About the service: Clough House is in a residential area of Leyland, close to the town centre and on the outskirts of Preston. The home provides accommodation for up to 14 people who need support with personal care needs, including those who are living with dementia. Accommodation is provided in single rooms, although one double room is available for those who wish to share facilities. The upper floor is served by two stair lifts, one at either end of the premises. There are communal areas available, including lounges and a dining area. Car parking facilities and outdoor seating is provided. At the time of our inspection there were 12 people living at the home.
People’s experience of using this service:
The views of people we spoke with varied. We received some positive feedback about the service provided. However, some people thought improvements could be made. The provider had systems to act on allegations of abuse and people felt they or their loved ones were safe living at Clough House. However, new staff were not recruited safely.
A system was in place for the reporting and recording of accidents and incidents, although medical advice had not always been sought when required. Relevant information had not been recorded. We made a recommendation about this.
The provider lacked oversight of the service, as they failed to carry out robust checks to ensure people received care and support in accordance with their wishes. The premises needed upgrading and modernising and some areas of the home needed a thorough clean.
The management of medicines was satisfactory. However, some creams were not stored safely.
Plans of care were detailed and person-centred. They reflected people's assessed needs well and had been consistently reviewed. Any changes in need had been recorded. People thought the provision of activities was satisfactory.
People's needs and choices were assessed before they moved into Clough House and the policies of the home indicated they were given choices, with their wishes being respected. However, we found people were not supported to have maximum choice and control of their lives and restrictions were imposed in some aspects of daily life. This did not promote choice, independence and respect.
Although people’s views varied in relation to the number of staff on duty, we found assistance was provided in a timely manner and therefore staffing levels were satisfactory at the time of our inspection. New staff received an in-depth induction programme and a broad range of training had been completed by staff, who were regularly supervised and observed at work. However, annual appraisals had not been introduced at the time of our inspection.
The provider had policies for the management of complaints and systems for recording complaints had been introduced. Feedback had been obtained from those who used the service and their relatives. Team meetings had been held for those who lived at the home and the staff team. Staff members said they felt able to approach the managers with any concerns, should they need to do so.
Rating at the last inspection:
This service was rated as good at the last inspection (published 21 December 2016).
Why we inspected:
This was a scheduled inspection based on the previous rating. However, we were aware of several recent safeguarding concerns in relation to restricted choice, lack of dignity, institutional practices and poor recruitment practices.
Enforcement:
We have identified breaches in relation to safe care and treatment, premises and equipment and good governance. Please see the action we have told the provider to take at the end of this report.
Follow up:
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will monitor the progress of the improvements, working alongside the provider and local authority. We will return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk