Cleveland House

About the service

Cleveland House is a care home registered to accommodate and support up to 11 people with mental health needs, learning disabilities and/or autism. At the time of the inspection, 9 people were using the service.

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

Right support

Staff, people and relatives told us that the service was good and that they could speak with the peripatetic manager as and when they wanted. There were sufficient staff to meet people’s needs and recruitment processes were safe. The provider had a system in place to record and monitor accidents and incidents. They worked closely with other professionals and had regular contact with them to ensure people’s needs were met fully.

Right care

Risk assessments were not always completed fully meaning staff did not always have the correct information on how to deliver safe care. People’s medicines were not always managed safely. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Right culture

There were quality assurance and governance systems in place to drive continuous improvement; however, the systems were not always working effectively because the provider had not identified some health and safety issues. Staff had received training of what constituted abuse and how to report any concerns to keep people safe. Staff and relatives commented positively about the changes being made by the new peripatetic manager.

For more information, please read the detailed findings section of this report. If you are reading this as a separate summary, the full report can be found on the Care Quality Commission (CQC) website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 3 November 2022).

Why we inspected

The inspection was prompted in part due to concerns received about how people were safeguarded at the service. A decision was made for us to inspect and examine those risks.

This was a focused inspection, and the report only covers our findings in relation to the key questions Safe and Well-led. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Enforcement:

We have identified breaches of regulations in relation to safe care and treatment and quality assurance at this inspection.

The overall rating for this service has now changed from good to requires improvement.

Please see the action we have told the provider to take at the end of this report.

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.

About the service

Cleveland House is a care home registered to accommodate and support up to 11 people with mental health needs, learning disabilities and/or autism. At the time of the inspection, 10 people were living at the home.

People's experience of using this service

Right support:

People and relatives told us they were involved in developing and reviewing care plans and risk assessments. Staff supported people to integrate and be part of the community. Staff knew people’s needs and ensured that each person received care and support that met their needs. People were able to make decisions about their care.

Right care:

People and relatives told us the care and support people received was excellent. Staff understood how to protect people from poor care and abuse. The service worked in partnership with other health and social care professionals to ensure people received effective care. People received kind and compassionate care from staff who had training and experience in providing personal care.

Right culture:

Staff placed people’s wishes, rights and needs at the centre of everything they did. The registered manager understood the importance of communicating and working closely with relatives. One relative told us, "Staff told me everything [about an incident], we have good communication with the home."

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.

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 5 July 2022).

Why we inspected

The inspection was prompted in part by notification of an incident following which a person using the service sustained a serious injury. This incident is subject to a criminal investigation and as a result this inspection did not examine the circumstances of the incident. However, the information shared with CQC about the incident indicated potential concerns about the management of risk of harm to people. This inspection examined those risks. We found no evidence during this inspection that people were at risk of harm from this concern.

We undertook a focused inspection to review the key questions of safe and well-led only. The overall rating for the service has remained Good based on the findings of this inspection.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Cleveland on our website at www.cqc.org.uk

About the service

Cleveland House is a care home registered to accommodate and support up to 11 people with mental health needs, learning disabilities and/or autism. At the time of the inspection, 10 people were living at the home.

People’s experience of using this service

The service was able to show how they were meeting the underpinning principles of right support, right care, right culture.

Right support:

People and their relatives were involved in care planning. Staff supported people to integrate and be part of the local community. Arrangements were in place to ensure people were safe. Risks to people were assessed, reviewed and actions put in place to keep people safe. People's equality characteristics were assessed and met by the service. Robust staff recruitment, support and training the service had in place helped ensure people received safe care. People made decisions about their care including the activities they took part in.

Right care:

Care plans were person-centred. This ensured care and support was tailored to each person's needs. Staff encouraged and supported people to be independent. People's privacy, dignity and choice was respected, and people developed positive relationships with each other and staff. 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. People's sensory and behaviour support needs were understood and met. People interacted with staff because their communication needs were assessed, and the provider ensured that systems were in place to support effective communication.

Right culture:

People led inclusive and empowered lives because of the ethos, values, attitudes and behaviours of the management and staff. The provision of training and support for staff and the good working relationships of the service with other professionals helped people receive good quality care, support and treatment. There were quality assurance systems in place for reviewing and improving the quality of the service. People, relatives and staff were confident that their concerns were heard because there was a complaints policy in place, which the provider was able to demonstrate they acted upon. People were supported by staff who understood best practice in relation to the wide range of strengths, impairments or sensitivities people with a learning disability and/or autistic people may have. This meant people received compassionate and empowering care that was tailored to their needs.

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

Rating at last inspection

This service was registered with us on 01 December 2020 and this is the first inspection. The last rating for the service under the previous provider was Good, report published on 18 October 2018.

Why we inspected

This inspection was prompted by a review of the information we held about this service. The inspection was also prompted in part by notification of a specific incident that took place in the provider’s other neighbouring service.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our reinspection programme. If we receive any concerning information we may inspect sooner.