Archived: Clipstone Hall and Lodge

Updated 1 August 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.

The inspection visit took place on 13 and 19 June 2019.

Inspection team

The inspection visit was carried out by an inspector, two assistant inspectors, a specialist advisor and a medicines inspector. Our specialist advisor was a nurse with experience in dementia care. The second day of our inspection was carried out by one inspector.

Service and service type

Clipstone Hall and Lodge 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

Our inspection was informed by evidence we already held about the service. We sought the views of Healthwatch Nottinghamshire. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We also sought the views of external health and social care staff, and commissioners from the local authority. Commissioners are people who work to find appropriate care and support services which are paid for by the local authority or by a health clinical commissioning group. Commissioners also undertake monitoring of the quality of services.

We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections, and we used this to plan our inspection.

During the inspection

During the inspection visit we spoke with seven people who used the service. We spoke with nine relatives and nine care staff. We spoke with the registered manager, deputy manager and the provider’s regional director. We also spoke with a health and social care professional. We looked at a range of records related to how the service was managed. These included ten people’s care records and how medicines were managed for eight people. We also looked at four staff recruitment and training files, and the provider’s quality auditing system. During the inspection visit we asked the registered manager to send us additional evidence about how the service was managed, and they did this.

Not all of the people living at the service were able to fully express their views about their care. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records.

Updated 1 August 2019

About the service

Clipstone Hall and Lodge is a residential care home providing personal care to 60 people aged 65 and over at the time of the inspection. The service can support up to 90 people. The care home accommodates up to 90 people across 5 units. Each unit is purpose-built and specialises in providing care to people living with dementia.

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

People and their relatives felt the service was safe. Staff understood how to recognise and report concerns or abuse. People were protected from risks associated with their assessed health needs. Risks associated with the service environment were assessed and mitigated. There were enough staff to keep people safe. People received their prescribed medicines safely and were protected from the risk of infections.

People and relatives felt staff got the right training to meet their needs. People were supported and encouraged to have a varied diet that gave them enough to eat and drink. A health professional said staff were good at highlighting concerns about people’s health needs and getting them the support they needed. People were supported by staff to access healthcare services when required. The provider had taken steps to ensure the environment was suitable for people's needs.

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.

People spoke positively about the staff who supported them. People also commented on how well staff knew them and supported them in the ways they preferred. People were involved in making decisions about their care, and relatives felt they were kept informed about their family member’s care. People said staff always treated them with respect. Staff had a good understanding of dignity in care and had training in this. Staff respected people's right to confidentiality.

People were regularly asked for their views about their care. Relatives were also involved in reviewing family members’ care with them. Records showed people’s views were documented and where possible, care was tailored to suit their wishes. Staff were proactive in responding to people’s individual needs and encouraged them to do things which were meaningful to them and made them happy. People were supported to maintain contact with their local community, and to continue with activities they had previously enjoyed at home.

The provider had a system in place to respond to complaints and concerns. People and their relatives were encouraged to talk about their wishes regarding care towards the end of their lives.

People and relatives felt the service was well-led. Staff felt supported in their work, and there was a positive team attitude. The management team kept a close eye on how the quality of care was, and any issues were identified quickly and resolved. The registered manager, deputy manager and provider clearly understood their roles and responsibilities in relation to managing a registered care home. The provider undertook audits of all aspects of the service to review the quality of care, and identify areas where improvements were needed.

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

At the last inspection the service was rated Requires Improvement (report published 25 April 2018). There was a breach of Regulation 12, where people’s medicines were not always managed safely, and the assessment of risks was not well managed. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This was a planned inspection based on the previous rating.

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.