CQC report explained · a residential care home
What the CQC found at Clarence House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found enough staff, thorough recruitment checks, effective safeguarding arrangements and safe medicines processes. Fire safety concerns identified previously had been addressed.
- Effective?
- Good
- Staff had training and a new induction process. People received support with consent, healthcare, food and drink, and their care records reflected their current needs.
- Caring?
- Good
- Staff were observed treating people with patience, kindness, dignity and respect. People were involved in decisions and supported to maintain independence.
- Responsive?
- Good
- Care plans included people's preferences and communication needs. Activities were varied, relationships were supported, and there was a complaints process, although one complaint was still ongoing.
- Well-led?
- Good
- The home had introduced audits and systems to monitor quality, risks and records. Inspectors found improvements since the previous breach involving governance and said the home was no longer in breach.
What inspectors found, August 2023
Rated Good; inspectors found safe, kind and personalised care, with clear improvements since the previous inspection.
This was an announced comprehensive inspection. One inspector visited from 11 to 14 July 2023, spoke with people, a relative and staff, observed care, checked the building and reviewed care, medicine, recruitment and management records.
The inspectors rated all five areas Good: Safe, Effective, Caring, Responsive and Well-led. They found enough staff, safe medicines practice, updated risk assessments, suitable training, kind and respectful care, varied activities and care plans that reflected people's preferences.
The home had previously been rated Requires Improvement in October 2022. The provider had completed an action plan, and inspectors found enough improvement to move the overall rating to Good. The home was no longer in breach of regulations 9 and 17.
Kind and respectful staff
Inspectors saw warm, unrushed interactions. People and relatives described staff as caring, patient and kind.
“Staff treated people with care, patience, respect and kindness.” from the report
Personalised care
Care plans and daily records included individual preferences, dislikes and support needs. People were involved in decisions about their care.
“People's care and support was centred around their choices and preferences.” from the report
Improved oversight
The home had introduced audits and updated risk assessments. Records were found to be current and consistent.
“The registered manager had introduced a number of auditing systems to maintain ongoing oversight and continued development of Clarence House.” from the report
Safe medicines and staffing
Inspectors found enough staff and effective checks on medicines, including records for administration and disposal.
“People received their medication safely by trained staff.” from the report
Complaint still being dealt with
minorOne complaint was still ongoing when inspectors visited. The home was following its policy, but families may want to ask what happened and whether it has now been resolved.
“One complaint was ongoing, and the registered manager was following their policy to respond to the issues.” from the report
- 01What was the outcome of the complaint that was ongoing during the inspection?
- 02How often are care plans, risk assessments and daily records reviewed and updated?
- 03How do you check that medicines are administered, recorded and audited safely?
- 04What activities would be available for my relative, based on their interests and communication needs?
- 05How will you use residents' and relatives' survey feedback to make further improvements?
This was an announced comprehensive inspection covering Safe, Effective, Caring, Responsive and Well-led, including infection prevention and control. This explanation was written from the published report of 3 August 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, October 2022
Rated Requires Improvement and remains in special measures; inspectors found important improvements but ongoing problems with risk records, fire safety and oversight.
This was an unannounced inspection carried out on 6 and 8 September 2022. Inspectors spoke with people living in the home, relatives and staff. They reviewed care plans, medicines records, recruitment files and management information, and looked around the building.
The home had improved since its previous Inadequate rating. Staff supported people safely, medicines were managed properly, safeguarding procedures were followed, and staff were trained and recruited safely. The home was rated Good for Effective, including consent, staff support, care planning and food and drink.
The home was still rated Requires Improvement for Safe and Well-led. Some risks were not recorded clearly, fire safety issues had not been dealt with quickly enough, and management systems did not reliably track incidents and improvements. The home remained in special measures and the CQC said it would re-inspect within six months.
Safeguarding
People were protected from abuse and staff knew how to raise concerns. Safeguarding referrals were made to the local authority when needed.
“People were protected from the risk of abuse. Staff had received suitable training in safeguarding and were confident discussing their concerns with the registered manager.” from the report
Medicines
Staff gave medicines on time and as prescribed. The electronic system showed that medicine stocks were correct.
“Staff administered people's medicines on time and as prescribed.” from the report
Staff support
Staff received induction, supervision, team meetings and mandatory training. New staff shadowed experienced colleagues before working alone.
“New staff completed a comprehensive induction and had time to shadow more experienced staff on shift before working independently.” from the report
Food and drink
Food and fluid records had improved and were completed accurately. People could choose meals and request alternatives.
“Food and fluid records were now completed accurately for each person.” from the report
Choice and consent
The home had improved how it assessed capacity and gained consent. People’s preferences were respected and care was provided in the least restrictive way.
“People made choices and their preferences were respected.” from the report
Risk information
needs fixingSome risks, including distress and changes in mental health, were not recorded in people’s risk assessments. This could leave new or agency staff without the information they needed.
“Not all risks were recorded in people's risk assessment documentation.” from the report
Fire safety
seriousThe alarm system had not been repaired promptly and the fire risk assessment had not been updated. The provider had not responded to risks identified by the fire and rescue service.
“There was delay in repairing the alarm system and the provider had not updated their fire risk assessment.” from the report
Management oversight
seriousThe provider remained in breach because incidents were not analysed fully and action plans did not show measurable completion or clear responsibility.
“The provider had not ensured a system of governance and oversight was in place to monitor and measure continuous improvement.” from the report
Lifting equipment
needs fixingLifting equipment had not been serviced. Inspectors were told it was not being used but would be serviced as soon as possible.
“We found lifting equipment had not been serviced, we were told the lifting equipment was not being used but would be serviced ASAP” from the report
- 01Have all residents’ risk assessments been updated, including information about distress and changes in mental health?
- 02What action has been taken to repair the alarm system and respond to the fire and rescue service’s concerns?
- 03How are accidents and incidents now analysed to identify risks and prevent them happening again?
- 04Can you show how action plans record who is responsible and when each improvement has been completed?
- 05Has the lifting equipment been serviced, and how do you make sure it is safe before it is used?
This was a focused follow-up inspection of Safe, Effective and Well-led; Caring and Responsive were not assessed and their previous ratings carried over. This explanation was written from the published report of 26 October 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.
Every inspection of Clarence House
3 rated inspections over a year: the service has improved, from Inadequate to Good.
- August 2023Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2022Requires improvementup from InadequateSafe: Requires improvementEffective: GoodWell-led: Requires improvement
- February 2022InadequateSafe: InadequateEffective: InadequateCaring: Requires improvementResponsive: InadequateWell-led: Inadequate
- March 2021Inspected but not ratedSafe: GoodWell-led: Good
- November 2019
Registered with the Care Quality Commission on 22 November 2019.
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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85 live-in carers within about an hour of Lancashire
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 £1,260 a week. 78 can care for a couple. 11 years' experience on average.
“She understands the needs of an elderly person in the early stages of dementia and has treated my mother with great kindness and skill.”
“Thanks to Tracy, Dad was always immaculately dressed and clean, his meals were all home cooked and nutritionally well balanced and his home was always kept really clean and tidy.”
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.