CQC report explained · a residential care home
What the CQC found at Clayton Brook House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Requires improvement
- Inspectors found enough staff and suitable safeguarding and risk management arrangements. However, medicines processes and records needed improvement, and infection control arrangements were not fully effective.
- Effective?
- Good
- Staff training, supervision and support had improved. People received support with healthcare, nutrition, choice and decision-making.
- Caring?
- Good
- Inspectors observed kind, respectful and sensitive interactions. Staff understood people's individual needs, routines, backgrounds and preferences.
- Responsive?
- Good
- Care plans were detailed and personalised. People had varied activities, community opportunities and communication support, and there were processes for handling complaints.
- Well-led?
- Good
- Management and leadership had become more settled. The home had quality checks, staff consultation and action plans for improvements.
What inspectors found, August 2018
Rated Good overall, but inspectors rated the home Requires Improvement for safety because medicines and infection control needed attention.
Inspectors made an unannounced visit on 30 and 31 May 2018. They observed care, spoke with relatives and staff, and checked care plans, medicines, recruitment, training, complaints and quality records.
The overall rating was Good. Inspectors found kind and respectful care, personalised support, suitable activities, effective healthcare support and improved management. Action taken since the previous inspection had addressed earlier problems with staff training, supervision, complaints and medicines.
Safety was rated Requires Improvement. Some medicines records and processes needed further work. Inspectors also found unpleasant odours, a stained floor covering and no specific infection control audit tool. The home put some matters right during the inspection and was given recommendations on infection control and manager induction.
Kind and respectful care
Inspectors saw positive interactions, and relatives described staff as compassionate, tolerant and friendly.
“We observed positive and meaningful interactions between people using the service and staff.” from the report
Personalised support
Care records described people's needs, preferences, routines and communication methods in detail. Staff knew the people they supported well.
“The information was very detailed and personalised; therefore a concise overview of the person's 'essential support' guide had been produced for staff to refer to.” from the report
Activities and community life
People were supported to take part in activities at home and in the community. Activity plans included opportunities to develop life skills.
“We saw agreed activity planners which confirmed each person had a varied programme of daily activities.” from the report
Improved leadership
Management arrangements had become more stable since the previous inspection. Staff said teamwork and morale were good, and managers were approachable.
“There were processes in place to monitor and check the quality of people's experience of the service.” from the report
Medicines records and checks
seriousSome medication file information had not been reviewed on time, and there were minor discrepancies in medicines administration records. The manager took action during and after the inspection.
“We found some processes, including minor discrepancies on Medicines Administration Records (MAR) required further attention to ensure people were safely supported with their medicines.” from the report
Infection control and odours
needs fixingInspectors found unpleasant odours in parts of the building and a stained floor covering. The home did not have a specific audit tool to monitor infection prevention and control consistently.
“However, we noted the provider did not have a specific audit tool for monitoring and managing infection prevention and control.” from the report
Induction for managers
minorThe induction programme covered care staff, but there was no structured induction for everyday management roles such as a deputy manager.
“We recommend that the service considers an induction programme to support and train new managers.” from the report
- 01What changes have been made to medicines checks and Medicines Administration Records since the inspection?
- 02What has been done to remove the unpleasant odours and replace or clean the stained floor covering?
- 03What infection prevention and control audit process is now used?
- 04What induction and support do new managers receive?
- 05How are people's non-verbal signs of dissatisfaction recognised and recorded as complaints?
This was an unannounced comprehensive inspection covering all five CQC questions and the premises and care provided. This explanation was written from the published report of 2 August 2018 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, June 2017
Rated Requires Improvement; inspectors found kind, personalised care, but problems with staff training, complaints, medicines and management.
Inspectors visited on 3 and 4 May 2017. The first day was unannounced. They observed care, spoke with relatives, staff and managers, looked around the home, and checked care plans, medicine records, recruitment files, complaints and quality checks.
People were supported by kind and respectful staff. Their care plans were detailed and personal. Inspectors found good support with health appointments, food, communication, choices, dignity and activities.
However, the home was not consistently safe, effective, responsive or well-led. Some medicines checks and risk assessments needed improvement. Staff refresher training and supervision were overdue, and complaints were not properly investigated or recorded.
The overall rating was Requires Improvement. This was worse than the previous inspection in January 2015, when the service met all the standards assessed. The home had been through an unsettled period, but some changes were being reversed and improvements were under way.
Kind and respectful care
Inspectors saw staff treating people with sensitivity and respect. Relatives described the staff as kind, caring and understanding.
“We observed positive and respectful interactions between people using the service and staff.” from the report
Personalised support
Care plans contained detailed information about people's needs, routines, preferences and ways of communicating. Staff used this information to provide individual support.
“Each person had a detailed person centred support plan that identified their individual needs and preferences and how they wished to be supported.” from the report
Health and nutrition
People were supported to attend healthcare appointments and changes in their health were monitored. Their dietary needs and preferences were known and catered for.
“People were effectively supported with their healthcare needs and medical appointments.” from the report
Choices and independence
People were supported to make choices in ways suited to their abilities. Staff encouraged independence and supported people to take part in activities at home and in the community.
“People were supported in a way which promoted their dignity, privacy and independence.” from the report
Staff training and supervision
seriousMany staff refresher training records had gaps. Regular one-to-one supervision had stopped, so staff lacked opportunities to discuss their responsibilities and development.
“The provider had failed to ensure all staff had received appropriate training and supervision.” from the report
Complaints were not properly followed up
seriousThe home had a complaints procedure, but records did not show enough about investigations, action taken or preventing problems happening again. The procedure was also not readily displayed or available on the website.
“The provider did not have suitable arrangements in place for receiving and acting on complaints, to ensure they are effectively investigated and any necessary action taken.” from the report
Medicines checks
needs fixingSome prescription checks and instructions for medicines given when needed were unclear. Medicine audits had not been completed since December 2016.
“We recommend processes for auditing medicine management practices are further developed to identify and rectify shortfalls in a timely way.” from the report
Disruption and staff turnover
needs fixingEarlier management changes to activities and staffing had unsettled people and affected continuity. Improvements had started, but staff turnover and agency use remained concerns.
“This had resulted in a lack of continuity of support and unnecessary disruption for people.” from the report
Management stability
needs fixingThere was no registered manager at the time of the inspection. The home was using an acting manager while recruitment and proposed management changes were under way.
“We found the leadership arrangements were in need of sustained improvement to promote a consistent management of the service.” from the report
- 01How have you completed the overdue refresher training and regular supervision for all staff?
- 02How do you now check repeat prescriptions, as-needed medicines and medicine audits?
- 03How are complaints recorded, investigated, answered and used to prevent similar problems?
- 04Who is currently responsible for managing the home, and when will a registered manager be in post?
- 05How do you maintain consistent staffing and individual activities for each person?
This inspection considered all five key questions, using observations, discussions and a sample of care, staffing, medicines, complaints and quality records. This explanation was written from the published report of 27 June 2017 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 Clayton Brook House
3 rated inspections over 3 years: the service has held its Good rating throughout.
- August 2018Goodcurrent ratingup from Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2017Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- February 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2013
Report published without a new overall rating.
- June 2013
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- April 2012
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 23 December 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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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.”
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