We carried out a review of the data available to us about Clarendon 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 Clarendon House, you can give feedback on this service.
Clarendon House is a care home registered to provide care, rehabilitation and support for up to eight people who are living with acquired neurological conditions. The home does not provide nursing care. The building has been adapted and is accessed over three floors by stairs. There were seven people living at the home at the time of inspection.
People’s experience of using this service and what we found
Improvements had been made and the home was well-led. The registered manager had introduced a new governance and auditing system following the previous inspection. Audits were up to date and identified any lessons learnt following incidents and accidents so that they could take action to keep people safe.
The home had a recruitment process in place, but this had not always been followed. We have made a recommendation about recruitment practices within the home. The provider was responsive to address the shortfalls found within this inspection and took immediate action.
People told us they felt safe and liked living at Clarendon House. One person told us, “You can talk openly, and I feel positive about this place. It's incredible.” Another person stated, “It's good here. They [staff] are good, you can talk to them.”
Care plans and risk assessments were person centred. Relatives told us staff knew their loved ones well. Staff supported people in a kind and compassionate way, considering their dignity and respecting people’s rights. 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 culture of the home was open and transparent. The registered manager demonstrated joint working with health professionals which provided specialist support to people, involving their families and other professionals as appropriate. Staff demonstrated good understanding around providing people with person centred care and spoke knowledgably about how people preferred their care and support to be given.
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 26 October 2021).
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 regulations.
At our last inspection we made recommendations about risk assessments, environmental safety and medicines management. At this inspection we found the provider had acted on the recommendations and had made improvements.
Why we inspected
We undertook this focused inspection to check the provider had followed their action plan and to confirm they met legal requirements. This report only covers our findings in relation to the key questions Safe and Well-led which contain those requirements.
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.
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 changed from requires improvement to good. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Clarendon 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.
Clarendon House is a care home registered to provide care, rehabilitation and support for up to eight people who are living with acquired neurological conditions. The building has been adapted and is accessed over three floors by stairs. There were seven people living at the home at the time of inspection.
People’s experience of using this service and what we found
Improvements were needed to the governance systems within the home. The systems for monitoring and checking that the home operates in a safe way were not effective. The home did not seek formal feedback from people, their relatives, staff or professionals they worked with. The registered manager and provider accepted that this was an area for improvement and had started to make plans to improve.
People had risk assessments, but some needed to be more detailed; this had not had an adverse impact on people as staff knew them well. There was a process for accident and incident reporting, but this had not been consistently followed to ensure the home learnt from events and used this learning to drive improvements. The registered manager and provider had started to devise a plan to improve this. We have made recommendations about risk assessments and learning lessons from events.
People received their medicines as prescribed. However, improvements were needed to ensure safe management of medicines which people took occasionally. We have made a recommendation about medicines.
People felt safe living at Clarendon House, feedback was positive, and staff were confident they were supported to have the best life possible. 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.
Infection control procedures were robust and operated well within the home. People and staff worked together and followed guidance to keep safe from COVID-19. Everyone we spoke with were positive about the management of the home and felt proud to work with people and their colleagues at Clarendon House.
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 27 October 2017).
Why we inspected
We received concerns in relation to environmental safety, medicines and the management of the home. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.
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 changed from good to requires improvement. This is based on the findings at this inspection. You can see what action we have asked the provider to take at the end of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Clarendon House on our website at www.cqc.org.uk.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service.
We have identified breaches in relation to the management of the service at this inspection.
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 for 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.
We found the following examples of good practice.
There were clear processes in place for visitors to the home. Families and friends met with their loved ones in a ‘visitors’ pod’ at the sister home to Clarendon House, there was an option of inside and outside pods which were wheelchair accessible. All visitors direct to the home or to the pods were subject to temperature checks, health screening questions, hand hygiene and Personal Protective Equipment (PPE).
People were supported by staff to continue with their lives and that included support to clean their home, cook and do their laundry. There were cleaning schedules in place for staff and this continued throughout the day. There was enough PPE and staff were observed wearing it correctly and in line with the current government guidance.
People and staff had participated in whole home testing for Covid-19, for staff this included a daily test. Risk assessments had been completed for all aspects of people’s care and support including risks associated with Covid-19. Staff had individual risk assessments in relation to their own health and support needs. People and staff had been offered a Covid-19 vaccine.
Staff had received training in how to put on and take off PPE and training in preventing infections was up to date. Audits took place daily, weekly and monthly to ensure compliance with infection control procedures. The home was supported by a range of in-house professionals such as psychologists and therapists. Weekly contact was maintained with medical professionals who reviewed people’s needs.
The registered manager told us group and individual meetings have enabled them to reflect and learn from the difficult events experienced during the pandemic so far and had also contributed to supporting the wellbeing and mental health of staff. The registered manager told us they were proud of their staff team and said, “I don’t have any worries, they are awesome”.
Clarendon House provides accommodation and personal care for up to eight people who are recovering from brain injury. At the time of this inspection there were four people living at the home.
There was a registered manager in post. 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 four people living at the home felt safe and well-supported.
Risk assessments had been completed to minimise the risks, both in terms of the physical environment and also in how to support people as safely as possible in meeting their goals.
Staff had been trained in in safeguarding adults and were aware of the types of abuse and how to make safeguarding referrals.
Plans were in place on how to support people in the event of an emergency.
There were robust recruitment procedures being followed to make sure that appropriate staff were employed to support people.
Staff and people felt the staffing levels were appropriate to meet people’s needs. Staffing levels were planned and adjusted to make sure people were supported to meet their rehabilitation goals.
People were supported with medicines with the aim of people managing their medication on their own.
Staff knew people’s needs well and the organisation had a training programme in place. This ensured that staff had thorough induction and opportunity to develop their skills and knowledge.
Staff were knowledgeable about the Mental Capacity Act 2005 and people’s consent underpinned how staff worked with people in meeting identified goals.
At the time of the inspection the people who lived at the home had full capacity to be involved in all decision making about their goals, care and support.
Systems were in place to support people with budgeting, shopping and cooking.
People felt the staff were very caring and supportive.
People’s needs had been fully assessed and interventions and goals set with people. These were detailed in care plans that were up to date with evidence of regular reviews. Care plans were person centred focusing on their goals for rehabilitation.
People were supported with leisure and recreational goals as well as domestic routines so that they could fill their time meaningfully as well as working to rehabilitation goals.
There was a system in place for managing complaints that people were aware of. No complaints had been made about the service since registration.
The service was well-led with an open culture.
There were systems in place to monitor the quality of service provided to people.