Archived: Clann House

Updated 28 May 2022

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.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was completed by two inspectors.

Service and service type

Clann House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service did not have a manager registered with the Care Quality Commission. This means that the provider is legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from a professional who work with the service.

The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

We used information gathered as part of monitoring activity that took place on 22 March 2022 to help plan the inspection and inform our judgements.

During the inspection-

Some people using the service had limited verbal communication. We spent time observing their interactions between themselves and with supporting staff. We spoke with two people who used the service about their experience of the care provided. We spoke with six members of staff. This included the newly appointed manager, deputy manager, care staff and auxiliary staff.

We reviewed a range of records. This included four people’s care records, and medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection visit, we spoke with the area manager and to three relatives. We received six emails from staff regarding their experience of working at Clann house.

Updated 28 May 2022

About the service

Clann House is a residential care home providing personal care and accommodation for up to 34 predominantly older people. At the time of this inspection there were 28 people living in the service. Accommodation is spread over two floors. Clann House is an older style property on the outskirts of Lanivet village, which is near Bodmin.

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

The inspection was prompted following concerns about the management of the service. At the time of the inspection, the manager was not registered with the Care Quality Commission (CQC). The manager had submitted their application with the CQC but later withdrew this. The provider put in place further interim management arrangements to oversee the service and an action plan following the inspection.

Feedback from staff, and from the review of records and care documentation evidenced there was poor oversight of the service which was affecting aspects of the operations of the service. Audits to oversee the service were not always fully effective in identifying areas for improvement. Confidential information was not always stored securely.

Some people could find it difficult to express themselves or manage their emotions. This could lead to distressed behaviour which could put them, or others at risk. People's care plans did not always inform, direct or guide staff in the actions to take when people were becoming anxious and how to support them. The manager told us that people in the service did not have a behavioural support plan. As staff had no guidance when a person became anxious, this meant that there was no consistent understanding or approach in how to support people.

Medicines were administered safely. However, records were not always accurate. There was no evidence of how managers responded to medication incidents with staff and if additional training, supervision and competency checks were being made. Some people were prescribed medicines to be taken when required. Staff did not record the reason for giving a when required medicine or whether it was effective.

People using the service and their relatives told us they felt they were cared for by skilled staff who were caring and respectful. We observed many kind and caring interactions between staff and people. Staff spent time chatting with people and knew the people they supported well.

There were some staff vacancies at the time of this inspection. Regular agency staff were being used to cover these absences whilst a recruitment campaign was on going. Duty rotas confirmed that there was always a mix of permanent and agency staff on duty so that people were supported by familiar staff. People told us that staff respond in a timely manner when they called for assistance.

All necessary recruitments checks had been completed. New staff completed an induction and staff training was monitored to ensure that it was updated.

The provider had effective safeguarding systems in place and all staff had a good understanding of what to do to help ensure people were protected from the risk of harm or abuse.

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.

The food provided by the service was enjoyed by people.

People were supported to access healthcare services, staff recognised changes in people's health, and sought professional advice appropriately

Staff were motivated and fully focused on ensuring people's needs were met.

Cleaning and infection control procedures had been updated in line with COVID-19 guidance to help protect people, visitors and staff from the risk of infection. Government guidance about COVID-19 testing for people, staff and visitors was being followed.

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

Rating at last inspection and update

This service was re-registered with us on 16 June 2021and this is the first inspection.

The last rating for the service under the previous provider, Amber Care (East Anglia) Ltd, was requires improvement published on 7 August 2020 with a further targeted inspection in December 2020. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of the key question. These inspections found improvement in the operation of the service had been sustained and regulatory breaches had been complied with.

Why we inspected

This inspection was prompted by a review of the information we held about this 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.

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

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service.

We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to safe care and treatment and good governance at this inspection.

Follow up

We will request an action plan for the provider to understand what they will do to continue to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress.

We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.