Background to this inspection
Updated
13 September 2018
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
The inspection took place on the 22 and 23 August 2018 and was unannounced.
On day one of the inspection, the team consisted of one adult social care inspector, a medicine inspector 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. The second day of the inspection was carried out by the same adult social care inspector.
We spoke with ten people who lived at the home, two relatives, the registered manager and regional manager. We spoke with 14 staff which included managers, care supervisors, care workers, activity, catering and support staff. We looked at nine peoples’ care and support records. We checked 16 people’s medicine administration records and observed medicine administration. We checked the storage and safety of medicine. We looked at eight staff recruitment and training files. We made observations of the delivery of care and support and looked around the home to check the environment. We cross-referenced practice against the provider’s own policies and procedures.
We also contacted social care and healthcare professionals with knowledge of the service. Following the visits to the home, we received further feedback from relatives and staff.
Prior to the inspection the provider completed a Provider Information Return (PIR). We used information the provider sent us in the PIR. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. Throughout the inspection we gave the registered manager opportunities to share their planned changes for the service with us. We reviewed notifications and any other information we had received. A notification is information about important events which the service is required to send us by law.
Updated
13 September 2018
This inspection took place on 22 and 23 August 2018. It was an unannounced visit to the service.
We previously inspected the service on the 12, 13 July and 2 August 2017. The service was rated Requires Improvement at the time. We found people were not always receiving their medicines in line with good practice. At the time of our last inspection the provider was working with the Clinical Commissioning Group (CCG) pharmacist to make improvements to the storage and administration of medicines. We have been monitoring the service to ensure improvements were made to the key questions, Safe and Well-Led. At this inspection we found improvements had been made.
Cliveden Manor is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
People living in the care home occupied either one or two bedroomed apartments. Accommodation was spread over three floors. A range of communal seating areas were available. People could choose to have a meal in a restaurant, bistro area or in their apartment. The first floor had an activities and library area. The second floor had a unit called ‘The Willows’, which provided support to people living with dementia.
The care home could provide nursing and care support up to 85 older adults, at the time of our inspection 76 people lived at the home.
The service had a registered manager in post. 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.
We received positive feedback from people, their relatives and staff on how the service was led. Comments included, “Very well run and have a great ability, endless patience,” “Splendid, seems to work very efficiently” and “Excellent, proactive, concerned about the residents in their care.”
People told us they were supported by staff who were kind and caring. People said “Sweet natured, so good, they put up with so much. Even the cleaners have time for you” and “All staff are so obliging, friendly, kind and compassionate.”
People told us staff treated them with dignity and respect and they were encouraged to be as independent as they could be. Comments from people included, “Staff are very good, very respectful and “Oh yes, we are treated very respectfully.”
The provider had processes in place to undertake pre-employment checks on staff to ensure they were suitable to work with people. People told us there were enough staff to provide them with safe care. We observed call bells were answered in a timely manner.
Staff were aware of the need to report any incidents and accidents. Trends in accidents were monitored and lessons learnt when things went wrong were shared within the home and across the provider’s locations.
People were supported by staff that had developed a good working relationship with them. Staff were aware of people’s likes and dislikes.
People were supported to engage in meaningful activities and keep in contact with family and friends. People were provided with lots of opportunities to visit places of interest in the local area and further away, for example, trips to the seaside, Hyde Park and National Trust properties.
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.