Clinton Lodge

Clinton Lodge is a residential care home providing personal care to up to five people. The service provides support to people with learning and /or physical disabilities. At the time of our inspection there were five people using the service.

Clinton Lodge is a detached building located in its own gardens in a residential area of Redruth.

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

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

Right Support:

People’s medicines were not always managed safely.

People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

People who experienced periods of distress had proactive plans in place to guide staff how to support them. Reasonable adjustments were made for people so they could participate fully in discussions about their support.

People’s care and support was provided in a safe, clean, well-maintained environment which met their physical needs. People had a choice about their living environment and were able to personalise their rooms.

People could access health and social care support in the community.

Right care

People’s care plans did not always reflect people’s up to date needs. People spent time undertaking activities that interested them, but records did not always clearly describe people’s aspirations or goals for the future. Information recorded about people’s needs was not always consistent across different records.

Risk assessments were undertaken but did not all contain sufficient information to help staff reduce risks.

The service had enough staff working each day to meet people’s needs and keep them safe.

Staff understood people’s individual communication needs.

Right culture

The provider had not provided enough support to the manager. This meant aspects of the service and people’s care had not been reviewed as frequently as needed or kept up to date. The service did not always reflect best practice.

People received care and support from staff who were trained to meet people’s needs and wishes. Staff knew and understood people well and were responsive to people’s needs.

The service involved appropriate professionals in planning people’s care.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update The last rating for this service was good (published 06 July 2022).

Why we inspected

We received concerns in relation to the management of people’s health needs. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection. We have found evidence that the provider needs to make improvements. Please see the safe, effective and well led sections of this full report. You can see what action we have asked the provider to take at the end of this full report.

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

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to safe care and treatment and good governance at this inspection.

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.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

The service was able to demonstrate how they were meeting underpinning principles of “Right Support, Right Care, Right Culture.

Right support:

The model of care and setting maximised people's choice, control and independence. The service was close to the centre of town and there was good access to the local community and amenities.

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 were supported by enough staff on duty. People received their medicines in a safe way. People were protected from abuse and neglect. People's care plans and risk assessments were clear and up to date.

Right care:

The support people received was person centred. Support plans had been developed for people, to understand the reasons for their behaviour, and provide guidance for staff to ensure consistent approaches were used when supporting people.

Staff knew people well and demonstrated an understanding of people's individual care, behavioural and communication needs. This helped ensure people people's views were heard and their diverse needs met.

People could communicate with staff. Staff understood their individual communication needs and were consistent in their approach and response. Care plans informed staff of any specific ways to best communicate with people.

The core staff team had the appropriate levels of knowledge and skills to support people and responded to their individual needs and choices. Staff promoted people’s dignity and treated them respectfully. They understood people’s needs and provided security and encouragement.

Right culture:

The staff at Clinton Lodge were committed to ensuring people were leading the lives they wanted. Staff created an environment that inspired people to understand and achieve their goals and ambitions.

People led lives that reflected their personalities and preferences because of the ethos, values, attitudes and behaviours of the management and staff. People were treated with dignity, respect and care.

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

People told us they were happy with their care and support they received. Relatives we spoke to were complimentary about the core staff team and how they were able to meet their family members care and support needs. A health and social care professional were complimentary about how people were cared for.

People were supported to access healthcare services, core staff recognised changes in people's health, and sought professional advice appropriately.

Cleaning and infection control procedures had been updated in line with COVID-19 guidance to help protect people, visitors and staff from the risk of infection. Government guidance about COVID-19 testing for people, staff and visitors was being followed.

The management team maintained oversight of complaints, accidents and incidents and safeguarding concerns. The management team engaged well with health and social care professionals. Systems to assess and monitor the quality and safety of the care provided were in place. They were effective in assessing quality and identifying and driving improvement. The service had clear and effective governance systems in place.

For more information, please read the detailed findings section of this report. If you are reading this as a separate summary, the full report can be found on the Care Quality Commission (CQC) website at www.cqc.org.uk

Last rating and update

This service was registered with us on 3 August 2020 and this is the first inspection.

The last rating for the service under the previous provider was good, published on 25 November 2017.

Why we inspected

This was the first inspection since the provider registered with the commission.

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 COVID-19 and other infection outbreaks effectively.

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