CQC report explained · a nursing home
What the CQC found at Clifton Lawns
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People said they felt safe. Inspectors found enough staff, robust recruitment, safe medicines management, clean premises and systems for learning from incidents.
- Effective?
- Good
- Care was planned around people's needs and rehabilitation goals. Inspectors found training and support for staff, but identified a lack of review of one person's mental capacity and no evidence of best interest decisions.
- Caring?
- Good
- Inspectors observed kind, friendly and encouraging interactions. People's privacy, dignity, cultural needs and independence were respected.
- Responsive?
- Good
- Care plans included people's goals and support needs. People had varied activities, community opportunities and support to maintain family contact.
- Well-led?
- Good
- The manager and staff were positive and supportive. The home gathered feedback, used audits and worked with other organisations to improve care.
What inspectors found, July 2019
Rated Good; inspectors found safe, kind and rehabilitation-focused care, but capacity reviews and end of life planning needed improvement.
This was an unannounced, planned inspection. Inspectors spoke with 10 people, the manager and staff. They looked around the home and checked care, medicines, recruitment and management records.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. People generally felt safe. Inspectors found enough staff, safe medicines systems, clean premises and kind interactions.
The home strongly supported independence and rehabilitation. People helped set goals, took part in activities and built links with the local community. Inspectors recommended that the home improve how it records people's wishes about end of life care.
Safety and medicines
Inspectors found safe medicines systems, suitable staffing and good safeguarding arrangements. People were supported to take increasing responsibility for their own medicines where possible.
“Medicines were managed safely.” from the report
Rehabilitation and independence
The home placed strong emphasis on helping people move towards less supported or independent living. People set goals, learned practical skills and took part in community activities.
“There was a strong emphasis on people being independent and rehabilitation.” from the report
Kind and respectful care
Inspectors saw friendly and encouraging interactions. Staff respected privacy, dignity, cultural needs and people's involvement in decisions.
“We observed interactions between staff and people were kind, encouraging and friendly.” from the report
Activities and community links
People could choose from many activities, volunteering opportunities and courses. These activities helped people build community links for moving on from the home.
“We saw people were engaged in many activities both within the service and in the community.” from the report
Mental capacity records
needs fixingOne person's capacity had been assessed in 2015 but had not been reviewed. Inspectors also found no evidence that best interest decisions had been made, although the manager took immediate steps to address this.
“There was also no evidence that best interest decisions had been made, although people were given everyday choices.” from the report
End of life planning
needs fixingThe home was not supporting anyone at the end of their life, and the manager said people's end of life preferences had not been explored. Inspectors made a recommendation to improve this.
“We recommend the service considers current best practice guidance on end of life care to ensure people's wishes are met.” from the report
Mixed views about food
minorPeople gave mixed feedback about the food. The home offered a range of options and involved people in menu planning.
“We received mixed responses from people about the food; some people told us it was good, others told us it was not so good.” from the report
- 01How do you now review a person's mental capacity, and how are best interest decisions recorded?
- 02How do you discuss and record each person's end of life wishes?
- 03How much support would my relative receive to manage their own medicines, and how would this change over time?
- 04What rehabilitation goals and community activities would be available for my relative?
- 05How do you use people's feedback, including feedback about food, to make changes?
This was an inspection of the care home covering all five CQC questions, including the premises and care provided; all five ratings remained Good from the previous inspection. This explanation was written from the published report of 6 July 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.
What inspectors found, December 2016
Rated Good; inspectors found safe, caring and personalised rehabilitation support, with guidance for some medicines still needed.
This was an unannounced inspection on 7 November 2016. One inspector spoke with four people using the home, managers, staff and a visiting professional. They also observed the home and checked care, medicine, staff and management records.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. People said staff were supportive and helped them work towards their goals. Inspectors found enough staff, safe recruitment, good medicine systems, personalised care plans and activities to support rehabilitation and independence.
There was one medicines shortfall. The home did not yet have written guidance for staff on when some 'as required' medicines should be given. The manager said this would be put in place immediately. A legal assessment for restrictions under DoLS had also been waiting since December 2015, although the home had followed up and continued to assess the person's capacity.
Supportive staff
People said staff helped them achieve their goals and develop independent living skills.
“People who used the service told us staff were supportive and helpful in enabling them to achieve their goals.” from the report
Rehabilitation support
The home used activities and therapies to help people build skills and confidence in managing their mental health needs.
“The therapies available to people helped them to develop their skills and confidence in managing their mental health needs.” from the report
Safe staffing and recruitment
Inspectors found enough staff and checks had been completed before staff were employed.
“Staff had been safely recruited and there were enough staff to meet people's needs.” from the report
Respect and independence
Staff supported people to make choices, take part in decisions and do as much as possible for themselves.
“We saw that staff encouraged people to decide what activities they were going to take part in during the day.” from the report
Active management
Managers used audits, meetings and feedback to identify and make improvements.
“Quality assurance systems in place were used to drive forward improvements in the service.” from the report
Missing medicine guidance
needs fixingSome 'as required' medicines did not have written protocols explaining when staff should give them. The manager said these would be put in place immediately after the inspection.
“Although the MAR charts had been annotated to indicate for what reasons these medicines were prescribed, there were no protocols in place to provide guidance for staff about in what circumstances each medicine should be given.” from the report
Delay to legal assessment
needs fixingOne application for restrictions under DoLS had been waiting for assessment since December 2015. The home said it continued to contact the local authority and provide care in the least restrictive way while waiting.
“An application had been made to the relevant local authority in December 2015 to request the restrictions be legally authorised under DoLS but an assessment had still not taken place.” from the report
- 01What written protocols are now in place for each 'as required' medicine, and how are staff checked on using them?
- 02What is the current position on the DoLS application that was still waiting for assessment at the inspection?
- 03How would you assess whether your rehabilitation programme is suitable for my relative before accepting a placement?
- 04How will my relative be involved in reviewing their care plan and rehabilitation goals?
- 05What activities and support are available to help my relative develop independent living skills?
This was an unannounced inspection of the overall service and all five key questions; inspectors spoke with four people and reviewed care and medicine records for three people. This explanation was written from the published report of 13 December 2016 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 Clifton Lawns
3 rated inspections over 5 years: the service has held its Good rating throughout.
- July 2019Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2016Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2014GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- January 2014
Report published without a new overall rating.
- September 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- June 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 27 January 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.
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