Clarendon Care Home

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

We assessed all quality statements within the effective key question. We found improvements had been made since the previous inspection in January 2023. The service was no longer in breach of regulations relating to consent to care and treatment, assessing people's needs and choices and staff support. This meant the effectiveness of people's care, treatment and support achieved good outcomes. Systems were in place to ensure consent to care and treatment, assessment of people’s needs and support to live healthier lives. Staff teams and external services worked well together. People, family members and external health and social care professionals told us they felt the service was effective.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

At the last inspection we identified the provider had failed to ensure people were provided with person-centred care. This was a breach of Regulation 9 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At this inspection we found improvements had been made and the provider was no longer in breach of Regulation 9. Assessments were completed before people moved to the home. This included where appropriate, consultation with other professionals involved in the person's care and family members. Care plans were then developed to include people's identified needs and the choices they had made about the care and support they wished to receive. Consideration was given to the level of care and support a person required prior to being admitted and how this may impact on the wider comfort, safety and overall, wellbeing of others. The providers where exceptionally mindful of the environmental restrictions and how this could impact on people’s ability to move safely and freely around the home.

Staff followed best practice guidance, which led to good outcomes for people. For example, they used recognised tools to assess the risk of malnutrition and the risk of skin breakdown. Staff supported people in accordance with the latest best practice guidance on oral care.

People and those close to them had been involved in developing their care plans to meet their individual needs and preferences. One relative told us, “They know him really well, and seem to get what he wants before he even knows it himself.”

Care plans and related records viewed showed consideration and reflection of current legislation and best practice guidance. For example, oral health care plans were in place.

The nominated individual told us they had worked hard on the care plans to ensure they were fit for purpose.

People and, where appropriate, family members were fully involved in decisions relating to their care. One family member told us, “I am always kept informed about every aspect of care, medicines, etc. They phone me, and the contact is excellent.” We observed all the staff knew each person well. Everyone, without exception, was called by name. We saw a care staff member notice that a person hadn’t got their favourite blanket, so they went to find it for them.

The admissions process included seeking information from relevant sources. For example, within care plans there were up to date health summaries which had been received from people’s GPs.

People received effective support. Their health and care needs were understood and information was communicated effectively between services to ensure their needs continued to be met.

There was excellent joint working with relevant health and social care external professions. A multi-disciplinary meeting was held monthly, providing an opportunity for any concerns to be discussed promptly. Feedback from external professionals was very positive. For example, one health professional told us, “At the Multi-Disciplinary Team meetings it is clear from the level of detail the nominated individual is able to provide that she knows her residents well. When she does not know the answer to a question she is open about this and takes steps to provide us with the information we require.” Another external professional said, “Contact with the home is extremely responsive. Updates are given by the home where needed and the home are also able to seek support. The home works well in collaboration with myself and where feedback and recommendations have been given these have been followed quickly and appropriately.”

Staff felt they had sufficient time to meet people’s needs and told us they always had sufficient appropriate information about any changes to people’s needs. We saw staff working together to meet people’s needs.

Staff supported people to attend hospital appointments. This meant people were supported to attend appointments by staff who knew them, but also that information required by other professionals during the appointment would be available. Any decisions or further treatment required following an appointment would also be known by the service.

People were encouraged to have meals in the dining room meaning they were supported several times a day to undertake some exercise. A pleasant courtyard garden was provided which enabled people to get fresh air. An activities organiser was employed who provided a wide range of activities for all people either in communal areas or bedrooms providing mental and physical stimulation.

Care plans included information about people's past medical history and how current medical needs should be supported. External health professionals felt they were contacted appropriately and any recommendations made were followed by staff. One external professional told us, “I feel assured they would know when to escalate any concerns or ask for support when they need it.“

The providers and staff knew how to seek advice and support when required. External professionals were positive about people’s care and told us the systems in place meant feedback and suggestions were followed.

People and family members were all happy with the care provided. Since the previous inspection there had been an increase in staffing levels, including the introduction of an activities staff member. This meant people were now receiving a higher level of individual attention and mental stimulation.

People had up to date, individual, person-centred care plans which reflected latest best practice guidance and these were updated to reflect any changes to people’s needs. Daily records showed people were receiving the care they required as identified in their care plans. The provider's quality monitoring processes included care records which helped ensure these remained appropriate for each person.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS). At the last inspection we identified the provider had failed to work within the principles of the Mental Capacity Act 2005. This was a breach of Regulation 11 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At this inspection we found improvements had been made and the provider was no longer in breach of Regulation 11. MCA assessments had been completed and showed where people did not have capacity to make decisions, such as for personal care and receiving medicines, decision specific assessments were made. These included consultation with those close to the person and decisions had been made in the best interests of the person. Where necessary, applications had been made to the relevant authority and nobody was being unlawfully deprived of their liberty. There were systems in place to ensure that renewal applications were submitted in a timely way prior to existing DoLS becoming out of date.

Care staff were following people's documented wishes. People's right to decline care was understood. Staff said that, should people decline care or medicines, they would return a short while later to offer assistance again. Should people continue to decline they would encourage but respect the person's decisions and inform the management team.

Where people had capacity to make decisions, we saw they consented with the proposed care and support. Where one person had capacity made what was considered to be an unwise decision, steps had been taken to ensure the person understood the risks of this decision. Staff were heard providing people with choices in relation to where they spent their time, what they wanted to do and if they wanted to be involved in activities.