We inspected Claydon House on 27 and 29 April 2015. The inspection was unannounced. Claydon House is registered to care for 49 people. There were 39 people living in the home when we inspected. This was because the first and second floors of the older part of the building were undergoing up-grading, so the rooms on these floors were vacant while the improvements were taking place. People cared for were all older people. They were living with a range of complex needs, including stroke and heart conditions. Many people needed support with their personal care, eating and drinking and mobility needs. People living at Claydon House were also living with dementia. The manager reported they provided end of life care at times. No one was receiving end of life care when we inspected.
Claydon House is a large house, which had been extended. People in the older building had residential and nursing care needs. People on the newer Admiralty wing extension were living with dementia. Due to building works people were only living on the ground and lower ground floor of the older building; mainly people with nursing needs lived on the ground floor and people with residential care needs on the lower ground floor. There were a choice of sitting and dining rooms on each floor. A passenger lift was provided between floors. The Admiralty wing had accommodation over three floors, two of the floors directly connected with the older building. Each floor had its own sitting/dining room. There was a passenger lift between floors. All rooms were en-suite and most included showers. Additional baths and toilets were also provided. There was a garden, which was wheelchair accessible.
There was a registered manager in post. They had been in post for approximately 18 months. A registered manager is a person who has registered with the CQC to manage the home. 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. The provider for the home was Caring Homes Healthcare Group Limited, a national provider of care. The home was supported by an area manager from the provider.
The manager had worked to make improvements across a range of areas since they came in post, however some areas relating to documentation had not yet been completed in full. This was because some parts of some people’s care needs were not documented and others were not always documented when their needs changed, although staff told us in detail how they met these people’s needs. Other people’s needs were fully documented and reflected what staff told us. The manager reported they had identified a need to support staff further with improving documentation. They had plans in place and were progressing this.
People told us they felt safe in the home. Staff were knowledgeable about safeguarding policies and how to recognise different types of abuse. The service ensured risks to people were identified and action taken to reduce risk, for example risk of falls and skin damage. Staff acted in a safe way when the fire alarm was activated. They followed the provider’s policies to ensure people were safeguarded in the event of a fire.
People were satisfied with staffing levels. There were enough staff on duty to support people at busy times of the day such as meal times, and to support people with 1:1 time. Staffing levels were regularly reviewed to ensure appropriate numbers of staff were available when people’s dependency changed. The provider had safe systems for the recruitment of staff.
Medicines were given out in a safe way. Medicines were kept securely and there were full records of medicines administration.
People reported staff were trained and able to meet their needs. Staff supported people in an effective and safe way, for example when they needed to be supported in moving. New staff reported positively on induction to their roles. Staff were provided with the training they needed. Supervision systems ensured individual staff training needs were identified.
Staff were aware of their role in supporting people who lacked capacity and of the Deprivation of Liberty Safeguards. Where decisions needed to be made in a person’s best interests, these took place and involved all relevant parties.
People’s medical needs were promptly addressed, including involvement of a range of healthcare professionals, for example the community psychiatric nurses. People who were assessed as being at nutritional risk were identified and supported in the way they needed to maintain or increase their weight.
People were positive about the meals. There were systems to ensure people who were living with dementia could choose what they wanted to eat. Where people could not support themselves independently to eat their meals, they were fully supported by staff.
People said the staff were caring and supported them in the way they wanted. We saw staff supporting people who were frail and/or living with dementia in a way which encouraged them in making choices and being independent. Staff were consistently respectful to people and ensured their privacy and dignity.
Staff were responsive to people. They ensured they got to know people, before they developed their care plans. Staff were aware of people’s individual needs, developing care plans which responded to these needs, for example in relation to changes in their mobility.
A wide range of activities were provided to people. These included individual and large group activities. Activities were available seven days a week and there were regular trips out of the home
People felt they could raise issues with the manager and if they did, the manager would take action. Records of complaints made by people showed the manager and provider took action where issues were reported to them.
People and staff made favourable comments about the management of the home. The manager had a well organised system for audit of service provision. Where issues were identified, action plans were in place and being progressed. Staff said the culture of the home was supportive to them. A member of staff reported “I think it is amazing here I like the staff and the residents.”
