Claremont Care Home

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

During our assessment of this key question, people told us they felt safe living in the home. There were processes in place to record accidents and incidents. Staff knew how to report safeguarding concerns however, in our conversations with staff, we found their knowledge in this area was not robust. We found risks to people's care were assessed and managed well. Areas of the home required work to make the environment safe and homely. The management team told us they had decided to make improvements to the environment following feedback received from people and relatives. People shared mixed feedback about staff numbers and how responsive staff were to their needs. In our observations of care and response time of staff, we found staff responded quickly when people pressed the call bell or requested their support directly. Medicines were administered safely, and people received their medicines at the correct times.

This service scored 72 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

In our conversations with people and relatives, they told us they felt safe with the care provided.

Staff told us they would report any accidents and incidents to the manager. Their comments included, "All incidents need documenting and reporting" and "everything is always reported and written down."

There were processes in place to record accidents and incidents. The provider listed all accidents and incidents, its nature, the resident involved, date and time of the day it had occurred, and actions taken. We reviewed evidence that the provider was considering patterns and trends on a monthly basis, and this included a review of where accidents had occurred, who had been involved and a review of actions taken.

We did not receive any concerns in the area following feedback from people and their relatives.

In our conversations with the management team, they told us concerns had been raised from healthcare professionals. The home manager told us they wanted to rebuild relationships with GP practices covering the home. We observed a sign had been put in place at the front door to ensure visiting healthcare professionals were attended to in a timely way when they visited the home.

During this inspection we gathered feedback from stakeholders working with the service and we also received feedback from professionals visiting the home. We were given examples where professionals had been consulted and involved in planning and delivering care centred around people's needs such as end of life care or care for people who lacked capacity to make decisions about their care. A visiting healthcare professional told us, "During the process to move home, the management and staff were quite supportive, best interest meetings with social workers were held so we could make the transfer smoothly." A new home manager had started in post and the home had voluntarily suspended new admissions to the service. In our review of people's care plan, we saw initial assessments were completed before people were admitted to the home.

There were processes in place to ensure people's needs were assessed before being admitted to the service. In our review of meeting minutes held between the management team and nursing staff, we saw the team discussed and monitored this documentation being completed in a timely way.

People told us they felt safe. Their comments included, "I have been here years; it’s alright" and “Yes, I’m safe, no problems.” Relatives agreed their loved ones were safe.

In our conversations with staff we were assured they knew about risks linked to people's care and managed these well. Staff knew how to safely support people with their meals by ensuring this was a safe consistency and texture if people had any swallowing difficulties. Nursing staff told us how they would manage the risks of a high or low blood sugar incident for people who were diabetic.

In our observations of care provided, we found staff supported people safely. For example, when carrying out moving and handling manoeuvres or when supporting people who were presenting as emotionally distressed. In our walks around the home with the home manager, they were responsive to people's requests and to any issues raised.

In our review of people's care records, we found risks to people's care were assessed and managed well, such as risks linked to catheter care, skin integrity, falls. For example, one person had risks associated to their skin integrity which required regular repositioning. This was recorded in their care plan and care notes showed this was completed in line with plans. Some people living at the home were losing weight and were at risk of malnutrition. The management team showed us the system they had in place to monitor people's weights regularly and we saw evidence confirming referrals had been completed to the relevant healthcare professionals, such as GPs and dieticians. In our review of people’s records, we could confirm that people's food intake was being recorded and if people declined their meals, evidence showed staff offering alternatives and snacks. The management team kept oversight of risks linked to people's care though the regular review of the service's clinical risk register and flash meetings.

People did not raise concerns about the environment. One person told us, "We go in the garden when it’s nice, not today." A relative commented on their view about improvements needed. They told us, "It’s a bit scruffy and could do with a refurb and cleaning in the corners." The service was going through a refurbishment process.

The management team told us they had made a decision to make improvements to the environment due to feedback received from people and relatives. We reviewed evidence showing the renovation plan had included improvements to safety systems and redecoration of the home. The home manager showed us the daily checks they completed, including on the environment, however, during our first visit, these had not been effective in addressing the areas where we found concerns.

During our walk around the home on the first day of our inspection, we observed some risks with the environment. We found heating on the top floor was not working well and people's bedrooms were cold. We found examples where areas that should not be accessible to people such as fuse boxes, were not locked. We found one handrail in a toilet and a radiator that need to be fixed. Although these issues had not been previously identified by management or staff, when we raised these issues with the management team, they took action; we did not find these concerns during our second and third inspection visits.

The home was going through a refurbishment process and several areas of the home were under renovation. For example, only one lounge was in use while the other lounge and communal areas were undergoing work. Some bedrooms were being renovated. There was a refurbishment plan in place that had started in August 2024 and was due to be completed in March 2025. There was a maintenance book were issues linked to the environment were recorded for action. The home manager's walkaround included a review of the safety of the environment. Although there were systems in place to monitor if the environment was safe, during our first visit, we found concerns with the environment that had not been previously identified by leaders or staff. For example, on our first visit to the home, we found radiators on the top floor were not working in people's bedrooms and corridors. We found two fuse boxes that were not locked, a handrail in a toilet that needed repairing and a radiator on the top floor that was damaged. We asked the home manager to take immediate action and on our following visits to the home we did not find any concerns.

People shared mixed feedback about staff numbers and how responsive staff were to their needs. Their comments included, "Seems to be enough staff”; "I don’t see staff very often, they are supposed to come and check on me. When I press my buzzer, they come eventually"; "There is not enough staff, I don’t see much of them" and "There’s not enough staff, but they are able to look after everyone. They come quite quick when I press the buzzer.” "Relatives told us, "There seems to be a lot of staff around, and they [staff] talk to them [people living at home]."

We got mixed feedback in relation to staffing levels. Some staff felt there was enough staff on shift when they had no staff absence/sickness. Some staff thought they could do with an extra member of staff. Agency staff are used for service users who require one-to-one support. Comments included “Unless we are short staffed from sickness yes, “One more staff member on shift I think please this would help us” and “I think there is enough staff on shift yes.”

We did not receive concerns from people and staff in relation to infection control. A relative told us, "It seems clean and tidy.”

The management team completed regular checks on staff's practice around infection and prevention, which included hand washing, cleanliness of the environment and laundry.

On our first inspection day, we identified two areas of the home where there were malodour’s. We discussed this the management team. We did not find concerns in our second and third visits.

There were infection and prevention policies and procedures in place. There was a team of staff allocated to cleaning and laundry tasks, but other staff were also available to support if required. The home manager's walkaround included checks on the cleanliness of the environment. There were monthly infection and prevention control audits completed by the management team.

Medicines were managed safely and were given at the correct times. Where people required supported to take their medicines covertly, pharmaceutical advice had been sought on how to safely disguise medicines in their food without altering effectiveness. Staff recorded the application of moisturising and barrier preparations on paper charts when giving people personal care. Records showed that these creams or gels were applied regularly to help maintain people’s skin integrity.

Staff we met knew service users well and were competent to use the home’s electronic medicine administration record (eMAR) system. The health professional visiting the home said they had seen people receiving good care and during observations we found staff were competent to administer medicines.

The service had safe systems for appropriate and safe handling of medicines. Staff were competent in administering medicines and medicine audits were detailed and helped to ensure that medicines were well managed. Medicines were stored safely. Controlled drugs were managed safely, in line with the home’s policy.