We carried out a comprehensive inspection on 1 December 2017. The previous comprehensive inspection was undertaken in November 2016. At this inspection the provider had breached two regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations. These breaches related to staffing and good governance. The service was rated as ‘Requires Improvement’. At this inspection we checked whether improvements had been made and the service was no longer in breach of the regulations.You can read the report from our last comprehensive inspection, by selecting the 'All reports' link for Clarence Park, on our website at www.cqc.org.uk.
Clarence Park is registered to provide accommodation for persons who require personal or nursing care for up to 43 people. The service cares for older people, some of whom are living with dementia. At the time of our inspection there were 39 people living in the service.
There was 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.
At our last inspection in November 2016 we found there were insufficient numbers of suitably qualified, competent, skilled and experienced staff deployed to meet the needs of people using the service. During this inspection we found some improvements had been made but this is an area that is still work in progress. The service is undertaking a recruitment drive.
At our previous inspection we found inconsistencies in people’s care records and in the frequency of care plan reviews. Although improvements had been made, this area still required further development. Some of the care plans we looked at did not provide enough detail for staff on how to meet people’s physical needs. Despite the lack of some detail within the plans, staff knew people well. They were able to discuss at length with us people’s life histories and their physical, mental and social needs and preferences.
At our previous inspection the provider did not have effective systems and processes for identifying and assessing risks to the health, safety and welfare of people who use the service. Although sufficient improvements had been made, this area required further development. Some shortfalls identified during this inspection had not been identified. In most cases the quality assurance process was more detailed and actions were taken in a timely manner. The service had an action plan in place which identified issues that needed to be taken forward within stated timelines.
Medicines were in the main managed safely but there were areas which required improvement, such as the need to update each person’s ‘as required’ medicines records.
Care plans contained risk assessments for areas such as falls, mobility, skin integrity and malnutrition. In most cases these were detailed and included guidance for staff on how to manage the risks of harm to people.
Regular maintenance and equipment audits relating to fire safety records, maintenance of safety equipment, gas safety, call systems, portable appliance testing (PAT) were undertaken.
People's rights were upheld in line with the Mental Capacity Act (MCA) 2005. This is a legal framework to protect people who are unable to make certain decisions themselves.
People received effective support from staff that had the skills and knowledge to meet their needs. We saw that the service’s induction was aligned with the Care Certificate. The Care Certificate is a modular induction which introduces new starters to a set of minimum working standards. Staff received on-going training to enable them to fulfil the requirements of the role.
People were supported to have enough to eat and drink. People were assessed for the risk of malnutrition and when required specialist advice and support was sought.
People spoke positively about the staff. Comments included; “Staff are alright, lovely girls”; “Everyone is cheery and friendly.” Staff understood the importance of maintaining people’s independence where possible.
People had access to a varied activities programme. People maintained contact with their family and were therefore not isolated from those people closest to them.
All of the staff we spoke with said they enjoyed working at the service. They said morale was “really good” and “we pull together.” They spoke highly of the registered manager and the deputy manager. The registered manager encouraged an open line of communication with their team. Regular staff meetings were held.
People were encouraged to provide feedback on their experience of the service. We viewed the feedback from the 2017 questionnaire which sought people’s feedback on the staff, individuality, the building and surroundings and activities. On all areas the service rated as either good or excellent.