Archived: Clifton Meadows

Updated 6 December 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

We carried out the inspection on 25 October 2017 and it was unannounced. The inspection team was made up of an Adult Social Care Inspector and an expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service. .

Prior to the inspection visit we gathered information from a number of sources. We looked at the provider information return (PIR). This is a form that asks the registered provider to give some key information about the service, what the service does well and improvements they plan to make.

We looked at notifications sent to the Care Quality Commission by the registered provider. We also obtained the views of professionals who may have visited the home, such as service commissioners, healthcare professionals and the local authority safeguarding team.

We spoke with the district manager, the manager, deputy manager, team leaders, care staff, catering staff and a domestic. We also spoke with 11 people who used the service, five relatives, and one health care professional. Observations helped us evaluate the quality of interactions that took place between people living in the home and the staff who supported them.

We used the Short Observation Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us. We looked at other areas of the home including the kitchen areas, outside garden space, some people’s bedrooms, communal bathrooms and lounge areas.

We reviewed a wide range of records, including people’s care records and staff files. We checked the medication administration records. We observed people having breakfast and lunch, and we observed an activity. We also reviewed the policies, procedures and audits relating to the management and quality assurance of the service provided at Clifton Meadows.

Updated 6 December 2017

We carried out this inspection on 25 October 2017. The inspection was unannounced, which meant the people living at Clifton Meadows and the staff working there didn’t know we were visiting. The service was previously inspected in July 2015 and was meeting all the fundamental standards.

The service did not 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 2008 and associated Regulations about how the service is run. The registered manager left the service in December 2016. A new manager had been appointed but did not stay, they left in June 2017. The deputy manager has been covering this post from June 2017 and had applied to CQC become the registered manager.

Clifton Meadows is a care home for older people who require personal care. It also accommodates people who have a diagnosis of dementia. The service is two separate buildings one is called Wentworth and can accommodate up to 25 people with advanced dementia, the other unit is called Solway and can accommodate up to 41 people. At the time of our inspection there were 53 people using the service.

Staff we spoke with understood what it meant to safeguard vulnerable people from abuse, and they were confident management would take any concerns they had seriously and take appropriate action.

We found there were sufficient staff on duty to meet people’s needs, However, we observed on Wentworth unit that deployment of staff could be improved to ensure people were supported in communal areas at all times.

Risks to people had been identified but we found these were not always followed. Systems were in place for safe management of medicines. However, we identified a number of errors that meant systems had not always been followed to ensure people received medications as prescribed.

People were not always protected by the prevention and control of infection procedures. We found the service was not kept clean or hygienic to ensure people were protected from acquired infections.

We found procedures were followed for the recruitment of staff. Staff supervision took place and staff told us they felt supported by the new manager. Staff received training that ensured they had the competencies and skills to meet the needs of people who used the service.

We found the service did not always meet the requirements of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). Most staff we spoke with had a satisfactory understanding and knowledge of this, and people who used the service had been assessed to determine if a DoLS application was required. However, we found the conditions attached to people's authorised DoLS were not always met.

People received a well-balanced diet, and we saw people accessed health care services as and when required. Referrals were made quickly to health care professionals when people’s needs changed.

People and the relatives we spoke with all said the staff were kind and caring. People also said staff respected them and maintained their dignity.

Care plans identified people’s needs and had good detail of how to manage people’s needs. However, we identified that some documentation did not always reflect peoples changing needs.

People told us they were listened to and were confident any concerns would be dealt with. Activities took place, however, people told us more could be organised and there was out of date information displayed.

There were processes in place to monitor the quality and safety of the service. Some of the issues we had identified had been picked up and an action plan was in place to resolve the issues. However, these processes were not always effective as not all the issues we had identified had been picked up.

During our inspection, we found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.