CQC report explained · a residential care home
What the CQC found at Clifton View
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from avoidable harm. Risk assessments had been updated, medicines were managed safely, and there were enough staff to meet people's assessed needs.
- Effective?
- Good
- People's needs and preferences were assessed and support plans covered health, communication and daily life. Some information about last-resort behaviour support and restraint remained generic and was still being updated.
- Caring?
- Good
- People were treated with kindness, dignity and respect. Staff supported people to make day-to-day choices and to be involved in activities such as meal preparation.
- Responsive?
- Good
- People received personalised support and took part in activities they liked, both at home and outside. Inspectors found that families were not always told what activities or one-to-one support had taken place.
- Well-led?
- Requires improvement
- The new manager had improved staff morale, audits and the culture of the home. However, communication with relatives, consistency of support and the service's recent management instability remained concerns.
What inspectors found, January 2020
HF Trust - Clifton View rated Good overall, with safe and caring support but continued weaknesses in leadership and communication.
Inspectors made unannounced visits on 5 and 16 December 2019. They observed care, spoke with people, relatives, staff and professionals, and checked care, medicines, recruitment and management records.
The home was rated Good for safe, effective, caring and responsive care. Inspectors found people were protected from harm, supported to make choices, treated with kindness, and helped to take part in activities and daily life.
The home was rated Requires Improvement for well-led. Communication with relatives was still not good enough, and relatives reported that the quality and variety of support could depend on which staff were working. The overall rating improved from Requires Improvement at the previous inspection, but the home still had work to do.
People were kept safe
Risk assessments were reviewed and staff understood how to reduce risks, recognise distress and respond safely.
“Risk assessments had been regularly reviewed and kept up to date.” from the report
Kind and respectful staff
Inspectors saw warm interactions. Staff understood people's individual ways of communicating and supported privacy, dignity and independence.
“We observed people being treated well by professional but friendly staff.” from the report
Choice and community life
People were supported to choose meals, activities and daily routines. Activities included cooking, arts and crafts, horse-riding, swimming, cinema visits and bowling.
“People participated in a range of activities based on their preferences, both in and outside the service.” from the report
Improved staff support
Staff reported better training and supervision, and inspectors found the manager had improved morale and created a more open culture.
“The culture of the service was greatly improved, and both people and staff appeared positive.” from the report
Communication with relatives
needs fixingRelatives said communication was still not regular enough. They did not always receive feedback about what their family member had been doing.
“At this inspection, although some improvements had been made, this continued to be an issue raised by all relatives we spoke with.” from the report
Inconsistent support
needs fixingSome relatives felt the quality and variety of support could depend on which staff were working, especially at weekends.
“Some relatives remained concerned about inconsistencies in the quality of care, particularly at weekends.” from the report
Care plan information still being updated
needs fixingAlthough behaviour support plans had become more individual, some last-resort strategies and restraint guidance still used generic information.
“Last resort reactive strategies including guidance on restraint practices still contained generic information from one person's support plan to another.” from the report
Staff turnover
needs fixingRelatives reported frequent staff turnover during the previous year. The manager was working to recruit and retain staff and to provide greater stability.
“Relatives told us there had been a frequent turnover of staff in the last year which had an impact on their family member who needed stability.” from the report
- 01How will you give relatives regular updates about what their family member has been doing?
- 02How do you make sure one-to-one funded time is being used, and how will you show families what activities have taken place?
- 03Have all behaviour support plans and restraint guidance been made specific to the individual?
- 04What has changed to make support consistent at weekends and when different staff are on duty?
- 05What is the current staff turnover, and how are new or agency staff introduced to people's needs?
This was an unannounced inspection covering all five CQC questions, including the care provided and the premises. This explanation was written from the published report of 7 January 2020 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, March 2019
HF Trust - Clifton View: Rated Requires Improvement; inspectors found kind, personalised care, but gaps in risk planning, staff knowledge and service oversight.
Inspectors visited on 22, 25 and 28 February 2019. They spoke with people, relatives, staff, managers and other professionals. They observed care and checked care files, staff records, medicines, complaints, incidents, audits and policies.
People were treated with kindness, respect and compassion. They were supported to make choices, be independent and take part in activities they enjoyed. Medicines, recruitment, staffing levels, cleanliness and access to health professionals were also found to be satisfactory.
However, changing risks and needs were not always properly recorded or shared with staff. Inspectors also found gaps in communication support, mental capacity assessments, staff supervision and quality checks. The overall rating fell from Good at the previous inspection in 2016 to Requires Improvement.
Kind and respectful care
Inspectors saw staff supporting people in a warm and compassionate way. People appeared relaxed and happy with staff.
“We saw staff members supporting people in a kind and compassionate way.” from the report
Personalised support
Care plans included people's likes and preferences. People were supported with activities, food choices and daily routines that suited them.
“People received personalised care that was individual to their needs.” from the report
Supporting independence
People were encouraged to do things for themselves, including setting the table, choosing food and doing laundry.
“We saw people's independence being promoted.” from the report
Medicines and recruitment
Inspectors found medicines systems, staff medicines training and recruitment checks in place. There were also enough staff on shift to meet people's needs.
“Robust recruitment procedures and checks took place before staff worked at the service.” from the report
Access to healthcare
People were supported to see health professionals when needed. The home worked with professionals including doctors, therapists and dieticians.
“The service regularly consulted with other professionals to provide care.” from the report
Out-of-date risk information
seriousA person's mobility needs had changed, but the care record did not contain a current plan or risk assessment. Agency staff then used the wrong technique, creating a risk of harm.
“Staff were supporting the person without an up to date plan or risk assessment leaving the person at risk of being supported in an unsafe manner by staff.” from the report
Communication support
needs fixingOne person had not used their eye-gaze communication technology for some time. Staff did not know how to support them to use it, which could limit their communication.
“This meant that the person may not be able to communicate effectively.” from the report
Staff knowledge and supervision
needs fixingSome staff were unclear about safeguarding, mental capacity, fire evacuation and other procedures. Regular supervision and competency checks had not been taking place.
“Staff had not been receiving regular supervisions and competency observations with management to discuss gaps in knowledge and find areas for development.” from the report
Weak quality monitoring
needs fixingAudits and action plans did not clearly show whether improvements had been completed. The report says a single, monitored service improvement plan was needed.
“Audits were undertaken to monitor the quality of the service.” from the report
Limited involvement of families
needs fixingPeople and relatives were not regularly asked for feedback. Relatives were also not always told promptly about management changes.
“This meant the people and their relatives were not engaged about changes at the service.” from the report
- 01How do you now make sure changes in mobility, health or behaviour are recorded in current care plans and risk assessments?
- 02How are agency staff shown the correct techniques and the latest information before supporting someone?
- 03What training and supervision have staff completed on mental capacity, safeguarding, communication methods and emergency procedures?
- 04How do you support people to use their preferred communication methods, including eye-gaze technology and Makaton?
- 05How are people and relatives now asked for feedback, and how are they informed about management or service changes?
This was a planned inspection covering all five key questions, with ratings given for Safe, Effective, Caring, Responsive and Well-led. This explanation was written from the published report of 19 March 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 Clifton View
3 rated inspections over 4 years: the service has held its Good rating throughout.
- January 2020Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- March 2019Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- April 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2013
Report published without a new overall rating.
- March 2013
Registered with the Care Quality Commission on 21 March 2013.
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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