CQC report explained · a nursing home
What the CQC found at Cleveland House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found that risks were regularly reviewed and managed, staff recruitment and training were suitable, medicines were handled safely, and infection control was effective. They found no evidence that people were at risk of harm from the concern about mechanical ventilation.
- Effective?
- Good
- This key question was not inspected during this visit. The report says ratings for key questions not inspected were carried over from the last inspection.
- Caring?
- Good
- This key question was not inspected during this visit. People, relatives and professionals nevertheless gave positive feedback about the care and support.
- Responsive?
- Good
- This key question was not inspected during this visit. The report says the service supported people's individual goals, choices and changing needs.
- Well-led?
- Good
- Inspectors found a positive, person-centred culture, approachable management and effective checks on quality and safety. Staff, relatives and external professionals spoke positively about the leadership.
What inspectors found, October 2022
Cleveland House is rated Good; inspectors found safe, person-centred care and strong leadership, with no evidence of harm from the ventilation concern.
This was an unannounced inspection on 30 September 2022. Inspectors looked at safety and leadership, including infection control and the management of people who needed mechanical ventilation. They toured the home, observed care, spoke with people, relatives, staff and health professionals, and checked care records and quality checks.
The home was rated Good for Safe and Well-led. Inspectors found that risks were identified and managed, staff were suitably recruited and trained, medicines were managed safely, and infection control was effective. They found no evidence that people were harmed by the concern about mechanical ventilation.
People and relatives gave positive feedback about the care. Inspectors found that staff supported people's choices, goals and rehabilitation needs, and worked with families and other professionals. The overall rating remained Good, the same as at the previous inspection.
Managing risks
Staff identified and regularly reviewed risks. They worked with families and health professionals to support people safely while still allowing them to make choices.
“People were not told they were unable to do something simply because it was too risky, people were supported by staff to manage any potential risks to safety.” from the report
Skilled and consistent staffing
The home had suitable recruitment checks, training and staffing levels. It tried to use the same agency staff when cover was needed, supporting continuity.
“The service was adequately staffed, and people told us they felt there was enough staff to support them safely.” from the report
Person-centred support
Staff supported people's goals, preferences and rehabilitation. Families were involved, and the home worked with in-house and external professionals.
“People were supported to meet their goals so that support was genuinely person centred and in line with people's choices.” from the report
Strong oversight
The home used audits, daily discussions and regular management meetings to monitor risks and improve care.
“The service demonstrated effective governance and accountability processes and practices to help drive up the quality and safety of care and support.” from the report
Inspectors raised no specific concerns in this report.
- 01How would you assess and manage my relative's risks, including any need for mechanical ventilation?
- 02What training and competency checks do staff have for my relative's nursing and rehabilitation needs?
- 03How will my family be involved in care planning and decisions about goals and changes in support?
- 04How do you maintain continuity of care when agency staff are needed?
- 05How do you record and review incidents, medicines and changes in my relative's condition?
This was a focused inspection of Safe and Well-led, including infection control and concerns about mechanical ventilation; the other key question ratings were carried over from the previous inspection. This explanation was written from the published report of 21 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.
What inspectors found, January 2019
Rated Good overall; inspectors found safe, kind and well-organised care, with some gaps in records, activities and meaningful engagement.
This was an unannounced inspection on 11 December 2018. Inspectors included adult social care inspectors, a nurse specialist, a pharmacist specialist and an expert by experience. They spoke with people, relatives, staff and a professional, and checked care files, medicines records, staff records and management checks.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. People and relatives generally said they felt safe and received good care. Inspectors found that risks were managed, medicines were administered safely, care plans were detailed and health professionals were involved when needed.
There were some shortfalls. Inspectors found gaps in some medicines records and one outstanding Deprivation of Liberty Safeguards application, both of which the manager acted on during the inspection. Some people were not involved in care plan reviews, activities were not consistent for everyone, and inspectors saw two occasions where staff did not have meaningful conversations with people.
Safe care
Inspectors found that people were protected from avoidable harm. Medicines were administered safely and environmental and fire safety checks were completed.
“People were safe and protected from avoidable harm. Legal requirements were met.” from the report
Kind and respectful staff
People were generally treated with kindness, dignity and respect. Staff knew people's individual needs and offered choices about their care.
“People were treated with privacy, dignity and respect and their choices, needs and rights were supported by the staff team.” from the report
Health and therapy support
The home involved a range of health professionals and had occupational therapists and physiotherapists to support people's health and abilities.
“A range of professionals from the wider team were involved in all aspects of people's care where it was required.” from the report
Management checks
Audits, reviews and team meetings were taking place. Inspectors found evidence that action was taken when checks identified improvements.
“Audits and reviews of the service and its operation had been undertaken. We saw evidence that actions had been taken to act on the findings.” from the report
Medicines records
needs fixingSome medicines records did not include all the expected information, including allergies, topical creams and the coding used for gaps. The manager acted immediately to make the information available.
“We noted some gaps in the information on administration records such as allergies, administration of topical creams and the coding system for gaps on the records.” from the report
Medicine guidance
needs fixingThe medicines policies were generic rather than specific to this home. The manager said protocols would be put in place for medicines that could pose risks.
“Policies and procedures were in place however, these reflected generic guidance and were not specific to the service provided.” from the report
Activities and outings
needs fixingSome people and relatives said activities were available, but not everyone confirmed this. One relative said their family member had only left the unit twice during their stay.
“That is a bugbear of mine, [name] has only left the unit twice in the time [name] has been here.” from the report
Involvement in care plans
minorCare plans were up to date, but not everyone said they had been involved in reviewing them.
“However, not all people confirmed that they had been involved in the reviews of their care plans.” from the report
Meaningful interaction
minorInspectors saw two occasions where staff did not engage people in meaningful conversation. The manager said staff would be reminded of the importance of positive interactions.
“However, we observed two occasions where staff did not engage in meaningful conversations with people.” from the report
- 01What changes have you made to medicines records and guidance for higher-risk medicines since the inspection?
- 02How will my relative be involved in creating and reviewing their care plan?
- 03What regular activities and outings are available, and how will you support my relative to take part?
- 04How do you make sure staff have meaningful conversations with people throughout the day?
- 05How visible is the registered manager, and how can relatives raise concerns or give feedback?
This was an unannounced inspection that looked at the premises, care and all five CQC key questions; the previous inspection had rated Effective Requires Improvement, while the other areas were Good. This explanation was written from the published report of 10 January 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 Cleveland House
3 rated inspections over 6 years: the service has held its Good rating throughout.
- October 2022Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- January 2019Goodstayed GoodSafe: GoodWell-led: Good
- April 2016GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- November 2014
Registered with the Care Quality Commission on 12 November 2014.
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.