Clairleigh Nursing Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

People were protected from the risk of abuse. Risks to people were identified, assessed, documented and reviewed to ensure their needs were safely met. Staff were deployed effectively to meet people’s needs.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Learning culture during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

People appeared to be relaxed and safe in their surroundings and with staff. One person told us, “Staff are very good, always around and I feel safe. I have been made to feel welcome and have settled in well.” Another person said, “Staff are very nice and come quickly when I use the call bell.” A relative told us, “It is always a relief to know [loved ones] are safe and well cared for. I never have any concerns about them [staff].” Another relative commented, “We have been so very impressed with the standard of care [loved one] receives from all the care staff. They are all very attentive and carry out their duties of care in a most conscientious way whilst also managing to be very friendly and comforting.”

Staff told us they would report any abuse or poor care practice to the nurse in charge and the home manager. They were confident the home manager would make a referral to the local authority safeguarding team and CQC if they needed to. A staff member told us, “I would always seek people’s consent that they are willing for me to help them, if they say no, I respect that. I can always go back later and try again. If it was a medicine issue, I would tell the home manager as we may need to refer the person to their GP.”

People were supported to stay safe, and systems were in place to ensure people were safeguarded from abuse and avoidable harm. Safeguarding policies and procedures were up to date and in line with best practice and legislation. Staff received safeguarding training and were aware of their responsibilities to report and respond to concerns. The home manager was knowledgeable about safeguarding procedures and their responsibilities in relation to the Duty of Candor. The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS). We checked whether the service was working within the principles of the MCA, whether any restrictions on people’s liberty had been authorised and whether any conditions on such authorisations were being met. People were consulted and supported to make choices and decisions for themselves. Staff promoted people's rights and worked within the principles of the MCA to ensure these were upheld. Staff received training on the MCA and DoLs. Where the supervising body (the local authority) had authorised applications to deprive people of their liberty for their protection, we found authorisations were in place within individuals care records and kept under regular review by staff.

A relative told us, “The doors are always open to discuss my [loved ones] care. Every month when they are 'resident of the day' I receive a phone call about them to ask if I have any concerns and to review my [loved ones] care. I also receive a phone call after a GP visit if any changes have been made.”

Staff were familiar with people’s daily routines, preferences, and could identify situations where people may be at risk. Staff told us information about risks to people and how they needed to be supported was recorded in individual care records. A staff member told us how they supported people with eating and drinking safely and with specific medical conditions. Another staff member told us how they supported a person at risk of falls while the person used a walking aid and how they supervised the person to make sure they could move around the home safely.

Risks to people were identified, assessed, documented and reviewed to ensure their needs were safely and appropriately met. Risk assessments included areas of risk such as falls, nutrition and hydration, skin integrity and choking. Risk assessments included information and guidance for staff on the actions to be taken to minimise the risk and chance of harm occurring. Risk assessments were personalised and detailed ways in which people could live independently as much as possible whilst being as safe as reasonably possible. Risk assessments were reviewed on a regular basis to ensure staff had up to date information reflective of people’s needs. Guidance for staff was clearly documented to ensure staff provided people with the support they required to keep safe. Staff told us risk assessments identified people’s specific needs and risks and informed them what they were required to do to reduce and manage risks with people. Staff received training on fire safety and health and safety awareness. The provider had health and safety policies and procedures in place to guide staff on how to work safely.

We did not look at Safe environments during this assessment. The score for this quality statement is based on the previous rating for Safe.

We observed there were enough staff deployed throughout the service to meet people’s care and support needs when required. A relative told us, “I have never had any concerns about staff training and the quality of the carers and nurses. There are certainly days when the staff seem more stretched, not sure if this is because of unexpected absences. However, the staff do an amazing job and respond to needs and requests no matter how challenging.” Another relative commented, “The nursing staff keep all relatives extremely well informed as to any developments or health issues of their loved ones. They appear to have a good knowledge of my [loved one] and my [loved ones] personal health needs and can advise on matters of my [loved ones] progression.”

Staff told us they were well supported by the home manager and the deputy manager. They told us they received plenty of training to keep up with and improve their practice. There were regular staff meetings and 11 at 11 meetings where they could share their views and opinions. The home manager showed us a dependency tool and told us they used the this to work out staffing levels required to meet peoples assessed care needs. If there were new admissions or people’s needs changed then they would review the staffing levels at the home. Staff told us there was always enough staff to on duty at the home to meet people’s care and support needs.

Robust recruitment procedures were in place. Recruitment records included completed application forms, employment references, health declarations, proof of identification and evidence that a Disclosure and Barring Service (DBS) check had been carried out. DBS checks provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions. Records relating to nursing staff were maintained and included their up-to-date PIN number which confirmed their professional registration with the Nursing and Midwifery Council (NMC). The provider had a training plan in place. We looked at the training matrix. This confirmed had received regular training and refresher training relevant to peoples care and support needs. A staff member told us, “We get plenty of training so that we can keep up with and improve our practice. I am up to date with all that I need for my continuous professional development (CPD).” The home manager told us that all new staff completed an induction in line with the Care Certificate. The Care Certificate is an agreed set of standards that define the knowledge, skills and behaviours expected of specific job roles in the health and social care sectors. It is made up of the 15 minimum standards that should form part of a robust induction programme.

We did not look at Infection prevention and control during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Medicines optimisation during this assessment. The score for this quality statement is based on the previous rating for Safe.