Cloverdale

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

At this assessment we assessed 4 of 5 quality statements within the caring key question. The scores of these areas have been combined with scores based on the rating from the last inspection published 28 October 2019, which was outstanding. The overall rating for this key question is now good. We observed a kind and caring culture with staff offering choices to people. This was supported by positive feedback from external professionals who worked with the service. Management encouraged staff to think how they could enrich people’s lives and guidance for staff around people’s communication needs was recorded in their support plans. Staff wellbeing was supported with the ability to express themselves through supervisions and meetings, however staff feedback included increased stress levels, in part from working alone at night. However, the high level of use of agency staff and lack of consistency in management raised concerns around the impact on quality of care. This was in part mitigated by regular agency staff being used and permanent staff knowing people well. In addition to this, the lack of employed drivers at the service, impacted on people’s ability to access the community, which the provider was aware of and taking action to resolve which included working with stakeholders around allocated 1 to 1 hours and arranging public or private transport if required.

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.

People and their relatives told us staff were kind and caring and felt staff knew them well, particularly their keyworkers. Keyworkers were permanent staff members, allocated to people. The provider’s survey also showed people who used the service felt their privacy and dignity was upheld by staff and the support guidelines in place provided good guidance for staff to follow in line with Right Support, Right Care, Right Culture guidance (RSRCRC). This guidance includes how to maximise people’s choice, control and independence, supports person centred care and people’s dignity and human rights and values and behaviours of staff and leaders. For example, guidance was in place for staff to follow to maximise people’s ability to communicate and make choices which meant they were involved and decisions around their care appropriately.

Staff demonstrated they knew people and their needs well, however, due to the high use of agency staff, feedback we received from staff included concerns around the lack of consistency with staff and management and the impact this would have on the quality-of-care people receive. This was discussed with the provider who confirmed agency staff employed by the service were regular agency staff. Relatives told us they were able to visit the service freely, however the lack of drivers among staff employed, impacted the capacity to support people who wanted to be taken to visit relatives, which meant people were not able to see relatives when they wanted which could impact on people’s distress. Other options with public or private transport were considered and used for appointments and the provider had an ongoing recruitment drive to resolve this problem.

As part of this assessment, we asked for feedback from external professionals who worked with the service. One professional told us they had observed staff treat people with compassion and knew people well. Feedback from professionals also included staff did not rush people’s care, people had good relationships with staff and new staff treated people with kindness and interest.

During the site visits to the service, we observed a kind and caring culture. We observed people who used the service were mostly relaxed with staff and we observed staff explained to people what they were doing when they supported them.

We did not look at Treating people as individuals during this assessment. The score for this quality statement is based on the previous rating for Caring.

People and their relatives told us staff promoted people’s independence and offered choices. Feedback also included people’s independence was supported so people could do things they liked as far as possible within their support hours. One person’s relative told us the family were able to visit Cloverdale as they wished, exchange emails and photos. However, people and their relatives also told us the lack of drivers employed by the service, impacted their ability to engage in meaningful activities outside of the home. Staff were working with people to identify new activities they wanted to do and how this could be achieved to maintain people’s independence.

The manager told us each person had their own personal schedules and they encouraged staff to think about how they could enrich people’s lives, which keyworkers would then discuss with people. Staff told us people were supported with their activities and they were working with people to find new activities they wanted to do.

We observed staff speaking to people offering choice and involvement in decisions. In addition, staff were observed to validate people’s efforts, and we saw people’s bedrooms were decorated as they wished.

People’s communication needs and how to support them to make choices, were recorded in their support guidance. In addition, people’s workbooks showed keyworkers set goals with them including going out and enjoying activities. Some goals were focused on promoting people’s independence, such as cleaning their bedroom and using the toilet, and did not include information about people’s aspirations and life goals. People’s support plans were being reviewed at the time of inspection and their goals and outcomes were included in this review. The level of detail in support guidance helped ensure staff provided consistent care and people were supported to be as independent as possible.

People’s relatives told us staff were mostly prompt and responsive, however at night only one staff member was on duty for the 4 people who lived at the service. This meant people may have to wait for staff to respond, which not all people were able to understand. However, one person told us, “when I didn’t feel well, staff had tried very hard to look after me and make me comfortable.”

Leaders told us the changes in the home including a new person moving in, staff leaving and changes in management had impacted the ability of staff to respond to people’s needs. This included changes in how people expressed themselves at night. In response, the provider had ensured there was a consistency with agency staff who knew people and how to support them and told us staff shift times had been adjusted to better align with people’s needs.

We observed staff responded to people as quickly as they could, however they could not always respond in that instant which for one person, could lead to distress. This had been identified by leaders and appropriate actions had been taken which included staff working with the provider’s support team and liaising with external professionals to support them.

Staff and leaders told us staff were asked to work additional hours to cover vacancies, but not all felt they wanted to as they told us they already worked long hours and work was stressful. In addition, night staff felt working alone at night could be stressful, which meant additional pressure was being placed on staff which did not support staff wellbeing. Leaders were aware and had a recruitment plan in place. The provider engaged with staff with a survey. The last survey showed staff felt supported, but at the same time 6 staff would not recommend the service as a place to work.

Staff had completed stress risk assessments and work- based risk assessments were completed for staff as required. In addition, staff were able to express themselves through supervisions, staff meetings, surveys and had a range of training to support them in their role.