Background to this inspection
Updated
25 November 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 checked whether the provider is 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.
This inspection took place on 3 October 2017 and was unannounced. The inspection team consisted of one adult social care inspector. The service was previously inspected in November 2015 when it was found to be ‘Good’ in all areas.
Prior to the inspection we reviewed the Provider Information Record (PIR) and previous inspection reports. The PIR is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We also reviewed the information we held about the service and notifications we had received. A notification is information about important events which the service is required to send us by law.
During the inspection we met and spoke with four people who used the service, two relatives who were visiting, five staff, the registered manager, the provider’s nominated individual and two visiting health professionals. Following the inspection we spoke with two additional relatives and a health and social care professional. We also inspected a range of records. These included two people’s care plans, four staff files, training records, staff duty rotas, meeting minutes and the services policies and procedures.
Updated
25 November 2017
Clinton Lodge is a small care home that can accommodate up to five people with learning and /or physical disabilities. At the time of our inspection five people were living there. Clinton Lodge is a detached building located in its own gardens in a residential area of Redruth.
The service was led effectively by a recently appointed registered manager with support from the provider’s nominated individual, who had previously been the registered manager. Staff said they were well supported by their managers. One staff member commented, “[The registered manager] is brilliant, so easy to work with.” A relative told us, “Both [the nominated individual and the registered manger] are really good people.”
Most of the people we met had limited verbal communication skills. However, people did tell us they were happy and enjoyed living at Clinton Lodge. Relatives told us, “The quality of the care is unbelievable” and “I wish every care home could be the quality of Clinton Lodge. It is really well run”.
One relative who was visiting on the day of our inspection told us, “[Person’s name] has chosen to stay here because he feels safe. We want to go out but he doesn’t. He has never done that before.”
Staff understood how to protect people from abuse and avoidable harm. Risk assessments had been completed and staff were provided with guidance on how to ensure people’s safety while encouraging independence. Regular fire drills had been completed and emergency evacuation plans which described how to support each person in the event of an emergency had been developed.
Staff had the skills and experience necessary to meet people care needs. Training was updated regularly and tailored to staff needs by the provider’s training lead. Staff told us, “Everything is refreshed six monthly or yearly depending on the course” and “I could not name all the training we do there is so much of it.” New staff received formal induction training and completed a minimum of three supernumerary shifts with each person before they were permitted to provide support independently.
Recruitment practices were robust and the service was consistently staffed appropriately to meet people’s care needs. On the day of our inspection each person was supported by their own member of staff. Staff rotas showed these staffing levels were routinely achieved and that each day a supernumerary manager was available within the service to provide additional support if required. Staff told us, “We always have enough staff” and “They always make sure it is covered if someone is sick. We never have a situation where we have less people than needed.”
Mangers and staff understood the requirements of The Mental Capacity Act 2005 and the importance of respecting people’s decisions and choices. Staff involved people in decision making throughout the day of our inspection and told us, “I involve my clients in everything. I like to make sure I offer three choices. I think people like to be involved” and “[Person’s name] tells you what he wants. He understands that he can choose.” One relative told us, “[Person’s name] is having his own life here. He is making his own decisions.”
Staff knew people well and understood their individual care and support needs. People’s care plans provided staff with detailed information on their individual likes and preferences. This included details of normal routines and information on how to provide support to help people to manage anxiety. Staff told us, “There is enough information in them, they tell you everything. [The person’s] past, their daily routines, night routines everything is in there.” Each person’s care plans also included detailed information on their individual communication preference and staff were able to communicate effectively with the people they supported.
People lived active and varied lives. They were routinely supported to access the local community and encouraged to try new activities. On the day of our inspection three people were away from the service for most of the day engaged with activities they enjoyed. Two people had chosen to staff in the service and these choices where respected. Relative told us it was sometime difficult to contact people as they were so often away from the service participating in different activities. One person’s relative told us, “They are very much focused on his experiences. They took him to laser tag the other day. I would never have thought of that.” People were regularly supported to engage in activities in the evening and staff told us, “We change shift times around people’s needs” and “There is never a problem with evening activities.”
The service’s quality assurance systems worked well and were used to drive continuous improvements in performance. Audits were completed regularly and action taken promptly where any issue were identified. People and their relatives were actively encouraged to provide feedback and the service regularly received compliments and thankyou letters from people’s relatives. In addition, the service used “Out in the community” feedback forms to gather views from local people and businesses on its performance. Responses received were consistently complimentary and included, “The young lady had a lovely caring manner. She listened to the young man, gave him choice and respected his decisions. A pleasure to hear” and “Good attentive care given - impressed!!!”