Cleveland House Care Home

Updated 11 February 2021

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

One inspector and a specialist advisor who had expertise in Infection Prevention and Control practices conducted the inspection.

Service and service type

Cleveland House 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. The service had a manager registered with the Care Quality Commission. This means that they and the provider are 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 the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority, professionals who work with the service and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used all this information to plan our inspection.

During the inspection

We spoke with two people who used the service and five members of staff including the regional support manager, registered manager, nurse, senior care worker and the chef. The inspection team minimised direct contact with people as they were self-isolating in their room due to the risk of COVID-19. The inspection team used techniques such as observing care interactions and staff engagement with people.

We reviewed a range of records. This included two people’s care records and multiple medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service including policies and procedures, accidents and incidents, lessons learnt and safeguarding referrals to the Local Authority were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We spoke with a further five members of staff including activity coordinators, care workers and administration workers. We also spoke with two relatives of people using the service.

Updated 11 February 2021

About the service

Cleveland House Care Home is a nursing home providing personal and nursing care to 27 people aged 65 and over at the time of the inspection. The service can support up to 45 people.

Cleveland House Care Home has three floors accessed by passenger lift with single rooms, shared toilet and bathing facilities on each floor. Outside there is a garden with seating areas.

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

Infection Prevention and Control (IPC) measures were not consistent in the service. Some senior members of staff were not wearing personal protective equipment correctly. One senior member of staff wore clothes which increased the risk of infection transmission. Staff were not consistently socially distancing.

Audits were regularly completed but these did not consistently identify issues that needed addressing.

Care plans and records were reviewed regularly. Care plans were person centred and clear in detailing what support the person required. People had not consistently been involved in the creation of their care plans and consent was not always sought.

People felt safe living at the home. People seemed relaxed and comfortable and staff knew people’s preferences. Staff treated people with dignity and respect and staff had good interactions with people.

People and their relatives spoke positively about the staff, service and the care people received.

Staff members had been recruited safely and there were enough staff to meet the needs of people using the service.

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.

Staff were able to demonstrate how they were meeting the underpinning principles of Right Support, Right Care, Right Culture guidance. People were treated with dignity and respect; people’s choices and preferences were sought, and staff prioritised the happiness of the people using the service.

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 28 June 2019).

Why we inspected

We received concerns in relation to infection prevention and control following a recent COVID-19 outbreak at the service. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection. The overall rating for the service has changed from good to required improvement. This is based on the findings at this inspection. We have found evidence that the provider needs to make improvement. Please see the safe and well-led sections of this full report.

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 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 regulation 17 (good governance) and regulation 12 (safe care and treatment) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the 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.