CQC report explained · a residential care home
What the CQC found at Paul Clarke Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Good
- Inspectors found enough staff, safe recruitment, appropriate safeguarding arrangements, medicines given as prescribed and infection control measures. Risks were assessed and staff knew how to respond.
- Effective?
- Requires improvement
- Mental capacity assessments and best-interest decisions were not always completed or recorded. One person at risk of choking was left alone with food despite their care plan, although staff training and weight monitoring improved after inspectors raised concerns.
- Caring?
- Good
- People were supported by a kind staff team who knew them well. Inspectors found that people were offered choices and treated with dignity, privacy and respect.
- Responsive?
- Good
- Care plans were personalised and people could choose activities, meals and how to spend their time. People could communicate in ways suited to them, raise complaints and access the community.
- Well-led?
- Requires improvement
- Management and quality systems did not reliably identify or correct problems. Concerns included overdue or incomplete building safety checks, missed audits, incomplete consent records and a failure to notify the CQC about an incident without delay.
What inspectors found, May 2020
Paul Clarke Home is rated Requires Improvement; inspectors found safe, kind and responsive care, but serious gaps in consent and management checks.
This was an unannounced, planned inspection on 03 March 2020. Inspectors spoke with people living in the home, staff and managers. They observed care, checked four people's records and reviewed recruitment, training, building safety and quality records.
The home was rated Good for Safe, Caring and Responsive. Inspectors found enough safely recruited staff, medicines were given as prescribed, people were treated kindly, and care was personalised. People could make choices, take part in activities and access the community.
The home was rated Requires Improvement for Effective and Well-led. Some mental capacity and best-interest decisions were not recorded, one necessary DoLS application had not been made, and one person's eating risk plan was not followed. Building safety checks and quality systems were not reliable, and a notifiable incident had not been reported to the CQC.
Safe staffing and medicines
There were enough staff, recruitment checks were carried out, and medicines records and stock levels matched. Staff administering medicines had their competence checked.
“People received their medicines as prescribed. Stock levels matched the Medication Administration Records (MARs).” from the report
Kind and respectful care
People said they liked the staff. Inspectors saw people being reassured and supported with dignity, privacy, choice and independence.
“People were supported by a caring staff team.” from the report
Personalised support
Care plans included people's preferences and people helped shape their support where they chose to. Staff knew people well and supported their chosen activities and community access.
“People had personalised care plans in place, and they were involved in developing these where they chose to.” from the report
Access to activities and communication
People could choose how to spend their time, go out and use communication tools suited to their needs.
“People were supported to communicate in a way that suited their needs.” from the report
Mental capacity and legal consent
seriousCapacity assessments and best-interest decisions were not always completed or recorded. One necessary DoLS application had not been made, and representatives had signed some consent forms without their legal authority being checked.
“People did not always have their capacity assessed when necessary, and those who did have their capacity assessed did not always have decisions made in their best interest documented.” from the report
Eating safety plan not followed
seriousOne person who was at risk of choking was left alone while eating, even though their care plan said staff should be present.
“we observed one person who was at risk of choking being left alone with food” from the report
Building safety checks
seriousChecks did not reliably identify problems. Gas safety had not been checked since 2018, water safety actions were incomplete, a fire risk assessment was missing, and two fire doors needed correction.
“The gas safety had not been checked since 2018, when it should be annually.” from the report
Weak quality oversight
needs fixingAudits and improvement plans did not consistently identify problems or make sure they were fixed. Some improvements happened only after the inspection.
“Systems were not effective at ensuring all building-related safety measures were in place and all omissions and areas for improvement were identified.” from the report
Late notification to CQC
seriousAn incident involving the police and a safeguarding referral was not reported to the CQC without delay. The provider sent the notification after inspectors raised it.
“We found one incident involving the police and a safeguarding referral had not been notified to us without delay.” from the report
- 01How are you now checking that every person has the right mental capacity assessment and recorded best-interest decision?
- 02What action was taken to make sure all required DoLS applications are made and kept up to date?
- 03How do staff make sure people at risk of choking are supervised in line with their care plans?
- 04How often are gas, fire alarm, fire door and legionella checks now completed, and who reviews the records?
- 05What changes have been made to ensure incidents are notified to the CQC without delay?
