Clifden House Dementia Care Centre

Updated 7 September 2022

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.

This was a focused inspection to check whether the provider had met the breach of Regulation 11 (Need for Consent) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 as we found the principles of the Mental Capacity Act 2005 were not being followed and people were at risk of having their liberty restricted, Regulation 18 (Staffing) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 the provider had not ensured there was a safe induction process for new staff and Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Systems in place to review quality were not always effective. Accurate documentation of people’s mental and physical health care needs and associated risks had not been maintained.

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 one inspector

Service and service type

Clifden House Dementia Care Centre 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. Clifden House 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 service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. 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

The provider was asked to complete a Provider Information Return (PIR) a few days prior to this inspection. This is information providers are required to send us annually with key information about the service, what it does well and improvements they plan to make. This information had not been processed by CQC at the time of planning this inspection, so could not be used when planning. This information was reviewed following the inspection.

We reviewed all the information we hold about the service including statutory notifications sent to us by the registered manager about events that had occurred at the service. A notification is information about important events which the provider is required to tell us about by law. We contacted the local market support team. We used all of this information to plan our inspection.

During the inspection

Not everyone living at Clifden House was able to tell us about their experiences. We spent time observing the interactions between people and staff in communal areas of the home, in order to help us understand people's experiences.

We spoke with ten people who used the service and contacted three relatives following the inspection. We spent time observing care and reviewing care records to help us understand the experience of people who could not talk with us. We spoke with seven members of staff including the provider, registered manager, care staff and housekeeping.

We reviewed a range of records. This included three peoples care plans in full and a further four to look at specific areas relating to the

Updated 7 September 2022

About the service

Clifden House Dementia Care Centre is a residential care home providing care and accommodation for up to 59 older people living with dementia or dementia type illness. Clifden House is an adapted building in a residential area of Seaford. The home had a lift to assist people in accessing upper areas of the home. There was access to an outside area with seating. At the time of the inspection there were 49 people living at the service one of whom was in hospital.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

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

IPC systems and processes were in place. The home looked clean and tidy and there were designated housekeeping staff. We identified an improvement was needed to the documentation of cleaning completed. This was rectified immediately by the registered manager.

Systems and processes had improved. A new electronic care system had been introduced. This was currently being used day to day alongside the previous system until all information had been reviewed and moved over.

They provider and registered manger had oversight of care documentation on this system and this enabled them to review and check how it was being used. The registered manager told us, “We are still finding new things we can add to the system and things that we could change to make it more user friendly, but I prefer it to the old system and so do the staff.”

Care documentation had been improved. As information was being moved to the new system it was being checked to ensure it was current and included all relevant information to support staff to be able to provide safe, effective care.

Improvements had been implemented to ensure that peoples consent and capacity were considered. Staff offered people choice and involved them in all day to day decisions. 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.

Peoples nutritional needs were met. Staff were able to tell us about peoples likes and dislikes and those who had specific dietary needs. Information was shared with the chef to ensure they were aware of any individual requirements.

The provider had robust recruitment processes in place. All new staff completed a period of induction overseen by the registered manager. Staff received training and told us they felt supported by the registered manager.

People received their medicines in a safe manner. Staff received training and medicine competencies were completed to ensure staff followed safe guidance at all times.

People told us they were happy living at Clifden House.

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 requires improvement (published 16 March 2020) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

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 carried out an unannounced comprehensive inspection of this service on 4 and 5 February 2020. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve systems to assess and review mental capacity, staff induction and quality assurance. We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers findings in relation to the key questions safe, effective and well-led. 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 requires improvement to good, based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Clifden House Dementia Care Centre on our website at www.cqc.org.uk.

Follow up

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