Clarence Road

Updated 1 July 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by 2 inspectors.

Service and service type

Clarence Road is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Clarence Road is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations. At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with the registered manager, team leader, 5 staff, 5 people who used the service and 2 relatives. We viewed 4 records including care plans and risk management plans and 4 staff files including recruitment and training records. We also viewed records relating to the management of the service.

Updated 1 July 2023

About the service

Clarence Road is a residential care home that can provide 24-hour support and personal care for up to 15 adults with mental health needs. The care home was split across three floors and each floor was accessible by lift. At the time of our inspection 15 people were using the service.

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

People were not protected from the risks of acquiring an infection as infection control practices were not being followed. We found the home smelt strongly and this related to an area not being cleaned frequently enough to remove the smell of urine.

Health and safety concerns were present within the service. These included the incorrect disposal of personal protective equipment (PPE), the lack use of PPE in kitchen areas by staff and external contractors other than the chef. We also found hot water temperatures within bathrooms not being brought to safe temperatures.

Medicines were not managed safely the administration procedure was not being followed. The premises were in need in of repair and showed signs of wear and tear. Relatives told us the service was not homely and did not feel homely for people when they visited.

Relatives told us the communication about changes at management level were not open and transparent. Quality assurance systems were in place, but these were not effective as they did not identify some of the shortfalls identified during our inspection.

The registered manager and provider acted upon feedback from the inspection and were in the process of addressing the issues identified.

People told us they felt safe at the service and they could find a member of staff to help them. Staff rota’s showed shifts were covered. People told us they were kept informed about their medicines and why they needed to take them.

Staff demonstrated they were aware of their safeguarding responsibilities and how to report concerns. Lessons learnt took place at the service after an incident and staff confirmed they took part in meetings to learn from lessons.

Staff were supported in their role and received appropriate training. People were able to enjoy food they liked and were supported to have enough to drink. Relatives did not think the food at the service was of good quality.

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. Consent to care and treatment was requested and staff did not force people to do something they did not want to. The service worked well with external health professionals to ensure people received support when they became unwell.

Rating at last inspection and update

The last rating for this service was good (published 22 January 2020).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

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.

The provider took action to reduce the risk of harm people faced in relation to infection control practices and health and safety concerns, however, their quality assurance systems were not effective to ensure shortfalls were identified and prompt action was taken.

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

Enforcement

We have identified breaches in relation to infection control, safe management of medicines, safe premises and governance within the service.

We served 2 warning notices due to there not being effective governance procedures to monitor the quality and safety within the service.

Please see the action we have told the provider to take at the end of this report.

Follow up

We have requested 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