Clifton House

Updated 9 August 2023

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

The inspection was carried out by 2 inspectors.

Service and service type

Clifton House is a 'care home'. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

The inspection was unannounced on the first day of the inspection 21 June 2023 we let the registered manager know we would be returning on 22 June 2023 to complete the inspection.

What we did before the inspection

We reviewed information we had received about the service since it registered with CQC. We used all this information to plan our inspection.

Due to technical problems, the provider was not able to complete a Provider Information Return. A PIR is information providers send us 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 and met 7 people who used the service and 3 relatives. We spoke with 9 members of staff including the provider, registered manager, deputy manager, head of care, kitchen assistant, senior care and 4 care staff. Following our site visit we spoke on the telephone with 5 care staff and 4 relatives.

We reviewed a range of records. This included 5 people’s care records and the medication records for 4 people. We looked at 2 staff members recruitment records. We also looked at a variety of records relating to the management of the service, including policies and procedures.

Updated 9 August 2023

About the service

Clifton House is a residential care home providing personal care to up to 39 people. At the time of our inspection there were 30 people using the service, the majority of whom were living with dementia.

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

Improvements had been made to the governance systems but further embedding was needed. The provider's systems had not always been effective at either identifying where improvements were needed, or acting on their own findings in a timely way.

Where risks to people were known due to their diagnosed health conditions, risk assessments and care plans were not always detailed to guide staff on how to support people safely. Some parts of the environment were not always kept clean, and this placed people at an increased risk of harm.

Improvements had been made to recruitment practice so staff were safely recruited. There were some vacant posts and the provider was actively recruiting to these. Staff received support and training to carry out their role although some more specialised training was due for completion so staff continued to be effective in their role. People received the support they need to eat and drink safely.

The provider had made improvements to the environment so it was a nicer place to live, and further work was taking place so it was more welcoming to people living with dementia.

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 practice although some improvements were needed to records in relation to this.

Staff were respectful of people and took time to offer support and reassurance when this was needed. There was ongoing work to improve the detail of care records to ensure these were accurate, detailed and person centred. We observed kind and caring interactions and people's dignity was respected.

People and relatives told us they were involved in their care although records did not always reflect this. Communication and involvement of people using the service had improved although further work was needed.

Complaints were handled appropriately. Staff we spoke with felt supported by the registered manager. Relatives spoke positively about the registered manager and the staff team.

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

Rating at the last inspection and update

The last rating for this service was inadequate (published 04 October 2022) there were 5 breaches of the regulations. We issued a warning notice and the provider completed an action plan. At this inspection we found improvements had been made and 3 breaches were met. However, we found the provider remained in breach of 2 regulations.

This service has been in Special Measures since 04 October 2022. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

This service is now rated as requires improvement.

Why we inspected

This inspection was carried out to follow up on actions we told the provider to take at the last inspection.

Enforcement

We have identified breaches in relation to the management of risk and systems for the oversight of the service.

Follow up

We will request an action plan from 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 continue to monitor information we receive about the service, which will help inform when we next inspect.