Background to this inspection
Updated
21 February 2020
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
One inspector and one assistant inspector carried out this inspection.
Service and service type
Claremont House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
We sought feedback from the local authority, Healthwatch and professionals who work with the service. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
Not everyone living at the service was able to clearly communicate with us. We spoke with the relatives of some people in order to try and ascertain their experience of the care. We spoke with six people who used the service and five relatives about their experience of the care provided. We spoke with nine members of staff including the provider, the registered manager, deputy manager, senior care workers, care workers, housekeeping staff, activity co-ordinators and catering staff.
We reviewed a range of records. This included five people’s care records and multiple medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed. We sought clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We spoke with three professionals who regularly visit the service.
Updated
21 February 2020
About the service
Claremont House is a residential care home providing personal care to 13 people at the time of the inspection. The service can support up to 16 people. The service is set across two floors with a lift and stairs to the first floor. There are some communal spaces such as a combined lounge and dining area, garden and reception area. The office is located inside the service. Each bedroom has a private toilet and sink and there are shared bathrooms available.
People’s experience of using this service and what we found
People’s care plans gave lots of information about how to safely support the person. However, risk assessments were not robust enough to ensure people were safe. Staff were still learning how to best use an electronic care planning and recording system. Staff knew people well but needed further development to be confident in their understanding of people’s conditions, and how this impacted their lives.
People had the opportunity to be involved in a variety of activities and more options were being planned but not yet in place. People had experienced a lot of positive changes since the last inspection but monitoring systems did not always identify concerns and did not yet drive improvement in the service.
Medicines were safely administered but records required further development to imbed best practice. People were supported to access all relevant health and social care professionals to meet their needs.
People were very happy living at the service and told us they felt safe because the staff were kind and caring. Relatives also told us they thought their family members were safe as the staff knew them well and knew how to support their needs. Staff had a good understanding of how to keep people safe and had received training in safeguarding adults.
Staff treated people with respect and showed patience and compassion when supporting them and delivering care. Interaction was good and people were chatting a lot and laughing. There was a warm and welcoming atmosphere in the service that made it feel like home. The service was clean and odour free and had recently been decorated making a pleasant environment.
People told us staff encouraged them to do what they could for themselves but that they could ask for help if they needed it. Relatives told us they and their family members were involved in care reviews. Staff gave people lots of choice about daily decisions such as for food or drink or how they spent their time.
People really liked the food and drink and there were many choices available. People could access anything they wanted, and a variety of snacks and drinks were accessible to people throughout the day and night.
People and their relatives were happy that any complaints would be managed quickly and effectively. They told us the registered manager was very approachable and they would be happy to speak with them if needed. One relative told us, “I am happy with how they look after [my family member], I think they are well cared for. I think [staff] do a brilliant job.”
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.
We have made a recommendation about staff training and development.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update: The last rating for this service was requires improvement (published 06 December 2019) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve.
At this inspection we found improvements had been made and the provider was no longer in breach of some regulations. However, we found enough improvement had not been made in other areas and the provider was still in breach of other regulations. The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.
Why we inspected
This was a planned inspection based on the previous rating.
Enforcement
We have identified a breach of regulation in relation to the safe assessment of risks. We also identified a breach about quality assurance systems to ensure the registered manager and provider had good oversight of the delivery of care. Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.