This inspection took place on 1 December 2015 and was unannounced. There were no breaches of legal requirements at our previous inspection in November 2014, but we did ask the provider to make some improvements to the service.
Clifton Manor Residential Home provides accommodation and nursing care for up to 47 people who have nursing or dementia care needs. There were 42 people living there at the time of our inspection. We spoke with six people living at the home, six relatives, six care staff, one senior care staff and the manager.
There was no registered manager at the service; a manager is required to register with us by law. 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 and associated Regulations about how the service is run.
At our last inspection in November 2014 we found that, there was no registered manager in place and there were also a number of other improvements required. People were not supported to have sufficient to eat and drink. Activities did not always reflect people’s needs. People did not always receive responsive care and staff did not always feel confident that concerns raised would be dealt with.
At this inspection we found that the provider had made some improvements.
Staff were not always deployed appropriately as people raised concerns and said staff presence was sometimes limited in areas of the home where they were needed. The provider recruited staff with the right skills and where required they took appropriate action to ensure people were kept safe.
People received their medicines as prescribed and in a timely manner. There was no system in place to ensure people who required prescribed creams and lotions had them applied correctly. Medicines were not always stored in a safe way.
People felt safe living in the home. Their relatives were confident people were safe and knew how to raise any concerns. Safeguarding issues were reported and investigated appropriately. People were able to take informed risks and these were managed by staff.
People gave positive feedback about the staff skills and knowledge to do their job. The provider was following the requirements set out for the MCA and DOLs and acted legally in people’s best interests if they did not have the mental capacity for particular decisions. However, some staff were not fully aware of what this meant for people.
People were supported to have a balanced diet that promoted healthy eating and drinking. They had access to other health care professionals and referrals were made if staff had concerns regarding people’s health.
People experienced a positive caring relationship with the staff who supported them. People were involved in making decisions about their needs and felt they were given choices and preferences. People were treated with dignity and respect at all times.
People’s feedback was positive about the care they received, but staff were not consistently responsive to people’s personalised needs. People participated in activities that helped stimulate them. Systems were in place for people to share their views and experiences. Complaints and incidents were addressed and dealt with in a timely manner.
The manager of the service was not registered with CQC at the time of our visit. We received positive feedback from people, their relatives and staff on the approachability of the manager and how they felt supported by them. Improvements had been made in regards to the quality monitoring of the service. There had been improvements identified, however to ensure this was consistent further monitoring was required. Management had discussed shortfalls and concerns at team meetings. The vision and values of the home were more positive.