We carried out a review of the data available to us about Cleveland House 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 Cleveland House, you can give feedback on this service.
Cleveland House is registered to provide accommodation for persons who require nursing or personal care and treatment of disease, disorder or injury for up to 32 people. At the time of the inspection 32 people with significant and complex needs were living at the service.
Cleveland House acts as both a residential home and provides short or long-term rehabilitation for people. The service consists of four units which are designated in accordance with people’s needs and level of support.
People’s experience of using this service and what we found
People living at Cleveland House benefited from a service that was committed to providing safe and high-quality care and support and a service which was well-led.
Staff recruitment process ensured staff were safe to work with people. Risks to people were identified and were managed and mitigated by staff to lessen the risk of harm to people. Policies and procedures were also in place to keep people free from the risk of abuse and harm.
We received positive feedback from both people living at the service and their relatives about the quality of the care and support they received from staff. People’s family and friends were actively involved in their loved one’s care. People were empowered and supported by staff to achieve their goals and aspirations.
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.
The service adopted a positive culture which was committed to delivering high-quality and tailor-made care to people. Staff understood, shared and practiced these values. Governance and quality assurance processes helped to monitor service performance and drive up improvements.
The service worked in collaboration with other relevant organisations to help achieve positive outcomes for people and to ensure people had access to the best possible care and support for their individual needs. We received positive feedback about the service from external health and social care professionals.
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 (last report published 10 January 2019).
Why we inspected
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
The inspection was prompted due to concerns received about the management of people requiring support with mechanical ventilation. A decision was made for us to inspect and examine those risks.
We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe and well-led sections of this full report.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
The overall rating for the service has remained good, based on the findings of this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Cleveland House on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
People’s experience of using this service: People and relatives told us they felt safe and the staff knew what to do to respond to any concerns. Medicines were handled safely. The registered manager confirmed the actions taken to address some gaps in the medicines records. Risks were managed appropriately, and environmental checks were completed.
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. Relevant deprivation of liberty applications had been submitted to the assessing authority. The wider professional team was involved in people’s care health and support needs.
People who used the service were supported with their choices, likes and needs. People’s privacy, dignity, respect and rights were supported in the service. Systems were in place to ensure people were able to communicate effectively.
There was evidence that some activities were provided to people of their choosing photographs confirmed some of the activities provided. Care plans contained good information about people’s individual needs and how to support them. A system was in place to deal with complaints. The service had evidence of positive feedback that they had received.
On the whole we received positive feedback about the registered manager and the operation and oversight of the service. Audits and monitoring was taking place that confirmed the service was safe for people to live in. Team meetings were taking place that provided staff with updates about the home and its operation.
Rating at last inspection: The service was rated as good overall with good in all of the key questions, except for effective which was requires improvement. The report was published on 28 April 2016. A recommendation was made in relation to ensuring capacity assessments were completed and deprivation of liberty applications were submitted appropriately to the assessing authority. During this inspection we found improvements had been made in this area.
Why we inspected: We undertook this inspection based on the previous ratings of the service.
Follow up: We will plan a follow up inspection as per our inspection programme. We will continue to monitor the service and if we receive any concerning information we may bring the inspection forward.
The registered manager was present throughout the inspection. 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.
Cleveland House was first registered with the Care quality Commission on 12 November 2014. This was the service's first inspection since its registration.
Cleveland House is a purpose built 32 bed care home with nursing, where clinical care is provided in a homely environment. All rooms are en-suite with their own wet rooms. Each room has patio doors to enable people to access their own outside space. The home has four specialist service areas for people who may have a variety of physical disabilities as well as either acquired brain injury, intellectual / learning disability, or mental illness associated with conditions such as epilepsy or sensory impairment. The space is divided into four eight bedded units on two levels. Its location in Banks, in between Preston and Southport, offers easy accessibility for visitors and to local amenities.
At the time of our inspection the home was using the two units on the ground floor, as service provision was being gradually implemented alongside the recruitment of specialist staff. There were 11 people living at the home at the time of our inspection, all of whom had an acquired brain injury.
The service had procedures in place for dealing with allegations of abuse. Staff were able to describe to us what constituted abuse and the action they would take to escalate concerns.
All the people we spoke with told us they felt safe at the home.
We looked at how medicines were ordered, stored, administered and recorded. We spoke with the senior carer who had responsibility for administering medication on the first day of the inspection and observed medication being given to people over the lunchtime period.
Staff understanding of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) was good and we saw that all staff had received recent training in both areas. However we found some issues within care planning documentation regarding compliance with the MCA and with formally gaining people’s consent. We made a recommendation about this.
We saw that staff attended regular training via the staff training matrix we were given and found staff to be knowledgeable about their role.
People and relatives were very complimentary about the approach of the staff team and the care they received.
Relatives we spoke with said they could visit the home whenever they wished to without restriction. They told us that staff called people by their first name and knew the people they were caring for well.
People we spoke with and their relatives told us they knew how to raise issues or make complaints. They also told us they felt confident that any issues raised would be listened to and addressed.
We found care plans were easy to read, navigate and contained good information. However we found a few issues with certain sections of people’s care plans not being signed or dated. We have made a recommendation about this.
We spoke with staff and asked them how the service demonstrated good management and leadership. The responses we received were very positive.
We saw that a wide range of audits took place at the service that were stored within a ‘Quality Assurance Audits file’.