Claremont House

We found the following examples of good practice.

The service was clean, tidy, and well maintained. It was free from clutter whilst remaining homely. There were enhanced cleaning schedules in place to include high touch areas which were regularly checked to ensure completion.

There were robust procedures in place to support visiting when it is safe to do so. There was a purpose built visiting pod which will enable visits to take place safely.

The service had social distancing prompt signs displayed throughout to remind people to social distance.

Effective staff cohorting procedures were in place. Staff were allocated to a “bubble” which involved working with the same colleagues and being allocated to a specific unit.

Risks to staff and people relating to Covid-19 were thoroughly assessed and managed. The service had assessed and taken measures to protect people who may be at increased risk, for example BAME people.

Claremont House is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Claremont House is registered to provide accommodation and personal care for up to 40 older people. The home has two floors and each floor contains two units which are known as Orchid, Rose, Iris and Lavender.

Recruitment processes were safe, although clearer recording of staff identification seen by the registered provider was needed. Staff we spoke with were able to describe the identification they provided which meant this was safe.

People told us staff were suitably skilled in their roles. Staff were supported through a programme of induction, supervision and training. There were sufficient numbers of staff in the home to meet people’s needs.

Care plans were concise, although they contained sufficient information for staff to provide effective care. People received timely access to healthcare and they had a positive mealtime experience.

Fire safety was sufficiently managed and the building was well maintained. The home had impressive gardens which people were able to freely access. Dementia friendly adaptations had been made to the home. The home was found to be clean and free from odour.

People consistently told us they felt safe living at Claremont House and systems in place ensured people were prevented from being at risk of harm. There was a calm atmosphere in the home throughout the duration of our inspection.

Although no complaints had been received since our last inspection, there were systems in place to show complaints would be dealt with effectively. People told us they knew how to make a complaint.

There was a programme of activities taking place and people told us they received sufficient stimulation which meant they were prevented from being socially isolated.

The registered manager was able to demonstrate how the home met the Accessible Information Standard. People’s equality, diversity and human rights were respected. Staff were seen to be kind and compassionate in their interactions with people. People told us staff respected their privacy and dignity.

Governance systems were effective in identifying areas for improvement and we saw action was taken where needed. People and staff were complimentary about the registered manager who was approachable.

The registered manager responded to concerns and specific incidents and took lessons learned to staff meetings to reduce the risk of them happening again.

The management of medicines was found to be mostly safe, although we have made a recommendation regarding time specific medicines. We have also made a recommendation around engagement with people and their representatives through meetings and surveys.

This inspection took place on 26 June and 03 July 2017 and was unannounced on the first day and announced on the second day.

The location is registered to provide accommodation and personal care for up to 40 older people, some of whom are living with dementia. The accommodation is over two floors linked by a passenger lift. Accommodation is in single rooms with each room having ensuite facilities. Lounge and dining facilities are situated on two floors with two units on each floor. One of the four units is used to provide respite care. At the time of our inspection there were 28 people using the service permanently and one person staying for respite care. Nine people used the service for respite care regularly.

The service had a registered manager in post. 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.

At our last inspection on 14 February 2016 we found the service was not meeting the regulation related to managing medicines. At this inspection we found medicines were managed in a safe way for people, although there were some gaps in recording of the application of topical creams.

We found sufficient numbers of staff were deployed to meet people’s assessed needs. This meant people‘s needs were met in a timely manner.

People told us they felt safe. Staff had a good understanding of how to safeguard adults from abuse and who to contact if they suspected any abuse. Risks assessments were individual to people’s needs and minimised risk whilst promoting people’s independence.

Effective recruitment and selection processes were in place.

Staff had an induction, and received supervision, appraisal and role specific training. This ensured staff had the knowledge and skills to support people who used the service.

People had choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service promoted this practice. Whilst people’s mental capacity was usually considered when decisions needed to be made, this had not been evidenced where people needed to consent to the use of bed sensor mats. This was addressed by the registered manager immediately.

People’s nutritional needs were met and they had access to a range of healthcare professionals to maintain their health and well-being.

Staff were caring and supported people in a way that maintained their dignity and privacy. People were supported to be as independent as possible throughout their daily lives.

Individual needs were assessed and met through the development of detailed, personalised care plans and risk assessments.

People and their representatives were involved in care planning and reviews. People’s needs were reviewed as soon as their situation changed.

People engaged in activities both inside and outside the service.

Systems were in place to ensure complaints were encouraged, explored and responded to in good time and people told us staff were always approachable.