We inspected Claydon House on 27 and 29 April 2015. The inspection was unannounced. Claydon House is registered to care for 49 people. There were 39 people living in the home when we inspected. This was because the first and second floors of the older part of the building were undergoing up-grading, so the rooms on these floors were vacant while the improvements were taking place. People cared for were all older people. They were living with a range of complex needs, including stroke and heart conditions. Many people needed support with their personal care, eating and drinking and mobility needs. People living at Claydon House were also living with dementia. The manager reported they provided end of life care at times. No one was receiving end of life care when we inspected.
Claydon House is a large house, which had been extended. People in the older building had residential and nursing care needs. People on the newer Admiralty wing extension were living with dementia. Due to building works people were only living on the ground and lower ground floor of the older building; mainly people with nursing needs lived on the ground floor and people with residential care needs on the lower ground floor. There were a choice of sitting and dining rooms on each floor. A passenger lift was provided between floors. The Admiralty wing had accommodation over three floors, two of the floors directly connected with the older building. Each floor had its own sitting/dining room. There was a passenger lift between floors. All rooms were en-suite and most included showers. Additional baths and toilets were also provided. There was a garden, which was wheelchair accessible.
There was a registered manager in post. They had been in post for approximately 18 months. A registered manager is a person who has registered with the CQC to manage the home. 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. The provider for the home was Caring Homes Healthcare Group Limited, a national provider of care. The home was supported by an area manager from the provider.
The manager had worked to make improvements across a range of areas since they came in post, however some areas relating to documentation had not yet been completed in full. This was because some parts of some people’s care needs were not documented and others were not always documented when their needs changed, although staff told us in detail how they met these people’s needs. Other people’s needs were fully documented and reflected what staff told us. The manager reported they had identified a need to support staff further with improving documentation. They had plans in place and were progressing this.
People told us they felt safe in the home. Staff were knowledgeable about safeguarding policies and how to recognise different types of abuse. The service ensured risks to people were identified and action taken to reduce risk, for example risk of falls and skin damage. Staff acted in a safe way when the fire alarm was activated. They followed the provider’s policies to ensure people were safeguarded in the event of a fire.
People were satisfied with staffing levels. There were enough staff on duty to support people at busy times of the day such as meal times, and to support people with 1:1 time. Staffing levels were regularly reviewed to ensure appropriate numbers of staff were available when people’s dependency changed. The provider had safe systems for the recruitment of staff.
Medicines were given out in a safe way. Medicines were kept securely and there were full records of medicines administration.
People reported staff were trained and able to meet their needs. Staff supported people in an effective and safe way, for example when they needed to be supported in moving. New staff reported positively on induction to their roles. Staff were provided with the training they needed. Supervision systems ensured individual staff training needs were identified.
Staff were aware of their role in supporting people who lacked capacity and of the Deprivation of Liberty Safeguards. Where decisions needed to be made in a person’s best interests, these took place and involved all relevant parties.
People’s medical needs were promptly addressed, including involvement of a range of healthcare professionals, for example the community psychiatric nurses. People who were assessed as being at nutritional risk were identified and supported in the way they needed to maintain or increase their weight.
People were positive about the meals. There were systems to ensure people who were living with dementia could choose what they wanted to eat. Where people could not support themselves independently to eat their meals, they were fully supported by staff.
People said the staff were caring and supported them in the way they wanted. We saw staff supporting people who were frail and/or living with dementia in a way which encouraged them in making choices and being independent. Staff were consistently respectful to people and ensured their privacy and dignity.
Staff were responsive to people. They ensured they got to know people, before they developed their care plans. Staff were aware of people’s individual needs, developing care plans which responded to these needs, for example in relation to changes in their mobility.
A wide range of activities were provided to people. These included individual and large group activities. Activities were available seven days a week and there were regular trips out of the home
People felt they could raise issues with the manager and if they did, the manager would take action. Records of complaints made by people showed the manager and provider took action where issues were reported to them.
People and staff made favourable comments about the management of the home. The manager had a well organised system for audit of service provision. Where issues were identified, action plans were in place and being progressed. Staff said the culture of the home was supportive to them. A member of staff reported “I think it is amazing here I like the staff and the residents.”