Archived: Clayhall House

Updated 27 March 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

The inspection was carried out by one inspector.

Service and service type

Clayhall 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 the information we already held about this service. This included details of its registration, previous inspection reports and notifications of any significant incidents the provider had sent us. We contacted the commissioning local authority to seek their views about the service. 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. We used all of this information to plan our inspection.

During the inspection

We spoke with one person who used the service and one relative about their experience of the care provided. Due to people’s communication needs we were not able to speak with other people using the service, but we observed how staff interacted with people. We spoke with four members of staff including the provider, registered manager, team leader and a support worker.

We reviewed a range of records. This included two people’s care records and multiple medication records. We looked at four 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.

After the inspection

We continued to seek clarification from the provider to validate evidence found. This included information about fire safety management.

Updated 27 March 2020

About the service

Clayhall House is a residential care home providing personal care to six people with learning disabilities and/or on the autistic spectrum at the time of the inspection. The service can support up to six people.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

People’s experience of using this service and what we found

The service was not always safe because medicines were not managed appropriately, the premises were potentially dangerous and there was a risk of the spread of infection. Risks to people and staff were not always properly assessed. Quality assurance systems had failed to identify and address shortfalls within the service. Care plans and pre-admission assessments did not fully cover people’s protected characteristics, such as culture and sexuality.

Systems were in place for responding to allegations of abuse and staff were knowledgeable about their responsibility in this area. There were enough staff working at the service to meet people’s needs. Pre-employment checks had been carried out to help ensure suitable staff were employed.

Pre-admission assessments were carried out to determine people’s needs. Staff were supported through training and supervision. People had enough to eat and drink. The service worked with other care agencies to promote and meet people’s health care needs. 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.

Staff were friendly and polite in their interactions with people and people told us staff were caring. People were supported to be as independent as possible and the service sought to meet needs around religion and ethnicity.

Care plans were in place which set out how to meet people’s needs. People and relatives were involved in developing these. The service sought to meet people’s communication needs and to provide information in an accessible format. A variety of social and leisure activities were offered, and people were able to maintain relationships with family and friends. Systems were in place for dealing with complaints.

There was a registered manager in place. People and staff spoke positively about them and about the working culture at the service. The provider worked with other agencies to develop knowledge and share best practice.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence. The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

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 11 September 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified breaches in relation to the safety of the care and support provided and the management of the service.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

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.