Clayton Manor

Updated 31 December 2019

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.

Inspection team

The inspection was carried out by one inspector.

Service and service type

Clayton 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.

The service had a manager who became registered with the Care Quality Commission shortly after our visit. 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 inspection

We reviewed information we had received about the service since the last inspection. As this was a focussed inspection responding to concerns, 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. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

For the purpose of this focussed inspection, we only visited the unit specialising in the care for people living with dementia. We spoke with seven people who used the service and four relatives about their experience of the care provided. We spoke with five members of staff including the registered manager, senior care workers, care workers and a member of the domestic staff. We completed two Short Observational Frameworks for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We reviewed a range of records. This included five people’s care records and multiple medication records. We looked at files in relation to staffing, including training to support safe care, weekly rosters, recruitment checks and agency worker information. A variety of records relating to the management of the service, including quality checks and safety procedures, monitoring forms and reports were viewed.

After the inspection

The registered manager sent us additional information, which included staff training, quality checks and meeting minutes.

Updated 31 December 2019

About the service

Clayton Manor is a residential care home providing personal and nursing care to 67 people at the time of the inspection. The service can support up to 75 people with different health and care needs. People are accommodated on different units across two floors in one building. One unit specialises in the care for people living with advanced dementia. This is the unit we visited during this focussed inspection.

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

We found that some aspects of the safety of people’s care could be improved, although people and relatives we spoke with told us the service provided safe care. We found that some aspects of risk management needed to be made more robust. We made a recommendation regarding this.

Service governance, including ensuring robust monitoring, record-keeping and implementing of lessons learned, needed to be improved to underpin a consistently safe, quality service. We made a recommendation regarding this. Following a few changes in service leadership, a new manager had been appointed and became registered with the Care Quality Commission shortly after our visit. As they had only recently started the new registered manager was still getting to know people, relatives and staff; however, those we spoke with praised the unit staff and leadership.

Those we spoke with told us that generally there were enough staff to keep people safe. The service had introduced an additional shift, based on their learning from incidents. The service still relied on agency workers, although their use had reduced. Staff and relatives confirmed that where possible the same agency workers were used, which promoted consistency. We highlighted to the registered manager the need to check whether agency staff had also been trained to deliver safe care for people living with dementia.

Regular meetings took place to keep people, relatives and staff up-to-date and involved in the service. We received positive feedback from those we spoke with about the service keeping them informed about their family members, as well as the service creating a homely, welcoming feel. Staff felt there was a positive team atmosphere.

People we spoke with felt safe living at Clayton Manor and in observations we saw people appeared relaxed around staff. One person said, “I am well looked after here, although I do not really need much looking after.” Relatives we spoke with praised the way in which staff kept their family members safe, particularly at times of distress. A relative told us, “I cannot sing their praises loudly enough, somehow they always find a way to get through.”

At our last inspection we found that 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. As this was a focussed inspection checking whether the service was safe and well-led, we did not revisit this particular aspect of care.

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

Rating at last inspection

The rating for the service following the last comprehensive inspection was good (published 24 July 2019).

Why we inspected

We received concerns in relation to the safety of people’s care. As a result, we undertook a focused inspection to review the Key Questions of Safe and Well-led only. Meetings and investigations were ongoing in relation to concerns raised and our inspection looked at the wider themes within the service.

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 remained good, although there was a deterioration of the Key Question Well-led to requires improvement. This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvements. Please see the recommendations we have made within the Safe section, as well as improvement needs identified within the Well-led section of this full report.

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

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.