CQC report explained · a residential care home
What the CQC found at Claremont
Not yet rated: the CQC has not published a rated inspection for this home, which is usual for a new registration.
What inspectors found, July 2023
Claremont is rated Requires Improvement; safety, consent and management still need work, but it is no longer in special measures.
This was an unannounced focused inspection following an earlier Inadequate rating. Inspectors visited the home, spoke with people, relatives, staff and a health professional, and checked care records, staff recruitment, safety records and management audits.
The home had improved in several areas. There were more staff, fire safety arrangements had improved, safeguarding systems were in place and staff had received training. People and relatives also gave positive feedback about staff relationships and the manager.
However, risks were not always properly assessed or managed. Emergency medicines could not always be given by a suitably trained member of staff. Required mental capacity assessments and best-interest decisions were still missing, and management systems had not reliably identified or corrected problems.
The overall rating and the ratings for Safe, Effective and Well-led are Requires Improvement. The home remains in breach of Regulations 11, 12 and 17. It has improved from Inadequate and is no longer in special measures, but the CQC will continue to monitor it and has requested an action plan.
Improved staffing
Staffing levels had improved and there were enough staff observed to respond to people and support an evacuation. Recruitment checks were also completed.
“We observed enough staff to respond to people, however, work was still required to establish people's individual hours and ensure they received these.” from the report
Safeguarding
Staff had safeguarding training and understood how to report concerns. Systems were in place for making safeguarding referrals.
“Staff had received safeguarding training and were confident in reporting any allegations of abuse.” from the report
Fire safety
The home had improved its fire safety arrangements and had the documentation needed to support safe evacuations.
“Improvements had been made in relation to fire safety. Appropriate documentation was now in place to support safe evacuations.” from the report
Relationships and support
People and relatives spoke positively about the home. People had good relationships with staff and the management team.
“People were happy at the service and had good relationships with the staff and management team.” from the report
Risks and emergency medicines
seriousRisk assessments were missing or not always effective. Staff trained to give emergency medicines were not always on duty, creating a safety risk.
“There continued to be times when there was not staff on duty suitably trained to administer emergency medication to people in line with their care plans.” from the report
Consent and legal safeguards
seriousCapacity assessments and best-interest decisions were still missing when needed. Not all conditions attached to deprivation of liberty authorisations had been met.
“Capacity assessments and best interest decisions were still not always completed when required.” from the report
Management oversight and records
seriousManagement audits had not reliably found problems, including medicine concerns. Records were not always accurate, complete or up to date.
“The provider had failed to assess, monitor and improve the quality and safety of the service, mitigate risks relating to the health and safety of others, maintain accurate, complete and contemporaneous records.” from the report
Individual support
needs fixingSome people's care was not fully individualised. Further work was needed around community access, healthy lifestyles, weight support and developing people's skills.
“Although some improvements had been made to some people's access to the community, this was not always individualised, and further work was required to fully support some people to be reengaged in the community.” from the report
Medicines records
needs fixingOn one occasion, a person did not receive medicines as prescribed. Some medicines records were also incomplete.
“However, we observed on one occasion a person not received medicines in line with the prescriber's instruction and some records had not been completed in line with best practice.” from the report
- 01How will you make sure a suitably trained member of staff is on duty to give emergency medicines whenever they may be needed?
- 02Which people currently need mental capacity assessments or best-interest decisions, and when will these be completed?
- 03How are you checking that all conditions attached to deprivation of liberty authorisations are being followed?
- 04How will you ensure rotas provide the right number of staff with the right training at all times?
- 05What checks now show that medicines records, risk assessments and care records are accurate and up to date?
This was a focused follow-up inspection covering Safe, Effective and Well-led; Caring and Responsive were not inspected and the report says the overall rating used ratings from the previous inspection for the questions not inspected. This explanation was written from the published report of 14 July 2023 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, February 2023
Claremont was rated Inadequate and placed in special measures because inspectors found people at risk of harm and widespread failures in leadership.
Inspectors visited on three unannounced days in September and October 2022. They spoke with people, staff, relatives and visiting professionals. They reviewed care records, health and safety documents and recruitment files for all four people living there.
The home was not safe. Risks such as choking, fire evacuation and infection were not managed properly. There were periods with only one staff member on duty, some staff had not completed important training, and safeguarding concerns were not always recognised or reported. Medicines were managed safely.
