Archived: Clayhall House

Clayhall House is a residential care home providing personal care to six people with learning disabilities and/or on the autistic spectrum at the time of the inspection. The service can support up to six people.

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 receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

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

The service was not always safe because medicines were not managed appropriately, the premises were potentially dangerous and there was a risk of the spread of infection. Risks to people and staff were not always properly assessed. Quality assurance systems had failed to identify and address shortfalls within the service. Care plans and pre-admission assessments did not fully cover people’s protected characteristics, such as culture and sexuality.

Systems were in place for responding to allegations of abuse and staff were knowledgeable about their responsibility in this area. There were enough staff working at the service to meet people’s needs. Pre-employment checks had been carried out to help ensure suitable staff were employed.

Pre-admission assessments were carried out to determine people’s needs. Staff were supported through training and supervision. People had enough to eat and drink. The service worked with other care agencies to promote and meet people’s health care needs. 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.

Staff were friendly and polite in their interactions with people and people told us staff were caring. People were supported to be as independent as possible and the service sought to meet needs around religion and ethnicity.

Care plans were in place which set out how to meet people’s needs. People and relatives were involved in developing these. The service sought to meet people’s communication needs and to provide information in an accessible format. A variety of social and leisure activities were offered, and people were able to maintain relationships with family and friends. Systems were in place for dealing with complaints.

There was a registered manager in place. People and staff spoke positively about them and about the working culture at the service. The provider worked with other agencies to develop knowledge and share best practice.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence. The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

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 11 September 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified breaches in relation to the safety of the care and support provided and the management of the service.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will request an action plan for 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

There were enough staff working at the service to meet people’s needs and robust staff recruitment procedures were in place. Appropriate safeguarding procedures were in place. Risk assessments provided information about how to support people in a safe manner. Medicines were stored and administered in a safe manner. However, they were not always recorded accurately and we have made a recommendation about this.

Staff received on-going training to support them in their role. People were able to make choices for themselves where they had capacity and where they lacked capacity family members were involved in decision making. The service operated within the principles of the Mental Capacity Act 2005. Deprivation of Liberty Safeguards where in place where appropriate. People told us they enjoyed the food. People were supported to access relevant health care professionals.

People told us they were treated with respect and that staff were caring. Staff had a good understanding of how to promote people’s privacy, independence and dignity.

Care plans were in place which set out how to meet people’s individual needs. Care plans were subject to regular review. People were supported to engage in various activities. The service had a complaints procedure in place and people knew how to make a complaint.

Staff and people spoke positively about the senior staff at the service. Quality assurance and monitoring systems were in place to help drive improvements at the service.

We found that the provider had made an assessment of people's support needs. Their support had been planned and delivered effectively. People received assistance that safely met their identified needs. A social worker told us "the person I visit has used the service for three months. I have no concerns about the way they are supported. They are able to play football and make frequent visits to the park and cafes." They said the service had promoted the person's wellbeing by assisting them to undertake activities of their choice.

People received support from suitably qualified, skilled and experienced staff. We found that appropriate checks were undertaken before staff began work. We spoke to staff and found they were knowledgeable about people's needs. The provider had some effective systems in place to monitor the quality of the service. They have told us that, as the service is new, auditing arrangements are still under development.

People's medication was stored and administered safely. People's care records were appropriately maintained.