the inspection of 7 April 2016.

In April 2016 we found the premises and equipment were not properly maintained. We found there was hot water at 50 degrees centigrade coming from two taps in bathrooms used by people who lived at the service. At a previous inspection in February 2016 we had also found water that was too hot coming from a different tap used by people living at the service. At this inspection we found another two taps with water coming from them that was too hot. This posed an on-going risk of people scalding themselves that had not been adequately addressed by the provider, despite being asked to rectify these issues at two previous inspections.

We also found at this inspection that there was no hot water coming from sinks in the laundry room for staff to wash their hands. There were several toilets and bathrooms, used by people living at the service, with no soap or paper towels. This meant people, visitors and staff were unable to wash their hands effectively after using the toilet.

At the inspections in April 2016 we had concerns about poor recording and missing records, of the information given to staff when they started a shift. We had raised the same concerns at previous inspections in February 2016 and October 2015. This meant it was difficult to establish what information had been provided for staff at each shift change to ensure they had the right information to meet people’s needs. At this inspection we were able to see records of daily handover meetings. The information in these records was basic, although staff told us they were given detailed verbal handovers. However, on the day of the inspection an agency worker asked repeatedly during the morning if they could have a handover as they did not know what peoples’ needs were. This meant the system for providing staff with information about people’s needs at each shift was still not robust.

The care we saw provided to people during the inspection was often task orientated rather than in response to each person’s individual needs. Care plans did not always give staff guidance about how to provide the appropriate care to meet people’s needs. People were not always referred to appropriate healthcare professionals in a timely manner. This mean relevant treatment to help people was delayed. The high reliance of the service on bank and agency workers meant that people did not always receive care from staff who knew and understo

Inspection areas

Safe

Inadequate

Updated 25 November 2016

The service was not safe. Premises and equipment were not properly maintained.

People were not always protected from risk of harm because risks were not always identified and managed. Medicines were not safely managed.

There were not always adequate numbers of staff on duty to meet people’s needs. Recruitment practices were not safe. Relevant employment checks, to ensure staff were suitable to work with vulnerable people, were not carried out before new staff started to provide care for people.

Effective

Requires improvement

Updated 25 November 2016

The service was not effective. Some people did not receive care and treatment that met their needs.

Referrals to external health professionals were not made in a timely manner. This put people at risk of their health needs not being met.

There were gaps in staff training and supervision which meant staff were not fully trained or supported in their role.

Management did not have a clear understanding of the legal requirements of the Mental Capacity Act 2005 and the associated Deprivation of Liberty Safeguards.

Caring

Requires improvement

Updated 25 November 2016

The service was not entirely caring. Staff were kind and compassionate when they spoke with people. However, social interaction between staff and people mostly occurred when staff completed tasks for people.

Care practices did not respect people’s dignity, promote their independence or enhance people’s well-being.

Responsive

Requires improvement

Updated 25 November 2016

The service was not responsive. People did not receive care and treatment that was responsive to their individual needs. The care provided to people was often task orientated rather than in response to each person’s individual needs

Care plans were not personalised to reflect people’s care and treatment needs. Care plans were not updated as people’s needs changed.

There was a lack of meaningful activities to meet people’s social and emotional needs.

Well-led

Inadequate

Updated 25 November 2016

The service was not well-led. The provider had not adequately assessed, monitored and mitigated the risks to people living in the service.

Some people did not receive consistent or good care because systems to provide and monitor people’s needs were inadequate.

Audit processes were not effective as these had failed to identify shortfalls in relation to the premises, medicines, care plans and the monitoring of people’s health needs.