About the service: East Clune Care Home can accommodate up to 30 people. This includes older people, people living with dementia and younger adults. Nursing care is not provided. The home is on two floors, with a lift providing access to the first floor. The service is located in the Clowne area of Chesterfield. At the time of our inspection there were 27 people using the service.

People’s experience of using this service:

Staff supported people in a compassionate, caring, responsive and friendly manner. They encouraged them to be as independent as possible, while taking into consideration their abilities and any risks associated with their care. All the people we spoke with made positive comments about how staff delivered care. They told us they were happy with the general environment and how the home was managed.

People received safe care and treatment. Assessments had been completed to help make sure risks associated with people's care were identified and managed in a way which respected their freedoms and choices. People were safeguarded from the risk of abuse. Accidents and incidents were monitored to identify and address any patterns or trends. People's medicines were managed in a safe way.

There were enough staff on duty to meet people's needs in a calm and unrushed manner, but further recruitment was required to minimise the use of agency staff. However, the provider made every effort to use the same agency staff, thereby giving people consistent care.

The service was clean and tidy, and people were protected from the risk of infection, however, some areas needed attention. We discussed this with the management team who gave reassurances plans were in place to address these areas.

Recruitment procedures continued to make sure staff employed were suitable to work with vulnerable people.

Staff had not always received the training they needed to develop and update their skills and knowledge. Support and supervision sessions had been provided.

Care and support was planned and delivered in a way that met people’s individual needs and preferences. Where possible, people had been involved in planning their care. Care plans outlined peoples’ needs and risks associated with their care, as well as their abilities and preferences.

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.

People received a varied and healthy diet that offered choice and met their needs. Everyone we spoke with was complimentary about the meals and snacks available at the home.

There was a range of social activities and events available for people to take part in if they wished to.

The service had an open and positive culture that encouraged involvement of people using the service, their families and staff. The management team was readily accessible and promoted teamwork. Staff had a clear understanding of their roles and responsibilities.

Checks and audits had been completed to identify any areas the service needed to improve. However, training had not been audited effectively to identify all shortfalls, and not all audits provided information about the timescales and completion dates to address the areas needing improvement.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk.

Rating at last inspection: Good (report published 24 September 2016).

Why we inspected: This was a planned comprehensive inspection based on the rating at the last inspection.

Enforcement: There is a breach in regulatory requirements. You can see the action we asked the provider to take at the end of the report. Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up: After our inspection we requested an action plan and evidence of i

This inspection was unannounced and took place on 9 June 2016. At our last inspection in December 2014 the fundamental standards and requirements of the Health and Social Care Act 2008 were being met at the service.

East Clune Care Home provides accommodation and personal care for up to 30 older people, including some who may be living with dementia. At the time of our visit, there were 24 people living at the service. There was a registered manager at this service. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons.’ Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People were supported safely when they received care. Staff recruitment, training and deployment arrangements helped to ensure this. People felt safe and both they and staff were informed and confident to raise any concerns they may have in relation to people’s care and safety.

People’s medicines were safely managed and risks to people’s safety associated with their health condition, environment or care equipment were assessed before they received care and regularly reviewed. People’s care plans showed staff the care actions required to mitigate any related risks, which staff understood and followed. This helped to protect people from the risk of harm or abuse.

People were satisfied with their care. People enjoyed their meals and they were supported to maintain and improve their health and nutrition in consultation with external health professionals when required.

Staff were trained, informed and supported to provide people with the care they needed. Staff understood people’s health, dietary and related care needs. People’s care plans were well maintained and helped to inform this.

Staff understood the Mental Capacity Act 2005 and followed this to obtain people’s consent to or provide care in their best interests when required. People’s related care plan records mostly helped to ensure appropriate decision making in relation to their care, treatment or finances in their best interests. Action agreed and confirmed by the registered manager following our inspection helped to fully ensure this.

People and relatives found staff to be consistently kind, caring and respectful. People were supported to maintain their preferred contacts with family and friends, who were appropriately informed and involved in their care.

People received individualised, timely care, which took account of their rights, known daily living routines and lifestyle preferences. Staff understood people and knew how to communicate with them in a meaningful way.

A range of environmental aids, adaptations and equipment helped to promote people’s independence, orientation and inclusion in home life. A successful funding award bid by the provider helped to ensure a more tailored and supportive environment designed for people living with dementia.

Peoples’ views about their care were regularly sought and they were consulted and supported to engage in home life in a way that was meaningful to them. People and their relatives knew how to raise any concerns or complaints they may have about the service and were confident these would be listened to and acted on.

People, relatives and staff were confident about the management and running of the service. The management culture was open, visible and approachable with a strong ethos of ‘teamwork.’ Staff understood their roles and responsibilities for people’s care and they were encouraged and supported to raise concerns or make improvements to this when required.

The provider had sent us written notifications when required, telling us about important events that occurred at the service, in accordance with their legal obligations to us.

Regular management checks of the quality and safety of people’s care and a

At our visit there were 26 people living at East Clune. We spoke with seven staff and eight people using the service, including a group of four people together. People told us they were happy with their care and support. One person said, "It’s marvellous here, I am very happy.” Another person said, “The staff are usually very good and help me where needed.”

We found the home was clean and hygienic and that people were mostly protected from the risks of infection. One person told us,’ I am especially impressed with the how clean the home always is.”

We also found where improvements were made since our last visit. These included in some of the provider’s arrangements to monitor the quality and safety of care and services people received. The improvements also meant that people experienced care and support that met their needs, protected their rights and ensured appropriate arrangements for the management of their medicines.

In this report the name of a registered manager appears who was not in post and not managing the regulatory activities at this location at the time of the inspection. Their name appears because they were still a Registered Manager on our register at the time.

At our last visit to East Clune on 28 February 2012 we found that people living in the home had limited opportunity to express their views or preferences regarding their care, staff had not received appropriate training in the Mental Capacity Act 2005 or the Deprivation of Liberty Safeguards and the provider did not have effective systems in place to ensure all essential health and safety checks were being carried out. In their action plan, the provider told us that they had put a number of arrangements in place to address these issues.

In the 12 months prior to our visit, the home manager had left their post and an acting manager had been brought into the home until a permanent replacement was recruited.

There were 21 people living at East Clune at the time of our visit. All of these people were receiving long term care, as opposed to short-term respite care. During our visit we found that some improvements had been made and people living in the home had access to more activities and residents meetings were taking place. We also found that people care plans did not always reflect their individual needs. People we spoke with told us they were happy but that sometimes staff seemed busy.

We spoke with six people who told us that they enjoyed living at the home. One person told us “The staff here are very kind, I feel safe living here”, another said “I don’t want to move now I’m quite happy”

All of the people we spoke with told us that they enjoyed their meals. However one person we spoke with told us that the food quality was “a little hit and miss”.

We also spoke with the relatives of people living at the home. Relatives were generally happy with the care provided by the home with one person telling us “Whenever we visit his room is always so clean and tidy. It’s so lovely I could live there myself”.