CQC report explained · a residential care home
What the CQC found at Medihands Clifton
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Medicines were stored securely and records had no gaps. Staff understood safeguarding, risks were reviewed, staffing was considered sufficient, and infection control arrangements were in place.
- Effective?
- Good
- Staff had completed training and refresher courses, and their competence was checked. People and relatives were involved in care planning, and staff worked with health professionals to meet people's needs.
- Caring?
- Good
- This key question was not inspected during this focused visit. The report says no concerns were identified in the information held, so the previous rating was used.
- Responsive?
- Good
- This key question was not inspected during this focused visit. The report says no concerns were identified in the information held, so the previous rating was used.
- Well-led?
- Good
- The provider used audits and checks to monitor care and act on problems. However, people and staff were not clear about the registered manager's role and presence.
What inspectors found, July 2021
Medihands Clifton rated Good; inspectors found safe, effective care and improvements, but some people were unclear about the registered manager's role.
This was an unannounced, focused inspection on 25 May 2021. Inspectors looked at Safe, Effective and Well-led because of concerns about staffing and staff skills. They spoke with people, relatives, staff and a health professional, and checked care, medicine, recruitment, training and quality records.
The home was rated Good in all three areas inspected. Medicines were stored and given safely. Staff had the right checks, training and support. Risks were assessed, staffing levels were considered sufficient, and the home was clean and managed infection risks appropriately.
The home had improved since the last comprehensive inspection, when it was rated Requires Improvement and breached two regulations. Inspectors found those breaches had been resolved. Caring and Responsive were not inspected at this visit, so their previous ratings were carried forward.
Safe medicines
Medicines were kept securely, given as prescribed and recorded properly. Staff were trained and assessed as competent.
“Medicines administration record charts had been completed appropriately and there were no gaps in recording.” from the report
Trained staff
Staff received induction, regular training and refresher courses. New staff were supported while they learned their roles.
“Staff had received training and undertook refresher courses to update their knowledge and skills which enabled them to undertake their roles effectively.” from the report
Good risk management
Risks were assessed and reviewed, and staff followed guidance from health professionals. The home investigated incidents and used what it learned to reduce repeat problems.
“The provider maintained records of investigations of incidents, accidents and concerns and showed action taken to minimise the risk of a reoccurrence.” from the report
Improved oversight
The provider had improved its monitoring since the last inspection. Audits covered medicines, care plans, records, risks, premises and staff training.
“The provider had made improvements and continued to develop the service since our last inspection.” from the report
Unclear manager role
needs fixingThere had been disruption in the registered manager's presence over the previous 15 months. Inspectors raised that people and staff were unclear about the manager's role and involvement.
“People and staff told us they were not clear about the role and presence of the registered manager at the service.” from the report
- 01Who is responsible for the home each day, and what is the registered manager's current role and involvement?
- 02How are staff training and competence checked now, especially for supporting people's mental health needs?
- 03How are medicines stored, administered and checked, and how are any errors dealt with?
- 04How are incidents, accidents and safeguarding concerns reviewed so lessons are acted on?
- 05How can residents and relatives raise concerns and see what action has been taken?
This was a focused inspection of Safe, Effective and Well-led only; Caring and Responsive were not inspected and their previous ratings were carried forward. This explanation was written from the published report of 22 July 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.
What inspectors found, July 2019
Requires Improvement; inspectors found kind, personalised care but unsafe medicine storage, outdated staff training and weak oversight.
This was a planned, unannounced two-day inspection. One inspector visited on 13 June and 20 June 2019. Inspectors spoke with seven people, six staff and reviewed care plans, medicine records, staff files and management records.
People generally spoke positively about the care. Staff were kind, respected privacy and supported independence. Care was personalised, activities reflected people's interests, and people received their medicines as prescribed.
However, medicines were stored in an unlocked office with the cupboard open and keys left in the door. Most staff had not refreshed important training for at least three years. The home's checks had not found these problems.
The overall rating was Requires Improvement. Caring and Responsive were rated Good. Safe, Effective and Well-led were rated Requires Improvement. The previous overall rating was Good, published on 24 December 2016.
Kind and respectful staff
People described staff as caring and said their privacy and dignity were respected. Staff supported people to make their own choices.
“People continued to be cared for and supported by staff who were kind and compassionate.” from the report
Personalised care
Care plans included people's strengths, preferences and care needs. They were reviewed when people's needs or wishes changed.
“Each person using the service had a care plan. These plans were person-centred and contained detailed information about people's unique strengths, likes and dislikes” from the report
Choice and independence
People were supported to go out independently, prepare food and decide about daily routines where they could and wanted to.
“Throughout our inspection we observed several people come and go as they pleased and travel independently in the wider community.” from the report
Activities and community links
People took part in activities at home and in the community, including day centres, voluntary work, shopping and social outings.
“People were encouraged and supported by staff to participate in vocational and leisure activities at home and in the local community” from the report
Staffing and cleanliness
Inspectors found enough staff available to meet people's needs, with recruitment checks in place. The home was clean and had clear infection control procedures.
“The service looked and smelt clean.” from the report
Medicine storage
seriousOn both inspection days, the medicines cupboard was open in an unlocked office, with the keys still in the cupboard door. Staff medicine training and competency checks were also not kept up to date.
“on both days of our inspection we found the cupboard where medicines were kept had been left open in an unlocked office with the keys still in the cupboard door.” from the report
Outdated staff training
seriousMost staff had not refreshed training in areas including safeguarding, mental health, infection control, food hygiene and the Mental Capacity Act for at least three years.
“most staff had not refreshed their training for at least three years in relation to mental health awareness, safeguarding adults, food hygiene, infection control” from the report
Missing mobility risk plans
needs fixingRisk plans were not available for staff to follow in relation to identified mobility needs. The manager agreed to develop plans to reduce the risk of falls.
“risk management plans were not available for staff to follow when faced with identified risks associated with people's mobility needs.” from the report
Weak quality checks
needs fixingThe home's audits had not identified the unsafe medicine storage or staff training gaps. The provider agreed to improve its governance systems.
“these governance systems had failed to pick up a number of issues we identified during our inspection.” from the report
Positive behavioural support training
needs fixingStaff understood how to respond to behaviour that may be challenging, but had not received relevant training. CQC made a recommendation about training in this area.
“staff had not received any relevant training to help them in this aspect of their role.” from the report
- 01How are medicines now kept locked, and how often are staff checked as competent to administer them safely?
- 02Which staff training has been refreshed since the inspection, including safeguarding, mental health, infection control and the Mental Capacity Act?
- 03Have mobility risk plans been completed for everyone who needs them, and how are falls risks reviewed?
- 04What positive behavioural support training do staff now receive?
- 05How has the home's audit system been changed so it identifies medicine, training and other safety problems promptly?
This was a planned inspection covering all five CQC key questions, with the previous Good ratings for all five questions reassessed. This explanation was written from the published report of 16 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.
Every inspection of Medihands Clifton
3 rated inspections over 5 years: the service has held its Good rating throughout.
- July 2021Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2019Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- December 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2014
Report published without a new overall rating.
- October 2013
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- January 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 18 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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