Clarence House Care Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

At our last inspection we identified concerns regarding infection control, and risks and the provider was found in breach of regulation. At this inspection we carried out a tour of the home and found many areas had improved. The home was clean, well presented and had a homely atmosphere. Risks associated with people’s care had been identified and managed to keep people safe. We received some comments from professionals visiting the service that referrals to them could be timelier, but it was also acknowledged that the management team and staff were willing to work with professionals and had improved. We observed staff interacting with people and found they were responding to people’s needs. However, some people and relatives we spoke with told us they sometimes had to wait a while for staff to support them. People received their medicines as prescribed by staff who were trained and competent in the safe handling of medicines.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People told us they felt safe living at the home. Although 1 person had concerns regarding carers not always responding when they wanted assistance. One person said, “You can shout for a carer, and they don’t come, they don’t like it when I shout.” Relatives also felt the home provided safe care. One relative said, “Oh yes, I definitely think [my relative] is safe here.” People had access to specialist seating and a variety of walking aid to ensure they had the right equipment to support their needs. Everyone we spoke with told us the home was clean and well maintained. Some areas were newly decorated.

Staff felt they were listened to, they told us the management team were approachable and took concerns seriously to promote safety.

Accidents and incidents were analysed, and actions taken to mitigate risks. We saw equipment, such as sensor mats, had been supplied for some people to minimise the risk of falls. Staff understood their roles and responsibilities to record and report accidents and incidents. Lesson learned following incidents were also discussed through supervisions and staff meetings.

People and their relatives were happy with the way the service worked in partnership with external professionals. People and their relatives told us staff accessed healthcare professionals when then needed them. One relative said, “The GP visits regularly and they [staff] always call and let me know if there is a change in [my relatives] condition. [My relative] also saw an optician about a month ago.” One person said, “The physio comes to help me get my legs going again.”

Staff and leaders knew the process to follow to assist with transitions between care services. The management team told us hospital packs provided information about people’s current care needs.

Professionals working alongside the home told us they had lots of input with Clarence House and told us people were referred to them as required. However, 1 professional said, “At times referrals could have been made earlier in the process instead of waiting a longer period of time before asking for our input. They [staff] have improved with communication between services and have willingly accepted help to improve in areas they know they need to improve in. We support them in any way we can and monitor practice while we visit.”

Care documentation showed people had been referred to healthcare professionals as required. Staff could explain people’s plans of care. The electronic care plan system supported staff to create a hospital pack to support communication of people’s needs when attending medical services.

People felt safe living at the home. Relatives also felt assured their family members were safe and cared for at the home.

Staff understood safeguarding and were aware of the need to report. Staff confirmed they would whistle blow to keep people safe. The management team understood their responsibilities and supported people in line with The Mental Capacity Act 2005 (MCA).

We observed staff interacting with people and found they were kind and caring. Staff knew people well and people responded to staff in a positive way. Throughout our observations, we did not identify any potential safeguarding concerns.

Systems in place guided staff in how and when to report safeguarding concerns. Systems were in place to ensure people were supported in line with the Mental Capacity Act 2005 (MCA). Where people lacked capacity, best interest decisions were made involving appropriate people. The management team kept a record of Deprivation of Liberty safeguards and knew when they needed to be reviewed.

People told us they received safe care and support, and family members echoed this. One relative said, “[Relative] had loads of falls before they came in here but none since they arrived.” Another relative said, “[Relative] has a mat [sensor mat] by their bed to keep them safe.”

Staff knew people well and could explain how they supported people safely and in line with their assessed needs. The management team told us they had worked on improving risk assessments and felt they gave more detail than before.

We observed staff supporting people in a safe way, for example, we saw 1 staff member gently guiding a person away from someone’s feet to prevent them tripping over. Staff supported people to sit in a comfortable position for their lunch and staff assisted people at their level and were speaking with them. People were supported to have plate guards as required.

Risks associated with people’s care were identified and managed to keep people safe. Accidents and incidents were analysed to show any trends and patterns and actions were taken to mitigate risks. People were assessed for equipment they required to ensure it was suitable.

People and relatives were happy with the environment and felt the home was safe and secure. People and relatives told us there had been improvement to the décor in the home and they felt this had contributed to a more homely environment.

Staff told us they worked in a safe environment and ensured the home was safe and secure. The management team told us about improvements they had made since the last inspection to make the environment more homely, such as décor.

During a tour of the home, we found the environment to be safe and free from clutter. Since our last inspection the provider had carried out some décor and maintenance which had improved the service. We saw equipment had been serviced in line with manufacturers guidelines.

There were arrangements in place to monitor the safety and upkeep of the premises. Environmental safety checks were in place, ensuring the environment and equipment was safe for people to use.

Everyone we spoke with commented that staffing had increased recently. Although we were told this could change at weekends. One relative said, “It has [staffing] definitely improved but I think it’s sometimes a bit short staffed at weekends.” Another relative said, “Staffing has increased lately but I think they could still do with more.” Another relative said, “Sometimes you have to wait for a carer, half an hour last time and by the time they [staff] got to [relative] it was too late.”

Staff felt supported and said they worked well together as a team. Staff commented this had improved. We asked staff if they felt there were sufficient staff working with them. One staff member said, “You can always use an extra pair of hands, but we can assist everyone with the current staff ratios.” Staff told us they received training and felt supported by the management team.

We observed staff interacting with people throughout the home and saw they responded to people in a timely way. Staff showed they were competent and knew people well.

The provider used a dependency tool to identify the number of staff required to meet people’s needs. The provider's recruitment procedure assisted them in employing suitable staff. Training records showed some staff required refresher training in order to meet the providers training policy. The registered manger was in the process of addressing this.

During our inspection we carried out a tour of the home and found the cleanliness of the home had improved. People and relatives commented positively about how clean and fresh the home was. One relative said, “I think it seems very clean here, I am happy with it.”

Staff told us the cleanliness of the service had improved. Ancillary staff felt supported and told us they had access to cleaning products and materials they required.

We carried out a tour of the home and found there had been improvements in the cleanliness and presentation of the service. The home was clean, and we did not identify any areas of concern in relation to cleanliness. Staff wore appropriate personal protective equipment such as gloves and aprons when carrying out certain tasks.

Processes in place to monitor infection prevention and control, were now effective. The registered manager had an infection control audit and identified areas of concern and ensured they were actioned in a timely way. The management team also conducted a daily walk round which included checking on infection control and cleanliness.

People told us they received their medicines as prescribed and told us they received their tablets at the correct time.

Staff informed us they received training in the safe handling of medicines and had their competencies checked on a regular basis.

Processes were in place to ensure people received their medicines as prescribed. There had been some work to improve protocols in place for medicines administered on an as required basis. Systems in place ensured medicines were stored and administered safely.