CQC report explained · a nursing home
What the CQC found at Clare House Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, August 2022
Clare House Care Home was rated Good; inspectors found safe, personalised care and improvements since the previous inspection, but some people felt staffing and activities could be better.
The inspection was unannounced and took place on 21 July 2022. Inspectors spoke with people living in the home, relatives and staff. They reviewed care plans, medicines records, staff recruitment files and records about how the home was managed.
The home was rated Good overall, with Good ratings for Safe, Responsive and Well-led. Inspectors found that people were protected from abuse, medicines were managed safely, care plans reflected people's needs and the home had systems to check and improve its service.
The previous inspection had rated the home Requires Improvement. The provider had been in breach of regulations about risk records, medicines, care planning and quality checks. Inspectors found enough improvement had been made and the home was no longer in breach.
Personalised care plans
Care plans included people's backgrounds, preferences, health needs and communication requirements. Staff knew how to support people in line with this information.
“People's care plans were personalised and contained information about people's religion, culture, family history, likes and dislikes” from the report
Safe medicines
Inspectors found medicines were administered by trained staff, recorded properly and checked through regular audits. The previous medicines breach had been resolved.
“During this inspection we found medicines were managed safely and the provider had a medicines policy and procedure in place.” from the report
Protection from abuse
The home had safeguarding procedures and staff understood how to respond to possible abuse. Relevant incidents were reported and investigated.
“People were protected against the risk of avoidable harm and abuse.” from the report
Learning and improvement
The provider used audits and action plans to improve the service. It also changed mattresses after learning from a person's rapid deterioration in mobility and skin condition.
“The provider had systems for assessing, monitoring and mitigating risk and improving the quality of the service.” from the report
Individual activities
The home offered group activities and one-to-one support. Staff also found creative ways to include people who could not attend group activities.
“Activity staff met regularly with people to provide one to one support to people, for example supporting them with letter writing or phone calls.” from the report
Staffing concerns raised by people
minorAlthough inspectors found enough staff to meet people's needs, several people said staffing levels sometimes felt too low. This is worth checking for the times of day that matter most to your relative.
“There are never enough staff as far as I am concerned” from the report
Mixed views about activities
minorThe home provided activities, but not everyone felt the programme matched their interests. The provider said it was reviewing the programme after restrictions and outbreaks had affected activities.
“However, the response from people who used the service was mixed.” from the report
Manager visibility
minorOne person said they rarely saw the manager, although people and staff generally said they could raise concerns with nurses or management.
“I rarely see [the registered manager]. They don't come around very often, but they seem very pleasant.” from the report
- 01How many care staff and nurses are normally on duty during the day, evening and night, and what happens when staffing falls below plan?
- 02How will you match activities to my relative's interests, communication needs and ability to join group sessions?
- 03Have the bathroom, corridor and garden changes described in the report been completed?
- 04How do you make sure improvements to risk records, medicines and care planning continue to be maintained?
- 05How often will the manager or senior staff speak with my relative and family about their care?
This was a focused inspection covering Safe, Responsive and Well-led; Effective and Caring were not inspected and their ratings were carried forward from the previous inspection. This explanation was written from the published report of 27 August 2022 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, December 2019
Rated Requires Improvement; inspectors found kind and effective care, but safety, care planning and management systems were not reliable enough.
This was an unannounced planned inspection on 22 and 23 October 2019. Inspectors spoke with people, relatives, staff and healthcare professionals. They reviewed care records, medicines records, recruitment files and management records.
The home was caring and effective. Staff were kind and respectful, people were involved in daily choices, and people were supported with food, healthcare, activities and relationships. There were enough staff observed during the inspection, and recruitment and infection control arrangements were suitable.
There were important shortfalls. Falls risks were not always managed well, some medicines instructions and opening dates were unclear, and incidents were not always investigated or used to show learning. Care plans did not always describe people's needs, pain management or end of life wishes clearly.
The overall rating Requires Improvement means the home was not consistently meeting the required standard. The previous rating was Good, published on 2 May 2017. The CQC required an action plan and said it would monitor progress and return for another inspection.
Kind and respectful staff
Inspectors saw kind and respectful interactions. People and relatives said staff supported people in a considerate way and did not rush them.
“During the inspection we observed staff interactions with people were kind and respectful.” from the report
Healthcare support
People were referred to healthcare professionals when needed. A healthcare professional said staff followed wound care plans and reported changes promptly.
“They always follow our wound care plan and inform us promptly of any changes or deterioration.” from the report
Choice and independence
People were involved in everyday choices about food, drink and care. Staff encouraged people to remain independent where possible.
“People were involved in day to day decisions about planning their care.” from the report
Activities and relationships
People could take part in activities, religious practice and community links. The home also began offering personalised one-to-one time with staff.
“People were supported to take part in activities in and out of the home.” from the report
Falls and medicines safety
seriousFalls assessments and records were not always accurate or updated. Medicines instructions and opening dates were sometimes unclear, creating a risk of unsafe or expired medicines.
“The lack of effective risk management and areas of poor medicines management, placed people at risk of harm.” from the report
Incomplete care plans
seriousSome care plans did not explain wound treatment or how to monitor pain for a person unable to communicate it. End of life wishes were missing or too limited in several records.
“Not having adequate details in people's end of life care plans meant their wishes and particular preferences for care at the end of their lives were not known to staff providing care.” from the report
Weak learning from incidents
seriousMinor incidents were not always investigated consistently. Records and audits did not reliably show what had been learned or whether changes had been put into practice.
“This meant we could not be sure lessons learned were implemented to improve service delivery.” from the report
- 01What changes have you made to falls assessments, falls records and checks on equipment such as movement sensors?
- 02How do you now make sure creams, ointments, eye drops and PRN medicines have clear instructions and correct opening dates?
- 03How are pain plans recorded for people who cannot communicate their pain?
- 04How do you record and discuss each person's end of life wishes and preferences?
- 05What does your latest audit show about incidents, medicines and care plans, and how do you check that actions have been completed?
This was an unannounced planned inspection covering all five key questions, the premises and the care provided; the report compares the ratings with the previous inspection published on 2 May 2017. This explanation was written from the published report of 18 December 2019 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Clare House Care Home
4 rated inspections over 7 years: the service has held its Good rating throughout.
- August 2022Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2019Requires improvementdown from GoodSafe: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- May 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2014
Report published without a new overall rating.
- May 2013
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- February 2012
Report published without a new overall rating.
- November 2010
Registered with the Care Quality Commission on 15 November 2010.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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At least 100 live-in carers within about an hour of Hillingdon
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £980 to £1,320 a week. 81 can care for a couple. 11 years' experience on average.
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