Claremont Court

We found the following examples of good practice.

People were supported to maintain contact with their loved ones, to have visitors and to go out in a safe way. Staff supported people’s families to be up to date with the current COVID-19 national guidance and informed them when any specific changes were required in line with the local health protection agency guidance. The registered manager ensured people’s individual needs, including their mental health and wellbeing, were discussed, included and considered when assessing individual and home-wide COVID-19 risks.

Staff knew how to correctly use personal protective equipment, how to manage any outbreaks of infections to prevent its spread, and how to effectively use the national testing programme to support good infection prevention and control. Staff told us they felt supported by the management throughout the pandemic.

The home environment was clean and hygienic. Staff were aware of good housekeeping principles in COVID-19 and there were clear plans in place for cleaning, disinfection and decontamination, as well as for safe laundry service provision.

This inspection took place on 04 May 2018 and was unannounced.

At our last inspection we rated the service Good with a rating of Requires Improvement in Responsive due to shortfalls in care planning, we made a recommendation in this area. At this inspection we found improvements had been made to care planning and the rating in Responsive had improved to Good. Evidence continued to support the overall rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At this inspection we found the service remained Good.

Why the service is rated Good.

People received safe care in which risks were managed and incidents were responded to appropriately. Medicines were managed and administered safely by trained nurses. People lived in a clean and safe home environment and plans were in place to keep people safe in the event of an emergency. There were sufficient numbers of staff at the home to keep people safe and checks were undertaken to ensure staff were suitable for their roles.

People were prepared food that matched their preferences and dietary needs. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. We made a recommendation about record keeping in relation to the Mental Capacity Act 2005. Staff had the training and support to carry out their roles effectively. People’s needs had been assessed and appropriate support was in place to ensure people’s healthcare needs were met.

People were supported by kind and compassionate staff that knew them well. The provider had systems in place to involve people in decisions and we found an inclusive atmosphere at the home. Staff encouraged people to retain skills and independence and care planning supported this. People’s privacy and dignity was respected by staff when receiving care.

People were very happy with the activities on offer at the home and we noted these matched people’s needs and interests. Care was planned in a person-centred way and we noted particularly positive outcomes were being achieved for people living with dementia. People’s care was regularly reviewed and records documented people’s wishes with regards to end of life care. Complaints were documented and responded to appropriately.

There was strong leadership at the home and people spoke highly of the management team. The provider had strong links with the local community that people benefitted from. Regular checks and audits were carried out and people’s feedback was gathered through surveys. Regular meetings were held which were used to involve people, relatives and staff in the running of the home.

Further information is in the detailed findings below.

Claremont Court provides nursing care and accommodation for a maximum of 57 older people who may be living with dementia. They also provide respite care. (Respite care is a service giving carers a break by providing short term care for a person with care needs). Accommodation is provided over three floors. At the time of this inspection there were 53 people living at the home, all apart from one person was living with dementia. The age range of people was from 63 to 101. There was no one receiving respite care at the time of our inspection.

During our inspection the registered manager was present. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Claremont Court was last inspected on 07 April 2015 when it was given an overall rating of ‘Requires Improvement’. Six breaches of Regulations were identified and requirement notices were issued. These related to medicines, consent to care, infection control, dignity and respect, staff levels and support and quality assurance systems. At this inspection we found that the requirement notices were met.

Everyone that we spoke with said that the manager was a good role model. Quality monitoring systems were in place that included seeking the views of people in order to drive improvements at the home.

People said that they felt safe and we observed that they appeared happy and at ease in the presence of staff. Potential risks to people were assessed and information was available for staff which helped keep people safe.

People told us that there were, on the whole, enough staff on duty to support them at the times they wanted or needed and we observed this to be the case during our inspection. Robust recruitment checks were completed to ensure permanent staff were safe to support people.

People said that they were happy with the medical care and attention they received and we found that people’s health needs and medicines were managed effectively. People’s needs were assessed and care and treatment was planned and delivered to reflect their individual care plan.

Staff were skilled and experienced to care and support people to have a good quality of life. New staff completed an induction programme and were provided with training and supervision after this. We did note that on some occasions staff did not respond appropriately to people who were living with dementia. We were given assurances that staff would receive further guidance about this.

People said that they consented to the care they received. Mental capacity assessments were completed for people and their capacity to make decisions had been assumed by staff unless there was a professional assessment to show otherwise.

People said that the food at the home was good and that their dietary needs were met. There were a variety of choices available to people at all mealtimes.

Equipment was available in sufficient quantities and used where needed to ensure that people were moved safely and staff were able to describe safe moving and handling techniques. Effort had been made to ensure the design and decoration of the home was suitable for people who lived with dementia.

Information of what to do in the event of needing to make a complaint was displayed in the home. During our visit we observed staff assessing if people were happy as part of everyday routines that were taking place.

People said that they were treated with kindness and respect. We observed interactions by staff to people that were warm, positive, respectful and friendly whilst remaining professional. We observed that staff routinely checked that people were happy with the support being offered. Staff understood the importance of respecting people’s privacy and dignity and of promoting independence.

People said that they were happy with the choice of activities on offer and that they were supported to maintain links with people who were important to them.

The majority of people who used this service had dementia, therefore, in order to gain some understanding of their experiences we spent time observing the interactions between the staff and people who lived in this home. We did speak with three people who used the service and a relative who was visiting their family member.

People told us the staff looked after them well. One person said "They look after me well and treat us with respect". A relative said "The staff discussed my relative's needs before they moved here". This relative also told us "Care is brilliant, my relative is so much better, calmer and they have gained weight". We found the staff cared for people and met their assessed needs.

People we spoke with and a relative told us the home appeared clean. We found that since the previous inspection action had been taken to improve the cleanliness of the home.

A relative told us there were enough staff to meet their family member's needs. We found the staff numbers had increased since the last inspection.

People we spoke with said " My room is clean I see the cleaners here most days" and " I feel the home is clean". However, other evidence did not support these views for all areas of the service.

We looked at a sample of areas in the home because concerns had been raised with us that the cleanliness of the environment had not always been adequately maintained. Our observations confirmed that cleaning standards in four of the five bedrooms we saw and their en suite bathrooms and one communal toilet were inadequate.

The staff we spoke with had not had practical training in cleaning or infection control but had completed an e-learning course. The staff told us that they did not know there were any policies relating to infection control, despite these being kept in the service.

This meant that people using the service were at risk of infection and areas of the home would have been unpleasant for people to use.

We reviewed a sample of the records to demonstrate that people using the service had received the care they required. These were inconsistent and had not always been completed.

In this report the name of a registered manager appears who was not in post and not managing the regulatory activities at this location at the time of the inspection. Their name appears because they were still a registered manager on our register at the time.