We carried out a review of the data available to us about Clifton Lawns on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Clifton Lawns, you can give feedback on this service.
Clifton Lawns specialises in providing a rehabilitation service for people with enduring mental
health conditions. The service can support up to 18 people. There were 14 people using the service on the day of our inspection.
People’s experience of using this service and what we found
People told us they felt safe. Staff understood their responsibilities in relation to safeguarding and had completed the relevant training. Sufficient staff were available to meet people’s needs and robust recruitment systems and processes were in place. The management of medicines was safe. People were supported, whenever possible, to administer their own medicines with varying degrees of support. The premises were clean, and staff followed infection control and prevention procedures.
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 practice. People's needs were assessed, and care was planned and delivered to meet legislation and good practice guidance. People were provided with a nutritious and varied diet and were also supported to shop and prepare meals for themselves on a weekly basis.
The majority of people told us they were well supported by staff. We observed kind and caring interactions from staff. There was a warm and friendly atmosphere in the service and staff were considerate towards people they were supporting. There was a strong emphasis on people being independent and rehabilitation. People’s privacy and dignity was respected.
The registered manager assessed people prior to them using the service, this also ensured people were willing to engage in the rehabilitation ethos within the service. People were well engaged in the ‘recovery star’ model to develop care plans and set achievable goals. Monthly reviews were undertaken with their identified key worker. People had a lot of activities to choose from including volunteering in the local community. This promoted community links for when people moved on from the service.
We have made a recommendation about end of life care.
We received positive feedback about the registered manager and staff felt supported in their roles. The registered manager ensured they sought feedback about the service from people, visitors, family and staff to drive and improve the service. Systems were in place to monitor the quality of care provided and continuously improve the service.
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 13 December 2016).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Clifton Lawns is registered to provide accommodation for up to 18 men who require support with nursing or personal care. The service specialises in providing a rehabilitation service for people with enduring mental health conditions. People who use the service have their own en suite bedrooms and access to the communal areas. At the time of this inspection there were 16 people using the service.
There was a registered manager in place at Clifton Lawns. 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 was present during the inspection. They were supported in the day to day running of the service by a deputy manager.
People who used the service told us staff were supportive and helpful in enabling them to achieve their goals. The service used creative means of engaging with people including art therapy, Reiki and Thai Chi; these helped people to develop strategies to manage their mental health conditions.
Staff had received training in safeguarding adults. They were able to tell us of the action they would take to protect people who used the service from the risk of abuse. They told us they would also be confident to use the whistleblowing procedure in the service to report any poor practice they might observe. They told us they were certain any concerns would be taken seriously by the registered manager.
Systems were in place to ensure staff were safely recruited. Staff demonstrated a commitment to providing high quality personalised care for the individuals who accessed the service.
Robust systems were in place to ensure the safe handling of medicines. People were supported to take responsibility for their own medicines whenever possible.
Regular checks took place to ensure the safety and cleanliness of the environment. People who used the service were responsible for cleaning their own bedrooms, with support from staff as necessary. Systems were also in place to reduce the risk of cross infection in the service.
Staff told us they received the training and supervision they needed to be able to carry out their roles effectively. Staff were able to demonstrate a good understanding of the legal frameworks under which individual’s placements at Clifton Lawns were arranged. The registered manager had also taken appropriate action to apply for restrictions in place in a person’s best interests to be legally authorised.
Staff we spoke with told us they enjoyed working in the service and felt valued by both colleagues and the registered manager. Staff felt able to raise any issues of concern or make suggestions to improve the service in supervision and staff meetings. We saw evidence that the registered manager listened to and acted upon the views of staff in order to drive forward improvements in the service.
Care records we reviewed included information about the risks people might experience. Care plans were in place to help ensure staff provided the level of support necessary to manage the identified risks. Care plans were regularly reviewed to address any changes in a person’s needs. People who used the service told us staff provided the right level of support to meet their needs.
People who used the service were able to access meals from the central kitchen or prepare their own meals with staff support as necessary. Staff told us they would try and encourage people to choose healthy ingredients and cooking methods.
People who used the service had opportunities to comment on the support they received. We saw that their views had been taken seriously and acted upon in order to improve their experience in the service.
Quality assurance systems were in place including regular audits and checks completed by the registered manager and an external management consultant employed by the provider. We found that the managers and staff demonstrated a commitment to continuing to drive forward improvements in the service.
We received positive feedback from community based professionals regarding the quality of care provided in the service.
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 and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service.