Care was not consistently effective, caring or responsive. People had limited choice, personalised support and activities. Staff sometimes used disrespectful language or responses that went against specialist advice. The home was not well-led, with poor records, weak checks on quality and continued problems from the previous inspection.
The overall rating fell from Requires Improvement in August 2021 to Inadequate. The home was placed in special measures. The CQC said it would request an action plan, work with the provider and local authority, and usually re-inspect within six months.
Medicines
Inspectors found that people received medicines as prescribed and staff followed systems for administering, recording and storing them.
“People received their medicines as prescribed.” from the report
Personalised rooms
People could choose their living environment and personalise their rooms. The home was described as homely.
“The service was homely, and people personalised their rooms and were included in decisions relating to the interior decoration and design of their home.” from the report
Some positive relationships
Despite inspectors' concerns about some staff practice, people and relatives said staff were kind. One family member was satisfied with how a complaint had been handled.
“Despite our observations, people and their relatives told us they felt the staff were kind to them.” from the report
End of life plans
People had plans recording their end of life wishes and preferences. The report also records recent compliments about earlier end of life care.
“People had end of life care plans documenting their preferences and wishes.” from the report
People were at risk of harm
seriousRisk assessments and care plans were incomplete or unclear. Fire evacuation arrangements were not up to date, no fire drills had been completed at the time, and staffing levels were not always enough for a safe evacuation.
“This placed people at risk of harm.” from the report
Safeguarding failures
seriousStaff had not been trained to recognise and report abuse. Several incidents were not identified as safeguarding concerns or reported promptly.
“Staff had not had training on how to recognise and report abuse.” from the report
Unsafe staffing and recruitment
seriousThere were periods when only one staff member was working, and some shifts did not include someone trained to give emergency medicine. Staff files did not contain all the required recruitment checks.
“The service did not always provide enough staff with the right mix of skills and competence to support people to stay safe.” from the report
Limited choice and personal support
needs fixingPeople could not always get up when they wanted to and had limited choice about meals and activities. Staff said they did not have enough time to provide personalised care.
“People had limited choice and control over their daily life.” from the report
Disrespectful care
needs fixingInspectors observed child-like language, raised voices and staff shouting across the home about people's toilet needs. Staff responses did not always follow advice intended to reduce distress.
“We observed people being spoken with in a child-like manner and with raised voices.” from the report
Poor management oversight
seriousThe provider's checks did not identify or address continuing risks. Records were not reliable, incidents were missed and the provider did not always notify the CQC about reportable events promptly.
“Quality assurance processes failed to identify individual risks to people's health and wellbeing were not effectively managed.” from the report
- 01How many staff are now on duty at all times, and is there always someone trained to give emergency medicine?
- 02What evidence can you show that fire drills, evacuation plans and fire risk arrangements are now up to date?
- 03How are safeguarding concerns identified, reported and reviewed, and which staff have completed safeguarding training?
- 04How are people's choking, dietary, behavioural and other health risks recorded and shared with every member of staff?
- 05How are people and their relatives now involved in care planning, daily choices, activities and decisions about restrictions?
This was an unannounced comprehensive inspection covering all five key questions and infection prevention and control; the report also compared findings with the previous inspection in August 2021. This explanation was written from the published report of 11 February 2023 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 Claremont
6 rated inspections over 7 years: the service has held its Requires improvement rating throughout.
- July 2023Requires improvementcurrent ratingup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- February 2023Inadequatedown from Requires improvementSafe: InadequateEffective: Requires improvementWell-led: Inadequate
- August 2021Requires improvementSafe: Requires improvementWell-led: Requires improvement
- December 2020Inspected but not ratedSafe: Inspected but not rated
- October 2019Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- June 2014
Report published without a new overall rating.
- August 2013
Report published without a new overall rating.
- May 2012
Report published without a new overall rating.
- June 2011
Registered with the Care Quality Commission on 19 June 2011.
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.
Weigh the report against the rest
Fees, photos and reviews from families
How to read CQC ratings and reports
What to check when you visit
16 live-in carers within about an hour of East Riding of Yorkshire
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 £1,030 to £1,420 a week. 14 can care for a couple. 7 years' experience on average.
“She was always 'just present enough': attentive, available, kind and engaging, but without ever over-stepping any boundary”
“What truly stands out is how mindful and attentive she is to all of my medical needs, always going above and beyond to ensure I’m comfortable and well cared for.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.