About the service:

• Clarence House Care Home is a residential care home that was providing personal care to 36 people aged 65 and over at the time of this inspection. Some of those residing at Clarence House Care Home were living with dementia. It is registered to provide care and support for up to 41 older people.

• This was the service’s first inspection under a new provider.

People’s experience of using this service:

• The provider’s quality monitoring auditing system was not robust enough to identify and rectify the concerns we found at this inspection and what they themselves had previously identified.

• Good practice guidance and the provider’s own policy and procedures had not been followed in relation to the management and administration of controlled medicines.

• Although people received a person-centred service, care plans that lacked detail and recent reviews put people at risk of receiving care and support that did not meet their needs, particularly as a high number of agency staff were being used within the service.

• We saw that people were involved in making day to day decisions about the care and support they received. However, people’s involvement in the planning of their care was not evident.

• The individual risks to people had been identified and managed but written assessments of the risks lacked detail and reviews. This put people at risk.

• We have made two recommendations to the provider about care plans.

• Accidents and incidents were recorded and actioned but full analysis was not completed to fully mitigate future risk.

• The risks associated with the environment and working practices had been managed.

• Staff recruitment was safe and there were enough staff to meet people’s needs.

• The provider had systems in place to help protect people from the risk of abuse and infections.

• People were happy with the care and support they received as were their family members.

• Staff demonstrated respect for people and interacted in a kind and meaningful way.

• People’s independence was encouraged and virtual assistive technology was being employed to further enhance this.

• People experienced positive, social and engaging mealtimes and their nutritional needs were met. They had access to healthcare professionals.

• Staff were supported, inducted and received ongoing training to further improve the service people received. People told us they had confidence in the staff’s abilities to support them.

• There was an open and transparent culture within the service and suggestions and opinions on the service was encouraged, investigated and listened to.

• Staff worked well together and shifts were well organised.

• The environment was safe and warm. Refurbishment was ongoing.

• People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. Accessible information was available to those that lived at the service and others in order to make informed decisions.

• Activities were provided that people enjoyed.

• Improvements to the service continued however we did not yet see the full impact of these at this inspection. The service met the characteristics of good in three key questions however concerns about the management of controlled medicines and issues with care planning meant the service was in breach of the Regulations in two of the key questions.

• For more information on our inspection findings, please see the full report which is on the Care Quality Commission (CQC) website at www.cqc.org.uk.

Rating at last inspection:

• This was the service’s first inspection under its new provider. The regulated activity of ‘accommodation for persons who require nursing or personal care’ was registered with the CQC on 12 June 2018.

Why we inspected:

• This was a planned comprehensive inspection based on the service’s new registration.

Follow up:

• We will continue to monito