Paul Clarke Home

Updated 6 May 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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team

The inspection was carried out by one inspector and one assistant inspector.

Service and service type

Paul Clarke Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as 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

The inspection was unannounced.

What we did

We used the information we held about the service to formulate our inspection plan. This included statutory notifications that the provider had sent to us. A statutory notification is information about important events which the provider is required to send us by law. These include information such as safeguarding concerns. We sought feedback from the local authority, and we asked Healthwatch for any information they wanted to share. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.

During the inspection

We spoke with four people who used the service, with three of those conversations being in more detail. We made observations in communal areas and we looked at the care records of four people who used the service, to see if their records were accurate and up to date.

We spoke with three members of care staff, a new manager who had been employed (but they were not yet working full time at the service) and the registered manager, who was also the provider. They have been referred to as the provider throughout this report. We also looked at records relating to the management of the service. These included three staff recruitment files, staff rotas, training records and quality assurance records.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at building safety records, improvement plans and additional evidence of action taken by the provider following our feedback.

Updated 6 May 2020

About the service

Paul Clarke Home is a residential care home, providing accommodation and personal care. This service supported people with learning disabilities and/or autism. The service was a large home, bigger than most domestic style properties. It was registered for the support of up to nine people. Eight people were using the service at the time of the inspection. This is larger than current best practice guidance. However, the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area. Accommodation was provided in one residential house with a garden.

People’s experience of using this service

Systems were not always effective at identifying areas for improvement. Checks on the building were not always effective. Action was taken following feedback, but this was largely prompted by the inspection. An action plan in place had failed to fully encompass all areas for improvement. One notification had not been submitted to us, as necessary.

People did not always have their mental capacity assessed when needed, decisions made in people’s best interest were not always recorded and one person did not have a Deprivation of Liberty Safeguards application made which put them at risk. The décor of the home was suitable for people living there, although building checks were not always effective. People were supported to have food and drinks of their choice, although we observed one person was not always being supported in line with their eating risks. People had their needs assessed. Improvements were made to weight monitoring following our feedback. Staff received training to be effective in their role. People had access to other health professionals and staff were kept up to date with changes in people’s care in handovers.

There were enough safely-recruited staff to support people. People were kept safe as risks were assessed and planned for and staff were aware of these. Staff understood their responsibilities to safeguarding people, report concerns and knew how to report them. People were supported to have their medicines as prescribed. Infection control measures were in place so people were protected. Lessons were learned when things had gone wrong, accidents and incidents were reviewed and the provider had recognised they could get additional support from an external consultant.

People were supported in line with Registering the Right Support; they were supported to make decisions and be independent. People were supported by a kind and caring staff team who knew them well. People had their dignity and privacy maintained.

People were supported in a way they liked and had personalised care plans in place to guide staff. People could partake in activities of their choice and could access the community. People were supported to communicate in a way that met their needs. Complaints were investigated and responded to. No one was needing end of life care at the time of the inspection, but the provider was aware of their responsibilities to support people.

People and staff were positive about the provider and staff team. The provider was clear about their responsibility about duty of candour and the previous inspection rating was being displayed, as necessary. People and staff were engaged in the service. A new charter had been introduced to support people in line with their human rights and to make it a fun place to live and work. The service worked in partnership with other organisations to support people.

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 1 March 2019). We had found breaches of regulation in relation to governance and submitting notifications. At this inspection enough, improvement had not been made or sustained and the provider was still in breach of regulations and we found an additional breach about consent.

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified breaches in relation to consent, governance and the submission of notifications. 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.