Clipstone Hall & Lodge

Clipstone Hall and Lodge is a residential care home providing accommodation and personal care to up to 90 people. The three storey premises were purpose built and were surrounded by gardens. The service provides support to people over 65 years of age, some of whom were living with dementia. At the time of our inspection there were 53 people living the service.

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

Medicines were administered safely however gaps in stock reporting of controlled drugs were identified and not all paperwork for prescribed medicines was included in care plans.

Audits had failed to identify the issues we found on inspection however the manager took immediate action to rectify issues during the inspection.

Staff were recruited safely and had been trained and upskilled in areas such as medicines management and pressure care since our last inspection.

The provider worked in partnership with other organisations and was clear on their role and responsibilities. All the people and families we spoke with praised the staff, stating they felt safe and were treated with kindness. One person said, “The staff are my family, I can’t praise them highly enough or ever thank them enough. There isn’t anything they wouldn’t do for any one of us.”

Peoples care needs were assessed prior to admittance to the home and regularly reviewed. People and their loved ones were included in this process and they were encouraged to express their wants and outcomes from the care they received. Care plans were person centred and were reviewed and updated regularly.

Staff treated people with respect and promoted their dignity and independence. People were encouraged to express their views and make decisions about their own care. People and their relatives told us they were updated and advised of changes and included in regular reviews of care plans.

Staff were knowledgeable about people needs and received training that supported people living at the home. New staff were supported by an experienced member of staff prior to being allowed to work independently.

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.

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

The last rating for this service was inadequate (report published 16 May 2022). 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.

This service has been in Special Measures since 16 May 2022. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection. The overall rating for the service has changed from inadequate to requires improvement based on the findings of this inspection.

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

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Clipstone Hall and Lodge is a residential care home providing accommodation and personal care to up to 90 people. The three storey premises were purpose built and were surrounded by gardens. The service provides support to people over 65 years of age, some of whom were living with dementia. At the time of our inspection there were 60 people living the service.

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

People were at risk of infection due to poor infection control practices. Premises and equipment were not clean or hygienic and staff were not clear on their responsibilities.

People did not receive their medicines safely. People were at risk of receiving their medicines in appropriately and against manufacturers guidance.

Whilst people told us they felt safe, there had been limited action to assess, monitor or improve the safety of the service and where action had been taken it was not clear or co-ordinated.

Identifying and reporting of risks, issues and concerns were unreliable and inconsistent. Where issues had been highlighted action was slow to be taken.

Roles, responsibilities and accountability arrangements were not clear and identified known issues were repeated.

People did not always receive personalised care and people's care plans did not always contain relevant up to date information.

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.

Safeguarding systems and processes were in place and people were protected from the risk of abuse, harm and neglect.

Staff were recruited safely. People and relatives told us they were happy with the care provided and felt well supported by caring staff.

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

Rating at last inspection

The last rating for the service under the previous provider was good, published on 1 August 2019.

Why we inspected

This service was registered with us on 6 February 2020 and this is the first inspection.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to person-centred care planning, safe care and treatment of people, governance and leadership and staffing at this inspection.

Please see the action we have told the provider to take at the end of this report.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

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 work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Special Measures

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe, and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it. And it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

We found the following examples of good practice:

• A visiting pod had been constructed in a ground-floor room with its own external entrance doors to allow up to two visitors from one household to see people within a COVID-19 safe environment. The home had a booking system which gave visitors an allocated time to stagger visitors and minimise numbers.

• The care team liaised with their designated GP practice throughout the pandemic and undertook weekly virtual ward rounds. Clinicians from the practice would still come out to the home to assess people when required. The staff had also developed a strong working relationship with their designated clinical lead who provided them with clinical advice and support.

• The home had a thorough testing process for staff and people living there. When four people tested positive for COVID-19, they were isolated effectively, and the outbreak was managed without the virus being passed onto any other staff or people.

• The provider was following best practice guidance in terms of ensuring visitors to the home did not introduce and spread COVID-19. Information and instructions for visitors were clearly displayed and explained by an administrator on their arrival at the entrance. Staff were adhering to personal protective equipment (PPE) use and social distancing guidance. People were supported to speak to families and friends by telephone or video calls if they could not attend the pod facility.

• Social activities were still supported as much as possible. They were taking place on a 1-1 basis but in-house social activities such as the 'Men's Club' and the 'Residents Meeting' took place in the home’s bar.