Clarence House Care Home

Updated 19 January 2024

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 Health and Social Care Act 2008.

Inspection team

The inspection team consisted of 2 inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Clarence 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. Clarence Hose is a care home with nursing care. 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.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 4 people who used the service and 14 relatives to gather their experience of the care provided. We spoke with 8 members of staff including the registered manager, care staff, nurses and ancillary staff. We observed staff interacting with people to understand the experience of people who could not talk to us. We reviewed a range of records including 4 people’s care documentation, multiple medication records and quality audits.

Updated 19 January 2024

About the service

Clarence House is a residential care home providing nursing and personal care for up to 78 people. At the time of our inspection there were 52 people using the service.

People’s experience of the service and what we found:

Quality monitoring systems were in place; however, these were not always effective. Some areas of improvement we identified during the inspection were not highlighted as part of the providers quality monitoring systems. For example, we found infection control shortfalls throughout the home including the kitchenette area and people’s ensuite facilities. Risks in relation to people’s care were not always being managed safely. Following our inspection, the registered manager took action to address these concerns. However, new systems and approaches required embedding into practice.

People did not always receive person centred care which took in to account their preferences. We received mixed views from people and relatives about the care and support.

People predominantly received their medicines as prescribed. However, we found some discrepancies mainly around record keeping relating to medicines management.

Staff told us they received training in safeguarding and knew what action to take if they suspected abuse.

The provider had a process in place to safely recruit staff. We observed there were enough staff available to support people.

Accidents and incidents were recorded, and action was taken to reduce future risks. The registered manager kept a record of safeguarding concerns and could evidence actions they had taken to protect people.

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 16 August 2017).

Why we inspected

We undertook a focused inspection to review the key questions of safe, caring and well-led only. For those key question not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

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

Enforcement

We have identified breaches in relation to infection control, risks associated with people’s care and good governance.

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.