We carried out a review of the data available to us about Clarendon 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 Clarendon Manor, you can give feedback on this service.
Clarendon Manor is a residential care home providing personal and nursing care to up to 35 people. The service provides support to older people and younger adults including those living with dementia. At the time of the inspection 33 people were using the service. The home provides accommodation in one adapted building with shared dining rooms and lounges. Some of the bedrooms have private gardens.
People's experience of using the service and what we found
Relatives told us they felt their loved ones were well looked after and received safe care from staff who were kind, caring and proactive. Some of the staff team had worked at Clarendon Manor for a long time so were able to provide consistent care. However, due to staffing pressures the home was relying on a lot of agency staff which sometimes impacted on the quality of care provided.
Staff had good knowledge of keeping people safe and managing risks to their health and safety. Overall, risks were assessed with guidance to support people contained in risk management plans, but we found some risk management plans for catheter care required further detail.
Although some quality assurance processes and audits took place, improvements were needed to ensure they were effective and helped mitigate risks to people. A new pressure mattress audit was implemented during the inspection and the registered manager planned to introduce audits of accidents, injuries and falls in response to our feedback.
Feedback from people, their relatives and staff about the management of the home was positive and management were described as approachable and supportive. When relatives reported any issues or concerns to management, they felt those concerns were listened to and acted on.
Staff felt they worked well as a team. They enjoyed working at Clarendon Manor and described the home has having a friendly atmosphere.
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.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at the last inspection
The last rating for this service was good (published 23 March 2019).
Why we inspected
The inspection was prompted in part due to concerns received about infection prevention and control in relation to COVID-19 and safeguarding. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.
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 the same.
We have found evidence that the provider needs to make improvements. Please see 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 Clarendon Manor 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 Manor provides accommodation and personal care for up to 35 people, some of whom are living with early stage dementia. The home is situated in a residential road in Whitnash. It is a period home which has been extended. The home is three storeys with bedrooms on the ground and first floor. There is lift access to the first floor. There were 34 people living in the home at the time of our inspection visit.
People's experience of using this service:
•People were protected from the risk of avoidable harm because staff had been safely recruited and they knew how to recognise and report abuse.
•There were systems to monitor the service to make sure it was safe for people and there were enough staff to deliver good quality care.
•Staff had the skills, training and support to meet people’s needs.
•Risks to people's health and well-being were assessed and well managed.
•People’s medicines were managed safely and in line with best practice guidelines.
•People were supported to see a health and social care professional such as a GP, if they needed to.
•People enjoyed their meals and had enough to eat and drink. Meals were prepared taking into account people’s cultural or religious beliefs and preferences.
•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.
•The home was warm, clean and comfortable. There was a friendly atmosphere and people appeared relaxed in their surroundings.
•Staff were motivated to provide compassionate care and improve people’s quality of life. They encouraged people to be as independent as they wanted to be and supported people to maintain their dignity and respect.
•Improvements had been made in the opportunities for people to engage in activities and they had more things to do during the day.
•There was a clear management structure that promoted person-centred values.
•Managers and senior staff monitored staff practice and carried out checks to ensure people received the care and support they needed.
•The registered manager had improved the safety of the premises since our last inspection.
Rating at last inspection:
At the last inspection the service was rated as 'Requires Improvement' with two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. (Report published 16 March 2018). At this inspection we found the necessary improvements had been made and the service is now rates as ‘Good’ overall.
Why we inspected:
This inspection was a scheduled inspection based on previous rating.
Follow up:
The performance of this service will continue to be monitored and we will visit the service again in the future to check if there are changes to the quality of the service.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Clarendon Manor is situated in a residential road in Whitnash. It is a period home which has been extended. The home is three storeys with bedrooms on the ground and first floor. There is lift access to the first floor.
Clarendon Manor provides accommodation and personal care for up to 35 people, some of whom are living with early stage dementia. 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. There were 29 people living in the home at the time of our inspection visit.
A requirement of the service’s registration is that they have 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 and the associated Regulations about how the service is run. There was a registered manager in post at the time of our inspection visit who was also the provider.
