Background to this inspection
Updated
12 June 2021
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.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
Inspection team
The inspection visit was carried out by one inspector.
Service and service type
Clarendon House Residential Dementia Care Home is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (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.
The registered manager was not present during the inspection as she was not on duty. She had already submitted an application to cancel her registration. A new manager has been appointed to replace the registered manager and the new manager had applied to be the registered manager of the home.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
Before the inspection we looked at information we held about the service. This information included any statutory notifications that the provider had sent to the CQC. Statutory notifications include information about important events which the provider is required to send us by law. This information helps support our inspections. We reviewed the last inspection report and information we had received about improvements made. We also reviewed information received from the local authority.
During the inspection
We visited the communal areas and some bedrooms. We spoke with three people using the service, the new manager, two care staff and one of the partnership members of the service. We reviewed a range of care records and records related to the running of the service. These records included three people's care files, medicine administration records and five staff records. We also looked at policies and procedures, checks and audits carried out.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We communicated with three social care professionals and a relative.
Updated
12 June 2021
About the service
Clarendon House Residential Dementia Care Home is registered to provide accommodation and personal care for a maximum of six adults who have dementia care needs. At the time of this inspection, there were three people using the service.
People’s experience of using this service:
At the inspection of 29 & 30 October 2019, we found four breaches of regulations. At our inspection of 29 July 2020, we found that improvements had been made and the provider had complied with three of the regulations. At this inspection we identified that further improvements had been made to the benefit of people using the service. Since our last inspection of 2020 the service had worked hard to make improvements in areas such as improving the premises, staffing arrangements, care documentation and in improving quality monitoring.
Risk assessments had been prepared for people. These contained guidance for minimising potential risks such as risks associated with falling, choking, suicide and risk associated with the pandemic. One person had been prescribed blood thinning medicine. We asked the provider to ensure that potential risks are identified and staff are informed of these risks, which they did, as this medicine is considered to be a high risk medicine.
The service followed safe recruitment practices and records contained the required documentation. The staffing levels were adequate to ensure that people’s care needs were attended to. Our previous inspection identified that there was inadequate deployment of staff. This was a breach of Regulation 18, Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 (Staffing). During this inspection we found that the service had made improvements in respect of this and staff were adequately deployed.
There were arrangements for safeguarding people. Care workers had been provided with training on safeguarding people and knew what action to take if they were aware that people were being abused.
There were suitable arrangements for the administration of medicines. Medicine administration record charts (MAR) had been properly completed. Medicine audits had been carried out.
The premises were well maintained and there was a record of essential maintenance and inspections by specialist contractors. Window restrictors were in place.
Suitable fire safety arrangements including personal emergency and evacuation plans (PEEP) and weekly fire alarm checks and fire drills were in place.
The premises were clean and tidy. Infection prevention and control measures and practices were in place to keep people safe and prevent the spread of the corona virus and other infections. Staff had received infection control training. They had access to sufficient stocks of personal protective equipment (PPE).
Staff were supported to care for people. They had received training and had the knowledge and skills to support people. Supervision had been carried out. However, no appraisal of performance had been organised for one staff who had worked over a year.
Staff understood their obligations regarding the Mental Capacity Act 2005 (MCA). People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.
Care needs of people had been attended to. There were suitable arrangements for caring for people requiring care for specific physical and psychological conditions. Care plans were in place.
The service had a policy on ensuring equality and valuing diversity. Effort had been taken to respond to the diverse needs of people who used the service.
At our last inspection the service did not have effective quality assurance systems for monitoring and improving the quality of the service provided for people. This was a breach of Regulation 17, Health and Social Care Act (Regulated Activities) Regulations 2014 (Good governance). During this inspection we found that the service had made improvements and was no longer in breach. Checks and audits of the service had been carried out and action had been taken to rectify deficiencies noted.
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 inadequate (published 16 July 2020) and there were breaches of regulation in relation to safe care and treatment, staffing, good governance and person-centred care. 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.
Why we inspected:
We undertook this focused inspection as we had concerns regarding the service, and we wanted to check that people were well cared for. The inspection was prompted in part due to concerns received about staffing and the safety of people who used the service. A decision was made for us to inspect and examine those risks. This report only covers our findings in relation to the Key Questions Safe, Effective, Responsive and Well-led. The overall rating for the service has improved to Good.
You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Clarendon House Residential Dementia Care Home on our website at www.cqc.org.uk.
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 coronavirus and other infection outbreaks effectively.