The Clavadel is a 32 bedded, purpose built short stay care centre for people requiring rehabilitation and convalescence following an operation or illness, such as a stroke. The service provides in-house physiotherapy and hydrotherapy. There is a minimum five-day stay and generally patients will return to their own homes within two weeks or so. However, the service can accommodate longer term stays if needed. At the time of our inspection 28 people were using the service.

This inspection took place on 29 September 2017 and was unannounced.

There was a registered manager in post. 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 and associated Regulations about how the service is run. The registered manager helped us during our inspection.

We carried out this inspection because during our inspection in August 2016 we found the registered provider was in breach of three of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These related to recruitment processes, ensuring people’s individual needs were recorded and a lack of quality assurance checks within the service. Following that inspection the registered provider sent us an action plan telling us how they planned to address our concerns. We carried out this inspection to check that action had been taken in line with their action plan and found that it had.

People were cared for by staff who were well trained, professional, polite and friendly. Interactions on the day demonstrated staff respected people, gave them the privacy they wished and enabled and supported them to be as independently as possibly whilst living at the service. People using the service had the capacity to make their own decisions. However, staff were aware of the principals of the Mental Capacity Act in that they were able to tell us there were no restrictions at the service.

People lived in an environment that was well maintained and was safe. Staff carried out appropriate health and safety checks and there was information relating to people in the event of an emergency, such as a fire. People’s rooms were well presented and comfortable. There was a communal lounge area where people could meet with friends and relatives. People could make their own decisions on where they wished to spend their time or eat their meals. People were offered choice in what they ate and staff were aware of people’s individual dietary requirements.

Although the registered provider did not provide specific activities for people, they supported people with making suggestions in relation to how people could spend their time. Such as attending activities in one of the other of the provider’s services. People could come and go as they pleased and the registered manager told us people often went into town to meet friends for lunch, etc.

People were supported to regain their health and mobility. This involved sessions with the in-house physiotherapists and with the use of the hydro pool. The registered provider had good relationships with external health professionals and a doctor from the local GP practice visited the service twice a week. Risks to people had been identified and where accidents and incidents occurred these were reviewed for trends and appropriate action taken.

People were cared for by staff who told us they felt supported and who met with their line manager on a regular basis. We found the registered manager had good management oversight of the service and there was a good working relationship between them and staff. Staff received a good range of training and staff met together regularly as a team to discuss all aspects of the service.

There were a sufficient number of staff available for people. Staff were attentive to people and did not leave them waiting fo

This inspection was carried out on the 19 August 2016. The Clavadel is a 32 bed, purpose built, short stay care centre specialising in post-operative rehabilitation and convalescent care. They cater for all types of orthopaedic rehabilitation, with an expertise in post-operative knee and hip replacement. At the time of our inspection the service provided care to 27 people; however three of these people had been at the service longer term.

There was a registered manager in post and at the inspection. 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 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 not always protected from being cared for by unsuitable staff because robust recruitment was not in place. There were documents missing in relation to pre-employment checks. On the day of the inspection there were not appropriate plans in plane in the event of an emergency and the building needed to be evacuated. However the registered manager did provide us with evidence of people’s personal evacuation plans.

There were no pre-admission assessments for people and the people’s records lacked any detailed around the planned care for the person. However the care that people received was effective and staff understood their needs. There was no activity provision for those people who had been at the service longer term.

Systems were not in place to make sure the service assessed and monitored its delivery of

care. However people and staff told us they were happy with the running of service.

People told us that they felt safe at the service. One person said “There are always staff around which helps me feel safe.” Staff had knowledge of safeguarding adults procedures. There were enough staff deployed at the service to meet the needs of people. Incidents and accidents were recorded and action taken to reduce the risks of incidents reoccurring.

People's medicines were managed safely and people understood the medicines that they received.

People received care from staff that had the training and experience to meet their needs. Staff's competencies were assessed regularly with staff and staff had support from senior members of staff.

People at the service had the capacity to make decisions we observed staff asking people for consent before they provided care.

People said that they enjoyed the food and were given choices. One person said, “The food is very good, if you don’t like what they have got they try their best to accommodate you.” Staff were all aware of people's dietary needs and preferences and those that required support to eat where provided this by staff. Health and social care professionals were involved with people’s care.

Without exception people said that the staff at the service were caring and respectful and people were involved in the decisions about their care. People were supported to be independent. Visitors were welcomed into the service.

People’s compliments and complaints were recorded and complaints addressed appropriately.

Staff understood the values of the service and said that they felt supported.

The registered manager had notified CQC about significant events and records were kept securely to protect people’s personal information.

We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.