Clifton Lawns is registered for up to 18 men who have severe and enduring mental health needs and require ongoing care and rehabilitation. There were 15 people living at the home on the day of our inspection.
This was an unannounced inspection. During the inspection we spoke with five people who used the service, two support workers, the deputy manager, the registered manager and a visiting community based professional. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.
We last inspected this service on 31 December 2013 when we found it was meeting the regulations we reviewed.
We found that people living in Clifton Lawns felt safe. Staffing levels were flexible in order to meet the individual needs of people who used the service.
Staff understood their responsibilities under the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS). We found action had been taken were necessary to ensure people’s capacity to make their own decisions had been assessed. Where any restrictions were in place we found these were legally authorised under the Mental Health Act 1983 or with people’s consent.
People received the support they required to take their medicines as prescribed. Staff responsible for administering medicines were regularly assessed to ensure their practice was safe.
Staff received a range of training and told us they were supported so they could deliver effective care. People reported the food was good. Where appropriate people who used the service were supported to make their own meals.
We observed good interactions between staff and people who used the service. People told us staff treated them with dignity and respect and were supportive in helping them to achieve their goals. This was confirmed by feedback from professionals we contacted prior to the inspection.
People’s needs were assessed and regularly reviewed so that staff could deliver personalised care and support. Staff ensured they worked closely with the wider multi-professional care team to ensure people’s needs were met.
Systems were in place to record and review complaints. People were encouraged to express their views about the service they received. Records we looked at indicated people had been satisfied with the way any complaints they had made had been dealt with.
People who used the service were supported to take part in individual and group activities both in the home and in the community. These activities were designed to support people to maintain and develop the skills they needed to progress to more independent living.
Staff told us they enjoyed working at Clifton Lawns and felt well supported by the registered manager and other staff in the home. People who used the service, staff and community based professionals told us registered manager was approachable and open to ideas to improve the service.
The registered manager had systems in place to regularly monitor and assess the quality of care provided in Clifton Lawns. Arrangements were in place to seek and act upon the views and opinions of people who used the service. Community based professionals who were involved in supporting people were also asked to provide feedback on the service provided at Clifton Lawns.
Following the inspection visit we were sent an action plan informing us how the provider was going to improve the management of medicines within the home.
We revisited the service and found evidence improvements had been made to the systems for the administration of medicines within the home. This meant people were safeguarded against the risk of the unsafe management of medication.
We spoke with two people who lived at Clifton Lawns. They told us they had no concerns about the support they received to take their prescribed medication.
We spoke with two members of nursing staff responsible for administering medication. They told us they believed the newly introduced medication administration system was an improvement and should help to reduce the risk of errors.
We reviewed the care files of three people who used the service. We found evidence there were procedures in place to ensure people's consent was gained in relation to the care and support they received.
We saw that care plans clearly identified the needs of the person and included the goals they wished to achieve.
People spoken with told us they received appropriate support with their medication. However we found improvements needed to be made to help ensure medicines were always administered safely.
We spoke with four members of staff, all of whom told us they were happy working at Clifton Lawns. We saw evidence that staff were appropriately qualified and provided with training relevant to their role.
We found that suitable arrangements were in place to manage an effective process for identifying, receiving and handling complaints for people living at Clifton Lawns.
People told us they could express their views and were involved in decision making about their support. They told us they felt listened to when discussing their plans and how they would achieve living independently.
Residents in general spoke positively about the staff and felt they treated them properly and looked after them in a way that respected their privacy, dignity and independence.
People living at the home we spoke with told us routines were relaxed and the standard of food was very good. They also said they were supported to follow their chosen interests.
Responses were generally positive about the care and support the service provides. Comments included,
"The staff are fantastic.'
'I get good help and support from the staff.'
'We have a good staff team who work well to support the service users.'
We spoke to people who told us they were satisfied with the food and one resident told us, 'We all get together every couple of weeks to talk about the menu and other things. We all make suggestions about what we'd like to see on the menu and they always deliver. Food's good here, you get plenty and you can have what you want. You can have a drink of juice anytime you want too. At weekends we sometimes get a take away or cook together. It's good to do that. Keeps me in practice cause I'll be moving out into my own flat soon and it's good for me'.
The residents told us that they felt they had satisfactory choices in their daily lives such as in rising and retiring times, food eaten and activities. There were varied and interesting activities to suit individual preferences.
Residents in general spoke positively about the staff and felt they treated them properly and looked after them in a way that respected their privacy, dignity and independence.
Residents told us they felt their views were listened to and that they knew who to speak to if they were not happy with something.