CQC report explained · a nursing home
What the CQC found at Cliftonville Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, December 2022
Rated Requires Improvement; inspectors found safer care overall but ongoing concerns about the environment, staffing consistency and management checks.
This was an unannounced focused inspection on 16 June 2022. Inspectors looked only at Safe and Well-led. They spoke with people, relatives, staff and a visiting professional, and reviewed care, medicines, recruitment and management records.
People were generally protected from abuse and avoidable harm. Risk assessments, medicines, safeguarding and accident reviews were mostly handled well. The home was clean, but there were gaps in cleaning records and COVID-19 testing for visiting professionals was not always followed at the time.
Inspectors found safety risks that the home's checks had not identified. These included an intruder access risk, windows that did not initially meet the required safety guidance, and a risk that people's dietary needs might not be followed correctly. The provider acted on some issues during or after the inspection.
The overall rating remains Requires Improvement, as do Safe and Well-led. The home had been rated Requires Improvement at the previous inspection. The provider had made enough progress to no longer be in breach of the regulations, but further improvement was still needed.
Medicines
People received their medicines as prescribed. Staff were trained and their competence was checked.
“People received their medicines as prescribed. Medicine administration records (MAR) were completed and details recorded as necessary.” from the report
Risk and safeguarding
Risk assessments were kept up to date and staff understood how to recognise and report abuse. Accident reviews were used to reduce the chance of problems happening again.
“Risk assessments were kept up to date and contained all the information required.” from the report
Clean environment
Inspectors found the home visibly clean and without unpleasant odours, although some cleaning records were incomplete.
“The home was visibly clean and odour free.” from the report
Listening to people
People and staff were asked for feedback, and inspectors heard that some concerns had been acted on. Staff also reported improved management support.
“People had been kept informed regarding difficulties in recruitment and felt the management team were addressing this.” from the report
Independence
People were supported to make choices, remain independent and take positive risks where appropriate.
“People were supported to be as independent as possible and were empowered to take positive risks.” from the report
Environmental safety
seriousInspectors found a risk of intruder access that had not been identified. It remained in place for the rest of the inspection, although a repair was arranged for the following day.
“However, despite the dangers being pointed out to the manager they failed to remove the risk for the remainder of the inspection.” from the report
Dietary requirements
needs fixingKitchen staff were not consistently using the available information about individual dietary needs. This created a risk that people could receive food that was unsuitable for them, although no harm was found.
“We found no evidence of harm; however, people were at increased risk of receiving a diet that wasn't suitable for them.” from the report
Unfamiliar agency staff
needs fixingStaffing levels appeared sufficient, but people and relatives said frequent use of unfamiliar agency staff caused anxiety and made it harder for staff to know people's preferences.
“There have been times when I've not known the agency staff and they don't know how I like things done.” from the report
- 01What checks are now in place to prevent intruder access and to make sure all windows meet the required safety guidance?
- 02How do you make sure each person's dietary requirements are followed by kitchen staff every day?
- 03What is the current level of agency staffing, and how are you reducing the number of unfamiliar agency workers?
- 04How do you check that your audits identify environmental and care risks before they affect people?
- 05Who is currently responsible for management while there is no registered manager, and what progress has been made towards appointing one?
This was a focused inspection of Safe and Well-led only; the ratings for Effective, Caring and Responsive were carried over from the previous inspection. This explanation was written from the published report of 7 December 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, December 2021
Cliftonville Care Home is rated Requires Improvement; inspectors found risks, incomplete records and weak oversight, although staff were kind and medicines were administered safely.
This was an unannounced focused inspection on 22 November 2021. Inspectors looked only at Safe and Well-led because concerns had been raised about risk management, records, staffing and oversight. They spoke with people, relatives and staff, and reviewed care, medicines, recruitment and management records.
The home did not always give staff accurate or up-to-date information about people's needs. Records did not consistently show that repositioning, oral care, food, fluids and safety checks had been completed. Some unexplained injuries had not been investigated. These issues created risks including pressure damage, choking, dehydration, malnutrition and abuse.
The home had safe recruitment and people said they felt safe and that staff were kind. Medicines were given as prescribed, and infection control measures such as PPE and cleaning were in place. However, audits did not find important gaps and the new manager's improvements had not yet become established.
The overall rating fell from Good at the previous inspection, published on 11 October 2019, to Requires Improvement. The provider was asked for an action plan, and CQC said it would monitor progress and return under its re-inspection programme.
Kind and reassuring staff
People and relatives said they felt safe, and people spoke positively about staff.
“Staff look after me well, they keep me safe and do what I need them to do.” from the report
Medicines
Medicines were administered as prescribed. Records were completed and staff had the required training and checks.
“Medicine administration records (MAR) were completed and details recorded as necessary.” from the report
Recruitment checks
The provider used references and DBS checks to assess whether staff were suitable.
“Safe recruitment practices were in place and the provider used references and the Disclosure and Barring service (DBS)” from the report
Infection precautions
Inspectors were assured about PPE, testing, cleaning, visiting arrangements and several other infection control measures, although shared sling cleaning records were incomplete.
“We were assured that the provider was using PPE effectively and safely.” from the report
Incomplete risk information
seriousRisk assessments and care plans did not always contain the information staff needed. Conflicting information and missing professional advice could lead to unsafe care.
“Not all risk assessments were kept up to date or contained all the information required.” from the report
Care tasks not recorded
seriousRecords had gaps for repositioning, oral care, food, fluids and hourly checks. Inspectors could not always be sure essential care had been provided.
“Records were not consistently completed to evidence care and support was delivered.” from the report
Unexplained injuries
seriousBruises, cuts and skin tears were found without an identified cause or investigation. This meant possible risks were not always addressed.
“Unexplained injuries had not always been investigated to identify a cause or to identify a risk that required mitigating.” from the report
Weak management checks
seriousAudits did not reliably identify missing or incorrect information, incomplete care records or failures to follow professional advice.
“Audits were not effective to ensure injuries to people were recorded appropriately and causes for the injuries were identified or investigated.” from the report
Limited feedback
minorPeople, relatives and staff were not always asked for their views. Relatives gave mixed feedback about opportunities to contribute to care reviews.
“People, relatives and staff were not always asked to feedback on the service.” from the report
Staff availability
needs fixingStaffing appeared sufficient during the inspection, but there were short periods when people needed help and staff were not immediately available. Agency staff had been introduced to increase numbers.
“There were times when people required support and staff were not available for a short time.” from the report
- 01How do you now check that repositioning, oral care, food, fluids and hourly safety checks are completed and recorded?
- 02How are risk assessments and care plans kept accurate when people's health needs or professional advice change?
- 03How are unexplained bruises, cuts and skin tears investigated and the findings acted on?
- 04What action has been completed from the manager's improvement plan, and how do you check that changes are now embedded?
- 05How do you make sure enough staff are available when someone needs immediate support?
This was a focused inspection of Safe and Well-led only; the other three key-question ratings were carried over from the previous comprehensive inspection. This explanation was written from the published report of 22 December 2021 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 Cliftonville Care Home
5 rated inspections over 8 years: the service has slipped, from Good to Requires improvement.
- December 2022Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- December 2021Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- October 2019Goodstayed GoodSafe: GoodWell-led: Good
- February 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- June 2012
Registered with the Care Quality Commission on 8 June 2012.
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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