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Inspection Summary


Overall summary & rating

Good

Updated 15 August 2018

We carried out an unannounced inspection of this service on 26 June 2018. Cloud House is a care home, specifically caring for up to ten women living with mental health conditions, learning disabilities or substance misuse problems. At the time of our inspection seven people were living in the service.

People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. This service provides personal care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had 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.

At our last inspection on 30 January and 2 February 2017, the service was rated 'Requires Improvement'. We identified four breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The systems for the safe management of medicines had not been maintained which meant people had not received their medicines as prescribed. Quality assurance systems and audits had not operated to assess and improve the quality and safety of the service provided. Recruitment processes had not been operated to ensure staff were of good character and the service had not maintained records as required. Staff had not received the training required to perform their roles. We also found one breach of the Care Quality Commission (Registration) Regulations 2009, as the service had not submitted notifications of incidents or allegations of abuse.

At this inspection we found the service had addressed all previous breaches and improvements had been made. The service has therefore been rated as ‘Good.’

Safeguarding procedures were in place and staff demonstrated a clear understanding of what abuse was and how to safely report any concerns. The service had detailed risk assessments in place to guide staff to best support people using the service. Infection control was being managed in a safe way and staff were provided with personal protective equipment to prevent the spread of cross infection. Staff were recruited safely to ensure they were suitable to support people and staffing levels were sufficient. People’s medicines were managed safely by staff who had received appropriate training.

The service completed pre-admission assessments to ensure they were able to meet people’s individual support needs. Staff had completed specific training, received an induction and had regular supervision to allow them to provide high quality support. There was clear evidence of the service working in a way which promoted equality and diversity and aimed to protect people from discrimination. Staff understood the Mental Capacity Act 2005 (MCA). MCA is law protecting people who are unable to make decisions for themselves. People who had capacity to consent to their care had signed their care plans and risk assessments and where consent was not applicable, the appropriate authorisation procedures had been completed. These are referred to as the Deprivation of Liberty Safeguards (DoLS). The service promoted healthy living through encouraging people to participate in activities and eat healthy food as well as access support from other health and social care professionals. People had choices around their meals. A weekly menu was prepared with people.

Records and observations confirmed the service worked in a person-centred way and detailed people’s individual preferences and support needs. People were observed to be able to approach staff at any time for support and staff were seen to be caring in their responses. Advocacy services were available to help people have their views and wishes heard. The service

Inspection areas

Safe

Good

Updated 15 August 2018

The service had improved from 'Requiring Improvement' to 'Good'.

People were protected from abuse because staff knew how to identify and report concerns.

Records were in place to monitor where people were at risk and what action staff needed to take to protect them.

The service undertook all necessary recruitment checks. There were sufficient numbers of staff to meet people’s needs.

People’s medicines were managed safely by staff who had received appropriate training.

There were systems in place to manage infection control.

Effective

Good

Updated 15 August 2018

The service had improved from 'Requiring Improvement' to 'Good'.

The service had ensured staff were suitably trained and had the right skills to support people.

Detailed pre-assessments were completed to ensure the service could meet people’s needs.

The service worked with other professionals to provide people with holistic care and encourage healthy living.

Staff understood the Mental Capacity Act 2005 (MCA) and sought people’s consent and views of their care and support.

Caring

Good

Updated 15 August 2018

The service remained caring.

People and their relatives told us staff were kind, caring and respectful.

People were involved in making decisions about their care and support.

Staff ensured people's right to privacy and treated people with dignity and respect.

People were supported to be as independent as possible.

Responsive

Good

Updated 15 August 2018

The service remained responsive.

Person centered care plans were in place and these reflected people’s individual preferences.

People were encouraged and supported to engage in activities of their choice.

The service had a complaints and compliments procedure in place and complaints had been responded to in full.

Well-led

Good

Updated 15 August 2018

The service have improved from 'Requiring Improvement' to 'Good'.

The management team and staff had a good understanding of the ethos of the service.

There was an effective system in place to monitor the quality of the service and identify shortfalls.