Since our last inspection in January 2017 we have reviewed and refined our assessment framework, which was published in October 2017. Under the new framework certain key areas have moved, such as support for people when behaviour challenges, which has moved from Effective to Safe. Therefore, for this inspection, we have inspected all key questions under the new framework, and also reviewed the previous key questions to make sure all areas were inspected to validate the ratings.
At our previous inspection we found the safety and leadership of the home required improvement. This was because the deployment of staff did not always support people's safety and people were not always given their medicines in accordance with their prescriptions. The provider's monitoring visits were not formally recorded to provide an audit trail of the actions taken to address issues.
At this inspection we found improvements were still needed to ensure people received consistently safe care. This was because risks were not always identified and managed to keep people safe. The provider’s checks were still not sufficiently robust to identify the issues we found and learning was not shared within the provider group. As this was the second consecutive inspection visit where we identified a lack of oversight and effective monitoring and the service was rated 'requires improvement', we found this was a breach of the regulations.
Staffing levels were sufficient to meet people’s needs and staff understood their responsibilities to safeguard people from potential abuse. Staff had received training to ensure they had the skills, knowledge and confidence to meet people's needs effectively. However, we observed some occasions when staff did not follow good infection control practice or safe medicines management. People's care plans included risk assessments to ensure staff knew the risks associated with people's care needs, but risks around some equipment and the environment had either not been recognised or managed appropriately.
The registered manager assessed people’s physical, emotional and social needs before they moved to the home and people continued to receive support to maintain their health and wellbeing. Care staff were knowledgeable about people's needs and how to address them. People were referred to other healthcare professionals when there was a change in their health or wellbeing. People were assisted to eat and drink enough to keep them as healthy as possible and staff understood people's individual nutritional risks.
There was a calm and homely atmosphere in Clarendon Manor. Staff understood the importance of respecting people's rights as individuals and their diversity. Staff worked within the principles of the Mental Capacity Act 2005 and supported people to make their own choices and respected the decisions they made. People had access to some activities to promote a sense of engagement and wellbeing.
People were supported to remain in the home at the end of their life if this was their wish. Staff worked with other healthcare professionals to ensure end of life care was co-ordinated and the right medicines were available to keep people comfortable.
You can see what action we told the provider to take at the back of the full version of the report.
Clarendon Manor is registered to provide accommodation and personal care for a maximum of 35 older people. On the day of our visit there were 30 people living at the home.
Following our last comprehensive inspection of the service in February 2015, we found the provider was providing the standard of service we would expect in four key areas and we rated the service ‘Good’.
A registered manager was 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.
People told us they felt safe living at the home. Staff had received training in safeguarding and protecting people from the risks of harm or abuse and understood their responsibilities to keep people safe. There were processes to minimise risks to people’s safety, however records did not always reflect people’s current care requirements.
Medicines were stored safely, but people were not always given their medicines in accordance with their prescriptions.
Overall, there were enough staff to support people. However, staff were not always available in communal areas and on the day of our visit staff did not have time to spend with people because they were so busy. Recruitment processes ensured staff were suitable to work with people who lived at the home.
Staff had a caring attitude and were keen to provide a relaxed and friendly atmosphere for the people who lived at Clarendon Manor. People told us staff were kind and respectful and had the right skills to provide the care and support they required. Staff treated people with dignity and respect.
Staff followed the principles of the Mental Capacity Act 2005 in their interactions with people. The registered manager understood their responsibility to comply with the requirements of the Deprivation of Liberty Safeguards (DoLS). They had applied to the Supervisory Body for the authority to restrict people’s rights, choices or liberty in their best interests.
People told us they enjoyed the food at the home and had a choice of meals. Where people had developed additional health needs, they were referred to the GP or other healthcare professionals.
Care records contained relevant information to help staff provide people with personalised care. Care plans contained a detailed description of peoples’ individual needs so people received care and support in a way that met their personal preferences. Care staff knew people well and communication between staff ensured information about any changes in people’s needs was shared.
People spoke positively about the care they received and said how well the service was led and managed by the registered manager. People told us if they had any concerns they would speak to the registered manager.
Staff we spoke with said that staff morale was very good and that the registered manager was approachable and responsive to suggestions made to improve the quality of service. However, some checks to ensure the safety and consistency of the service were not always effective. Improvements were required in gathering the views of people and their relatives about the quality of care provided.