Cleggsworth Care Home is registered to provide personal care and accommodation for up to thirty eight people. It caters for both long term and respite stays. The home is located in Smithybridge village, which has a variety of shops and other amenities close by. It is near to public bus routes and the train station is in close proximity. At the time of the inspection there were twenty seven people living at the service which is divided between two floors.
We last carried out an unannounced comprehensive inspection on 9 June 2015. We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This resulted in us serving two warning notices and making one requirement action. The overall rating for this service was ‘Inadequate’ and the service was therefore placed in 'Special measures'. A service in “Special measures” is kept under review and inspected again within six months. The expectation is that a service found to have been providing inadequate care should have made significant improvements within this timeframe.
The warning notices stated that the service must be compliant with these regulations by 30 September 2015. The service sent us an action plan informing us what action they intended to take to ensure they met all the regulations. They informed us they would be compliant with these by November 2015 and requested an extension until that date, which we agreed.
This was an unannounced comprehensive inspection which took place on 12 November 2015 to check the required improvements had been made and to follow up on what action had been taken to address the warning notices and requirement actions. We found that they had met the warning notices, the requirement action had been complied with and significant improvements had been made. As a result the service has been removed from “special measures”
The home did not have a registered manager; however our records showed the current manager has made an application to register with the Care Quality Commission. A registered manager is a person who has registered with the Care Quality Commission 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.
Improvements had been made in staffing levels. We were shown a copy of the duty rota. We saw that four care workers were on duty between 8am and 8pm. Since our last inspection a senior care worker was now on duty during these times, providing cover between both floors. This is an increase in staffing levels. During our inspection we observed that call bells and requests for assistance were answered promptly and there were sufficient staff to meet peoples needs. Despite this increase in staffing provision some people we spoke with thought that at times there were not enough staff available to support people promptly.
The home was clean and equipment was serviced and well maintained. Areas of the home had been redecorated and new furnishings and fittings had been purchased. There was a planned programme of ongoing improvements.
People we spoke with felt safe at Cleggsworth Care Home. Policies and procedures were in place to safeguard people from abuse and staff had received training in safeguarding adults. They were able to tell us how to identify and respond to allegations of abuse. They were aware of the whistleblowing (reporting poor practice) policy.
Staff were safely recruited and received the training and support they needed to carry out their roles effectively. Staff told us they liked working in the home and were positive about the improvements the new manager had made.
People told us the staff were caring and that they were well cared for. During the inspection we found the manager and staff to be caring and responsive to people.
We found there were safe systems in place for managing medicines.
The manager and staff demonstrated a good understanding of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). The MCA and DoLS provide legal safeguards for people who are unable to make their own decision.
People’s care records were detailed and person centred. They contained good information to guide staff on what was important to people and the care and support people required. Risks to people’s health and well-being were identified and plans were in place to reduce or eliminate the risk. We did note that for one resident this was not done in a timely manner.
People were supported to access health care services when necessary. Improvements had been made in the recording systems to help ensure health care professionals advice was acted upon.
A programme of activities within the home had recently been introduced.
Procedures were in place to prevent and control the spread of infection. Systems were in place to ensure all necessary health and safety checks were completed. There were procedures in place to guide staff in the event of an emergency that could affect the provision of care, such as loss of gas, electricity, heating or breakdown of essential equipment.
We found there was a robust system in place for quality assurance. Weekly and monthly checks had been introduced to assess, monitor and review the service. Records were kept of any issues or concerns and any actions taken to address them.
We saw there was a system for gathering people’s views about the service and acting upon suggestions and ideas.
There was a system in place for dealing with complaints about the service. People told us complaints were acted upon and they had confidence the manager would deal with any concerns.
People were complimentary about the new manager and the recent improvements that had been made and said the manager was approachable.