The manager knew the needs of people who used the service and people and staff were positive about her input in to the service.

The manager had taken action to improve the quality of the service and planned to make further improvements to their auditing system.

The registered provider had oversight of the service. They audited and monitored the service to ensure the needs of people were met and the service provided was of a high standard, however some of the issues we found had not been picked up and addressed.

Claremont House is a registered care home situated in Heckmondwike in West Yorkshire. It provides accommodation and personal care for up to 40 people living with dementia. At the time of our inspection there were 26 people living there on a permanent basis and five people receiving temporary residential respite care.

There was a registered manager in post who had been registered since October 2015. 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.

Staff had received training in how to keep people safe. All the staff we spoke with demonstrated they understood how to ensure people were safeguarded against abuse and they knew the procedure to follow to report any incidents.

The service had completed some risk assessments in detail and there were risk reduction plans in place, but we could not see the evidence that all risks had been identified and reduced. The systems for recording risks in people’s files was not easy to follow and did not correlate between the risk index and other risk information in people’s files.

Staff had recently undertaken refresher training in the management of medicines and were waiting for the results of their assessments. Competency assessments around medicines were not up to date. On the first day of our inspection we found errors in the management of medicines for one person. This was raised with the registered manager who acted immediately on this concern.

We found the environment to be maintained to a high standard and was extremely clean with good infection control practices in place. Staff were observed to follow good practice guidelines in the management and prevention of infections.

Staff received an induction and training to ensure they had the skills to meet the needs of the people who lived there. Staff were supported to continually develop by obtaining nationally recognised qualifications and by on-going supervision.

People were supported to eat their meals by care staff appropriately and sensitively and people told us how much they enjoyed their meals. People’s nutritional and hydration needs were met, although we had concerns about one person which we addressed with registered manager. People were encouraged to drink throughout the day.

The home was compliant with the Mental Capacity Act 2005 (MCA) Deprivation of Liberty Safeguards (DoLS) and had applied for authorisations to the local authority and were awaiting the outcome for several requests. We did find relatives had consented on behalf of their relations when there was no evidence of the legal authority to do so. When this was brought to the attention of the management team they responded immediately to correct this error.

We found all the staff to be caring in their approach to the people who lived there and treated people with dignity and respect. Staff knew the people they supported very well and were keen for people to feel they were at home at Claremont House. We observed staff to be kind and compassionate throughout our inspection. Relatives spoke highly of the care at Claremont House and described it as 5 star and second to none.

Care provision was personalised and support plans were reviewed regularly to ensure they were relevant to the people who lived there. Families were invited to input into the reviews of their relative to ensure known preferences and views were incorporated into people’s care plans.

Complaints were handled appropriately and people were happy that any concerns raised had been acted upon.

The home was well led and the management team encouraged an open and transparent culture where people were able to make suggestions for change and improve the quality of the service.

We went back on this visit to check whether improvements had been made.

We looked at the menus in place and found that hot options were now available at breakfast time every day. One person told us "I look forward to my breakfast it sets me up for the day",

We saw the home had bought new crockery. This enabled people who required a their meals to be softened to have their meals presented in an appetising way.

We saw evidence which showed staff at the home were accurately recording what people were eating throughout the day.

We looked at documentation which showed senior members of staff were observing mealtimes taking place. This meant staff were ensuring the quality of the mealtimes were maintained.

We saw the kitchen had arrangements in place to ensure that high calorie snacks were available for people between meals.

We spoke with three people who lived at the home and they all told us they thought the food served to them was very good. We also spoke with two members of staff. One of them told us; "The new crockery is really good. It means people's meal's don't look like mush anymore". Another said; "Mealtimes are enjoyed by people. They really enjoy the cakes and buns in an afternoon with their cups of tea".

We also spoke with two people's relatives and one of them told us "I know when I go home that my relative is safe and that makes me happy."

There were systems and processes in place to review and evaluate the quality of the services provided. Since our last visit the home had employed a part time maintenance man. The home had recently been redecorated and all of the communal areas within the home were very clean and tidy. Automatic hand gel dispensers had been installed throughout the home. Door handles and hand rails had been secured. We saw that new flooring had been fitted in a number of areas.

Peoples clothing appeared clean and we saw their clothes and personal items were stored neatly within their wardrobes and on their bedside drawers. Peoples rooms included personal items such as family photographs, soft toys and furniture. Each of the bedrooms and en-suite toilets we looked at were bright, clean and free from odours. Shower curtains were hung neatly and appeared clean.