This inspection took place on 10 July 2018 and was unannounced. Clarendon Nursing Home has previously been inspected by the Care Quality Commission (CQC) when managed by another provider. However, the service was registered as new in July 2017 when a new provider took over the service at that time. This is the first inspection of the service since that date. You can access previous inspection reports about the service by selecting the 'all reports' link for Clarendon Nursing Home on our website at www.cqc.org.uk.

Clarendon Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Clarendon Nursing Home accommodates up to 51 people in one adapted building across three floors. One of the floors specialises in providing care to people living with dementia.

The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are 'registered persons'. Registered persons have a legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run. The registered manager had a good understanding of their role and responsibilities particularly with regard CQC registration requirements and their legal obligation to submit notifications of events or incidents at the service.

At this inspection we found management monitoring and oversight of the safety and quality of the service was not as effective as it should have been. We identified medicines in one clinical room had not been stored at recommended temperatures. This posed a risk to people’s health and wellbeing as their prescribed medicines may not have worked as intended. Senior staff had been aware of this issue but had not removed medicines from this room to reduce this risk to people.

We identified concerns about the numbers of staff on duty at the time of our inspection. People and staff told us at times there were not enough staff to meet people’s needs. We observed staff took longer to respond to calls bells during the afternoon. Staffing levels had not been formally reviewed when new people started to use the service or as people’s needs changed. This meant the provider could not be assured that staffing levels had been adequate at all times to safely meet the needs of all the people using the service.

We found staff were not consistently being provided opportunities through supervision and appraisal to discuss current working practices and any concerns they had about this. The provider could therefore not be assured that senior staff were promptly identifying and addressing concerns that could impact on the health and wellbeing of people using the service.

After our inspection the provider took steps to address the concerns we found. Medicines were removed from the unsafe clinical room. The provider increased staffing numbers in the afternoon. Arrangements were made to bring all outstanding supervision and appraisal meetings up to date.

Other checks and audits of the service had been more effective. When areas for improvement had been identified through these checks, senior staff acted to make any changes that were needed. Learning from incidents, safety concerns and when things went wrong, was also used to make improvements at the service to ensure people’s ongoing safety and wellbeing.

People were safe at Clarendon Nursing Home. Staff knew how to safeguard people from abuse and followed appropriate guidance to minimise identified risks to people's health, safety and wellbeing. Regular checks of the premises and equipment were carried out to ensure these were safe and posed no risks to people. Staff followed good practice to ensure risks to people were minimised from poor h