We carried out a review of the data available to us about Clayton Manor 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 Clayton Manor, you can give feedback on this service.
Clayton Manor is a residential care home providing personal and nursing care to 67 people at the time of the inspection. The service can support up to 75 people with different health and care needs. People are accommodated on different units across two floors in one building. One unit specialises in the care for people living with advanced dementia. This is the unit we visited during this focussed inspection.
People’s experience of using this service and what we found
We found that some aspects of the safety of people’s care could be improved, although people and relatives we spoke with told us the service provided safe care. We found that some aspects of risk management needed to be made more robust. We made a recommendation regarding this.
Service governance, including ensuring robust monitoring, record-keeping and implementing of lessons learned, needed to be improved to underpin a consistently safe, quality service. We made a recommendation regarding this. Following a few changes in service leadership, a new manager had been appointed and became registered with the Care Quality Commission shortly after our visit. As they had only recently started the new registered manager was still getting to know people, relatives and staff; however, those we spoke with praised the unit staff and leadership.
Those we spoke with told us that generally there were enough staff to keep people safe. The service had introduced an additional shift, based on their learning from incidents. The service still relied on agency workers, although their use had reduced. Staff and relatives confirmed that where possible the same agency workers were used, which promoted consistency. We highlighted to the registered manager the need to check whether agency staff had also been trained to deliver safe care for people living with dementia.
Regular meetings took place to keep people, relatives and staff up-to-date and involved in the service. We received positive feedback from those we spoke with about the service keeping them informed about their family members, as well as the service creating a homely, welcoming feel. Staff felt there was a positive team atmosphere.
People we spoke with felt safe living at Clayton Manor and in observations we saw people appeared relaxed around staff. One person said, “I am well looked after here, although I do not really need much looking after.” Relatives we spoke with praised the way in which staff kept their family members safe, particularly at times of distress. A relative told us, “I cannot sing their praises loudly enough, somehow they always find a way to get through.”
At our last inspection we found that 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. As this was a focussed inspection checking whether the service was safe and well-led, we did not revisit this particular aspect of care.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The rating for the service following the last comprehensive inspection was good (published 24 July 2019).
Why we inspected
We received concerns in relation to the safety of people’s care. As a result, we undertook a focused inspection to review the Key Questions of Safe and Well-led only. Meetings and investigations were ongoing in relation to concerns raised and our inspection looked at the wider themes within the service.
We reviewed the information we held about the service. No areas of concern were identified in the other Key Questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those Key Questions were used in calculating the overall rating at this inspection.
The overall rating for the service has remained good, although there was a deterioration of the Key Question Well-led to requires improvement. This is based on the findings at this inspection.
We have found evidence that the provider needs to make improvements. Please see the recommendations we have made within the Safe section, as well as improvement needs identified within the Well-led section of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Clayton Manor on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Clayton Manor is a nursing home providing personal and nursing care to 64 people at the time of the inspection. The service provides care to people living with dementia, nursing needs and to younger adults with disabilities. The service can support up to 75 people. Accommodation is set out over two floors in three units.
People’s experience of using this service and what we found
People and their relatives told us that they were happy with the standards of care in the home and that staff met all their needs. People’s experience was summed up by two people, who said, “This place makes me feel really comfortable and safe” and “I have absolutely no concerns about safety and a lot of that is down to retention of good, hard working staff”.
There were enough staff to meet the needs of the people living in the home. Staff commented that at times the service used agency staff, and this placed pressure on them. The provider has recently recruited more staff and had an ongoing recruitment drive to increase permanent staffing numbers. Recruitment was managed safely, and staff received training when they started with the service and on an ongoing basis.
Medication was managed safely, and people received their medication when required.
The home was clean and well maintained. Equipment was checked regularly to ensure this remained safe. Staff had access to protective personal equipment to reduce the risk of infection.
Accidents and incidents were recorded and analysed for patterns and lessons were learnt from any incidents within the home. Safeguarding incidents were recorded and reported.
People were supported to eat and drink enough and people had choice in relation to food. The feedback was mixed in relation to food, however recent changes to menus were being reviewed and improved to reflect the feedback.
People were supported to access other healthcare services and we received positive feedback from healthcare professionals who worked regularly with the service.
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.
People told us that staff were kind and compassionate and knew them well. They always respected their dignity and privacy.
People had access to activities that they were interested in and felt they were supported to maintain relationships with people that were important to them.
Concerns were responded to promptly to reduce escalation to formal complaints. People were aware how to complain and we saw complaints were dealt with appropriately.
There was no registered manager at the time of our inspection, however the post had been recruited to and an interim manager was covering the service.
Checks and audits were carried out regularly. These were effective at identifying issues where practice needed to be improved.
The manager and provider actively sought people’s feedback about the service and were open and transparent when things went wrong. They looked at good practice and ways to improve the service on a continuing basis.
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 (published 8 July 2017).
Why we inspected
The inspection was prompted in part due to concerns received about staffing. 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 caring sections of this full report. The provider has taken appropriate action to mitigate the risks identified and this has been effective.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Clayton Manor on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
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The home has a registered manager. 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. The registered manager and regional manager were in attendance at the time of the inspection.
We found that the service was safe and effective. People told us they felt safe and we saw that staff knew how to ensure they were safe. From our observations it was clear that staff cared for the people they looked after and knew them well. People who lived at the home were protected from the risk of potential abuse because staff had undertaken safeguarding training, to recognise and respond to potential signs of abuse. Staff had a good understanding of what safeguarding meant and how to report it.
People's medicines were handled safely and were given to them in accordance with their prescriptions. Care plans showed that people's GPs and other healthcare professionals were contacted for advice about people’s health needs whenever necessary.
Staff were recruited safely and we saw evidence that staff had been supervised regularly. Staff told us that they enjoyed working at the service and felt well supported in their roles. They had access to a wide range of training which equipped them to deliver their roles effectively.
Each person living in the home had a plan of care and risk assessments in place. These were specific to them and were regularly reviewed. The home offered a wide range of both group and individual activities that had a positive impact on their lives. Visiting was unrestricted and people's relatives told us they felt included in the care of their family members.
The Mental Capacity Act 2005 and the associated deprivation of liberties safeguards legislation had been adhered to in the home. The provider told us that some people at the home lacked capacity and that a number of Deprivation of Liberty Safeguard (DoLS) applications had been submitted to the Local Authority in relation to people’s care. We found that in applying for these safeguards, peoples’ legal right to consent to and be involved in any decision making had been respected.
We saw that infection control standards in the home were monitored and managed appropriately. The home was clean, safe and well maintained. We saw that the provider had an infection control policy in place to minimise the spread of infection and that all staff had attended infection control training.
People living in the home knew who the registered manager was. People and relatives we spoke with said they would know how to make a complaint, none of the people or their relatives we spoke with had any complaints.
The home had quality assurance processes in place including audits, staff meetings and quality questionnaires. The home also had up to date policies in place that were updated regularly. The provider regularly checked the quality of care at the home through visits and audits. These showed the home was performing well in all aspects of care and people’s care records were maintained to a good standard.
End of life care was good with the service ensuring a person’s final days were lived comfortably surrounded by the people who knew and cared for them.
People benefitted from living in a well organised, forward thinking home where their needs were put first. The culture of the home was open and people felt confident to express their views and opinions