Clarence House Care Home

Clarence House is a residential care home providing nursing and personal care for up to 78 people. At the time of our inspection there were 52 people using the service.

People’s experience of the service and what we found:

Quality monitoring systems were in place; however, these were not always effective. Some areas of improvement we identified during the inspection were not highlighted as part of the providers quality monitoring systems. For example, we found infection control shortfalls throughout the home including the kitchenette area and people’s ensuite facilities. Risks in relation to people’s care were not always being managed safely. Following our inspection, the registered manager took action to address these concerns. However, new systems and approaches required embedding into practice.

People did not always receive person centred care which took in to account their preferences. We received mixed views from people and relatives about the care and support.

People predominantly received their medicines as prescribed. However, we found some discrepancies mainly around record keeping relating to medicines management.

Staff told us they received training in safeguarding and knew what action to take if they suspected abuse.

The provider had a process in place to safely recruit staff. We observed there were enough staff available to support people.

Accidents and incidents were recorded, and action was taken to reduce future risks. The registered manager kept a record of safeguarding concerns and could evidence actions they had taken to protect people.

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.

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 16 August 2017).

Why we inspected

We undertook a focused inspection to review the key questions of safe, caring and well-led only. For those key question not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for Clarence House on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to infection control, risks associated with people’s care and good governance.

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 continue to monitor information we receive about the service, which will help inform when we next inspect.

Effective systems were in place to ensure visitors to the service followed government guidelines for wearing Personal Protective Equipment (PPE). Facilities were available for visitors to sanitise their hands and put on PPE. Screening questions and a temperature check were standard requirements for all visitors. Staff supervised all essential visitors to ensure social distancing and infection control guidelines were followed.

People were supported to maintain contact with their relatives in different ways including telephone and video calls, and window visits. The service had created a visiting pod to reduce the risk of spreading infection. The entrance to this was separate to the main entrance of the home. The service had implemented a system to allow contact visits following recent government guidelines.

All staff were trained in safe infection, prevention and control (IPC) practices. We observed staff wearing appropriate PPE and sufficient supplies were available. The service had implemented a uniform policy to reduce the risk of spreading infection.

A programme of testing for COVID-19 was in place for people who lived in the home and staff. There had been a good uptake of people and staff receiving the COVID-19 vaccine.

The environment was clean, hygienic and well ventilated. Cleaning schedules were in place and being followed. The service's IPC policy was up to date and in line with current guidance. The service had plans in place and knew how to respond to an outbreak of infection to ensure the safety of people and staff.

Highgrove Care Home is a 78 bed nursing home, providing care to older adults with a range of support and care needs. At the time of the inspection there were 26 people living at the home. The home is divided into four discrete units, although the registered provider had stopped using two of the units and therefore, only two units were in use at the time of the inspection.

Highgrove Care Home is located in Mexborough, a small town in Doncaster, South Yorkshire. The home is known locally as Highgrove Manor. It is in its own grounds in a quiet, residential area, but close to public transport links.

The service had a registered manager who had been registered with the Care Quality Commission since February 2016. 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.

People told us they felt safe living at the home. Assessments identified potential risks to people, and management plans were in place to reduce these risks. Recruitment processes were safe and we saw there were sufficient staff on duty to meet people’s needs.

Systems were in place to make sure people received their medications safely, which included key staff receiving medication training and regular audits of the system. Although, at the time of the inspection one room where medicines were stored was too warm.

It was a very warm day and periodically, we noticed a smell of urine in one particular area of the home. However, all other parts of the home looked clean and did not smell.

People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Staff had completed an induction and essential training at the beginning of their employment. This was followed by additional training and periodic refresher sessions. They also received regular support and supervision to help them meet people’s needs.

People were supported to eat and drink to maintain a balanced diet, and snacks were available between mealtimes. The people we spoke with said they were happy with the meals provided.

The registered provider had appropriate arrangements in place to ensure they adhered to the requirements of the Mental Capacity Act 2005.

People were treated with respect and kindness. Staff demonstrated a good knowledge of how to respect people’s preferences and ensure their privacy and dignity was maintained.

Relatives had been encouraged to be involved in planning their or their family members’ care. Care plans checked reflected people’s needs and had been reviewed and updated to reflect people’s changing needs.

People had access to social activities, as well as outings into the community.

There was a system in place to tell people how to raise concerns and how these would be managed. People told us they had no complaints, but would feel comfortable raising any concerns with the registered manager.

There were systems in place to assess if the home was operating correctly and people were satisfied with the service provided. This included meetings and regular audits. Action plans were in place to address any areas that needed improving.