Archived: Clitheroe

Updated 6 December 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service and to provide a rating for the service under the Care Act 2014.

The inspection took place on 17 and 18 October 2017 and the first day was unannounced. The inspection was carried out by an adult social care inspector and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Before the inspection we reviewed information we held about the service including complaints, safeguarding information and statutory notifications received from the service. A statutory notification is information about important events which the provider is required to send to us by law. We also reviewed previous inspection reports.

As part of the inspection we contacted three community healthcare professionals who were involved with the service for their comments, including a community psychiatric nurse, a district nurse and a phlebotomist. None of the agencies we contacted expressed any concerns about the service. We also contacted Lancashire County Council contracts team and Healthwatch Lancashire for feedback about the service.

We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.

During the inspection we spoke with four people who lived at the home and five visitors. We spoke with three care staff, the cook and the manager. We observed staff providing care and support to people over the two days of the inspection. We reviewed in detail the care records of three people who lived at the home. We also looked at service records including staff recruitment, supervision and training records, policies and procedures, complaints and compliments records, records of quality and safety audits that had been completed and fire safety and environmental health records.

Updated 6 December 2017

We carried out a comprehensive inspection of Clitheroe on 17 and 18 October 2017. The first day of the inspection was unannounced.

Clitheroe 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. Clitheroe accommodates up to 28 people in one adapted building who receive personal care. At the time of this inspection there were 20 people living at the home.

At the time of our inspection the service did not have a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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. The previous registered manager had left on 14 April 2017 and a new manager had been in post since 23 April 2017. The manager advised that she planned to submit an application to CQC to become the registered manager for the service.

During a previous inspection on 5, 6 and 13 July 2016, we found a breach of the regulations relating to staffing levels at the home. We carried out a follow up inspection on 12 January 2017 and found that improvements had been made and the provider was meeting the regulation. During this inspection we found that all regulations were being met. However, we found that some staff had not received Mental Capacity Act 2005 training and a Deprivation of Liberty Safeguards application had not been submitted to the local authority in respect of one person who lived at the home.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way; the policies and systems at the service supported this practice. However, we found the staff we spoke with lacked a clear understanding of the main principles of the MCA and some told us they had not received MCA training.

We found appropriate policies and procedures in place for the safe management of people’s medicines and people told us they received their medicines when they should.

People told us they received safe care. Most people and their relatives that we spoke with were happy with staffing levels at the home. Staff felt that staffing levels were appropriate to meet people’s needs.

People who lived at the home liked the staff who supported them and felt that staff had the knowledge and skills to meet their needs.

We saw evidence that staff had been recruited safely. The staff we spoke with understood how to safeguard vulnerable adults from abuse and were clear about the action to take if they suspected abusive practice was taking place.

We found that people’s risks were assessed and managed appropriately. Care plans and risk assessments were updated when people’s needs changed. This meant that staff had up to date information to ensure they were managing people’s needs and risks effectively.

We found that staff received an appropriate induction, effective training and regular supervision. Staff told us the manager was approachable and they felt well supported by her.

People were happy with quality of the meals provided and told us they had lots of choice at mealtimes. We saw evidence of this during our inspection.

People received support with their healthcare needs and were referred to a variety of community healthcare professionals where appropriate.

We observed staff communicating with people in a kind and respectful way. People told us staff respected their privacy and dignity and encouraged them to be independent.

People were supported to take part in activities inside and outside the home. People who lived at the home were happy with the activities available.

We saw evidence that the manager requested feedback about the service from people who lived at the home and acted on the feedback received.

People who lived at the home and their relatives told us the home was well managed. They felt that the staff and the manager were approachable. Staff told us they felt standards of care at the home had improved since the arrival of the new manager.

The manager regularly audited many aspects of the service and shared the outcomes of audits with the provider. We found that the audits completed were effective in ensuring that appropriate standards of care and safety were maintained at the home.