Clarendon House

Updated 4 March 2020

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 Care Act 2014.

Inspection team

This inspection was carried out by one inspector.

Service and service type

Clarendon 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.

The service had a manager registered with the Care Quality Commission. 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.

Notice of inspection

This inspection was unannounced on the first day.

What we did before the inspection

The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

We reviewed information we had received about the service since the last inspection. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection-

We spoke with three people who used the service. We spoke with four members of staff. We also spoke with the registered manager and the assistant director. We also spoke with three professionals who regularly visited the service.

We reviewed a range of records. This included three people’s care records and multiple medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and updated documentation.

Updated 4 March 2020

About the service

Clarendon House is a care home providing accommodation for up to seven people with learning disabilities and mental health disorders. At the time of our inspection seven people were living at the home.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service received planned and co-ordinated person-centred support that was appropriate and inclusive for them.

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

Overall the home was well decorated, and most areas well maintained. However, there were parts of the property in need of better cleaning routines. The organisation’s quality assurance team had assessed this area as being partly met.

Medicine systems were safe. Prompt action was taken by the registered manager following feedback on the findings of the inspection. These included developing protocols which detailed the order multiple pain relief medicines were to be administered as required. Risk assessments were developed on the potential harm to people who smoked and had prescribed creams and lotions that could be flammable.

Quality assurance systems were in place and action plans were set on how to develop service delivery. However, the audits had not identified that the use of language in some documents was not always respectful. We raised this with the registered manager who assured us action would be taken.

Individual risks were assessed and risk reducing measures were in place. There were opportunities for people to take risk safely.

There were people whose behaviours at times placed them, the staff and others at risk of harm. Guidance on how staff were to manage incidents were in place which the registered manager monitored and analysed.

The registered manager took prompt action following our feedback and updated risk assessments and guidance regarding the use of key codes for some people to gain access from and into the secure garden. Action was also taken to make clear the distraction techniques to be used by staff in behaviour support plans.

People were supported to have 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. People told us they made their day to day decisions. People subject to Deprivation of Liberty Safeguards (DoLS) and Community treatment orders were aware of the conditions and their meaning.

People told us they felt safe living at the service and for some people the sense of security came from having staff present and from the environment. The staff we spoke with had attended training in safeguarding, they knew the procedure which included the types of abuse and how to report their concerns.

There were sufficient staff on duty and people said they had the assistance necessary from staff to meet their needs

The induction for new staff included the Care Certificate. Staff said the training was good and there were opportunities for professional development. Staff said the team was new and they were supportive of each other.

People were supported with their ongoing healthcare. People told us meals were “ok.”

People told us the staff were kind and caring and the staff told us how they showed kindness and compassion

External professionals that gave feedback told us the staff made referrals in a timely manner. Their advice was followed and where this was not effective there were discussions on adapting guidance. External professionals said there was always staff available to support them with their visit.

Pen pictures and life stories were detailed and gave an insight into people’s early life, a history of their medical conditions and family dynamics. People knew they had a care plan and they said there were monthly meetings to discuss their progress made on goals. An activities coordinator was employed to support people with meaningful activities.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Good (published on 12 July 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.