This was a planned inspection that looked at the overall quality of the home, including both the premises and the care provided, and rated all five key questions. This explanation was written from the published report of 6 May 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
Paul Clarke Home was rated Requires Improvement; inspectors found kind, safe and personalised care, but staff training and quality checks were not reliable enough.
This was the first inspection under the service's registration. It was an unannounced visit on 23 January 2019 by two inspectors. They spoke with six people, staff and the acting manager, observed care, checked three care records and reviewed recruitment, training and management records.
People were described as safe, happy and treated with kindness. Staff knew people well, supported their choices and encouraged independence. Care plans were personalised, medicines were managed safely, and people had access to activities and healthcare.
The main weaknesses were staff training, including training about learning disabilities, health conditions and the Mental Capacity Act. Quality checks were not completed consistently, and the provider had not acted quickly enough on known gaps. There was no registered manager in post, and one required notification had not been sent to the CQC.
The overall rating Requires Improvement means the home was not consistently meeting the standard expected. Safe, caring and responsive were rated Good. Effective and well-led were rated Requires Improvement.
Kind relationships
People were happy with the care and had positive relationships with staff. Inspectors saw a friendly and inclusive atmosphere.
“People were treated with kindness and compassion by staff.” from the report
Choice and independence
People were supported to make choices, express their views and build everyday skills such as preparing meals and budgeting.
“People's independence was respected and promoted.” from the report
Safe medicines
Medicines were received, stored, given and disposed of safely. Stocks were monitored so people were less likely to run out.
“Medicines systems were organised and people were receiving their medicines when they should.” from the report
Personalised support
Care plans reflected people's preferences and communication needs. People could choose how to spend their time and take part in activities they enjoyed.
“People told us and their records confirmed they were involved in planning and reviewing their care” from the report
Access to healthcare
People were supported to use healthcare services when needed. Hospital passports were kept up to date.
“People had timely access to healthcare services when required.” from the report
Staff training gaps
seriousSome staff began working with people without training in areas relevant to their roles. Training was also missing for some health conditions and for the Mental Capacity Act.
“New staff had started to work with people and completed an induction but this induction did not include any training.” from the report
Weak quality monitoring
seriousThe training matrix did not include all staff, audits were not always completed and improvement actions were not always dealt with promptly. This was a breach of Regulation 17.
“Improvements were required to the governance systems in place to ensure the quality and safety of the services was monitored” from the report
Missing regulatory notification
seriousThe provider did not tell the CQC about one authorised Deprivation of Liberty Safeguards authorisation. This was a breach of Regulation 18 of the Registration Regulations.
“We found one person had an authorisation in place and the provider had not notified us.” from the report
No registered manager
needs fixingThere had been no registered manager since April 2018. The provider was acting as manager while seeking to recruit or register a manager.
“There had not been a registered manager in post since April 2018.” from the report
Some needs not fully considered
needs fixingPeople's diverse needs were not always assessed and planned for. Their sexuality had not been considered in care planning.
“People's sexuality had not been considered so it was not clear what support people needed in this area” from the report
Recruitment records
minorA risk assessment for a staff member with a conviction had not been kept on file. The CQC recommended seeking advice to make recruitment procedures more robust.
“A suitable risk assessment had not been kept on file to show how the provider had considered the risk and any actions taken as a result.” from the report
- 01Which staff training gaps identified in the report have now been completed, particularly training about learning disabilities, health conditions and the Mental Capacity Act?
- 02How do you now check that every staff member is competent before working with people?
- 03Has a registered manager been appointed or registered, and who is currently responsible for the home's day-to-day management?
- 04How are audits and the quality improvement plan now completed, reviewed and followed up?
- 05How do care plans consider people's diverse needs, including sexuality, relationships and communication?
This was a scheduled, unannounced inspection covering all five CQC questions and both the care provided and the premises; it was the first inspection under this registration. This explanation was written from the published report of 1 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 Paul Clarke Home
2 rated inspections over a year: the service has held its Requires improvement rating throughout.
- May 2020Requires improvementcurrent ratingstayed Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- March 2019Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- October 2017
Registered with the Care Quality Commission on 13 October 2017.
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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Most charge £980 to £1,190 a week. 93 can care for a couple. 9 years' experience on average.
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