This inspection took place on 25 and 26 April 2018 and was unannounced. Clairleigh Nursing Home is a 'care home'. People in care homes receive accommodation and nursing, or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Clairleigh Nursing Home accommodates up to 30 people. There were 25 people living at the home at the time of our inspection.

At the last comprehensive inspection in March 2017 we found breaches of regulations because risks to people were not always accurately assessed or managed safely and because the provider’s systems for monitoring the quality and safety of the service were not always effective in identifying issues or driving improvements. Following that inspection the provider wrote to us to tell us the action they would take to address our concerns. At this inspection we found that staff had addressed the issues we had identified, in line with the provider’s action plan.

The service had 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 2008 and associated Regulations about how the service is run.

At this inspection we found risks to people had been assessed and staff worked to manage identified risks safely. People were protected from the risk of abuse because staff were aware of the action to take if they suspected abuse had occurred. People’s medicines were securely stored and safely administered. Medicine administration records were up to date an accurate.

The provider followed safe recruitment practices. Staffing levels were determined based on an assessment of people’s needs and there were sufficient staff deployed to keep people safe. The registered manager reviewed incidents and accidents when they occurred, and acted to reduce the likelihood of recurrence. Staff were aware of the steps to take to reduce the risk of infection when supporting people.

Staff were supported in their roles through an induction, training and regular supervision. People were supported to maintain good health and had access to a range of healthcare services. Staff worked to ensure people received consistent joined up care between different services. 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. Staff sought consent from people when offering them assistance and worked in line with the requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) where people lacked capacity to make decisions for themselves.

The living environment at the service met people’s needs. People were supported to maintain a balanced diet and most people spoke positively about the food on offer at the service. Staff treated people with dignity and respected their privacy. People were involved in making decisions about their care and treatment. Staff treated people with care and consideration. People’s needs were assessed to ensure the home was able to meet their needs. They received care and support which reflected their individual needs and preferences.

People were able to maintain the relationships that were important to them. The provider offered people a range of activities in support of their need for social stimulation. Staff provided people with appropriate care and treatment at the end of their lives. The provider had a complaint policy and procedure in place which informed people on the steps to take to raise a concern. People and relative were aware of how to complain and expressed confidence that any issues they raised would be dealt with appropriately.

The service worked in

This inspection took place on 30 and 31 March 2017 and was unannounced. At our last inspection of the service in January 2015 we found that the provider was meeting regulatory requirements. Clairleigh Nursing Home provides accommodation and nursing care for up to 30 people. At the time of our inspection 26 people were living at the service. The home had 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.

At this inspection we identified a breach of regulations because risks to people had not always been accurately assessed or action taken to manage risks safely. We also found a further breach of regulations because the provider’s systems for monitoring the quality and safety of the service were not always effective in driving improvements and the monitoring system for conditions placed on people’s Deprivation of Liberty Safeguards (DoLS) authorisations did not always ensure conditions were met. We also found that records relating to people’s care were not always up to date or provided conflicting information about people’s current conditions.

You can see what action we told the provider to take in respect of these breaches at the back of the full version of the report.

People were protected from the risk of abuse because staff were aware of the types of abuse that could occur and the action to take if they suspected abuse. There were sufficient staff to meet people’s needs and the provider followed safe recruitment practices, although improvement was required to ensure professional references were provided by staff wherever possible and that the roles of referees were clearly identified when references were provided.

Staff were supported in their roles through an induction and training, and through regular supervision, although improvement was required to ensure all staff were up to date with training in areas considered mandatory by the provider. People’s medicines were stored securely and administered safely by trained staff.

Staff sought consent from people when offering them support and the provider worked within the requirements of the Mental Capacity Act 2005 (MCA) to ensure decisions were made in people’s best interests, where they lack capacity to made specific decisions for themselves. People were supported to eat and drink sufficient amounts and to access to a range of healthcare services when required.

People told us staff were kind and caring. Staff treated people with dignity and respected their privacy. People were involved in decisions about their care and treatment and had been consulted with regards to the planning of the care. People’s care plans were reviewed on a regular basis and reflected their individual needs and preferences. People were supported to take part in a range of activities they enjoyed and were able to maintain the relationships which were important to them.

Any complaints received by the service had been dealt with in line with the provider’s complaint’s policy and procedure which was accessible for review by people and relatives when required. The provider had systems in place to seek feedback from people and we saw examples of improvements having been made at the service in response to people’s feedback. People, staff and healthcare professionals spoke highly of the registered manager and their leadership within the service. The provider and registered manager also had a strong focus on making continuous improvements to the service.

People and relatives we spoke with said that the staff were friendly and respectful and they were satisfied with the care provided at the nursing home. One person told us that they were kept involved and that their opinion and consent was sought in the care planning. A relative of a person who had recently started to live at the home told us that their loved one was feeling settled and was being well supported by staff. “The staff and the manager are very caring,” they said.

At our inspection we found that people were involved in their care planning and their consent was sought in decisions related to their care. Care was suitably planned and records were maintained appropriately and stored securely. However, we also found that at times there weren’t enough suitably qualified staff on duty and that some staff were not up to date with their training.

People we spoke with said that the staff were friendly and respectful. They were satisfied with the care provided at the nursing home. One person we spoke with said, “the manager and the staff here look after me very well”.

People we spoke with said they were happy with the care they received. They said the staff were respectful and friendly. Two relatives we spoke with said that they were very satisfied with the care provided at the home. One relative said, “all the staff and especially the manager here are very welcoming and supportive”. People said they felt staff supported them in they way they wanted and were caring and helpful.

People told us that they were happy with the care at the home. They said that they were

well cared for and that the staff were friendly and supportive.

This inspection took place on 29 and 30 January 2015 and was unannounced. At our last inspection at the home, 13 June 2013, we found the provider needed to make improvements relating to staff and supporting workers. We checked with the provider in November 2013 to see what action had been taken. The provider demonstrated they were meeting these standards without the need for a visit.

Clairleigh Nursing Home provides accommodation and nursing care for up to 30 older people. The home had 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.

People using the service said they felt safe and that staff treated them well. Safeguarding adult’s procedures were robust and staff understood how to safeguard the people they supported. There were enough staff to meet people’s needs. There was a whistle-blowing procedure available and staff said they would use it if they needed to. The manager demonstrated a clear understanding of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS). Appropriate recruitment checks took place before staff started work.

Risks to people using the service were assessed; care plans and risk assessments provided clear information and guidance for staff on how to support people with their needs. People using the service had been fully involved in planning for their care needs. Medicine records showed that people were receiving their medicines as prescribed by health care professionals. People were being supported to have a balanced diet.

There were regular meetings where people were able to talk about things that were important to them and about the things they wanted to do. They knew about the home’s complaints procedure and said they were confident their complaints would be fully investigated and action taken if necessary. There was a wide range of appropriate activities available to people using the service to enjoy. The home produced a range of newsletters with information for people using the service and their relatives.

A proactive approach was taken with people regarding their preferences for the end of life care. Staff had completed training on end of life care. When necessary additional support was provided to the home by a local hospice end of life care team. The provider was working towards achieving the accreditation in the Gold Standards Framework (GSF) which promoted good practice in end of life care.

The provider took into account the views of people using the service, relatives, staff and health care professionals through surveys. The results were analysed and action was taken to make improvements for people at the home. They recognised the importance of regularly monitoring the quality of the service they provided to people and there was a strong emphasis on continuous improvement. They worked with other organisations to ensure they were following and developing best practice. Night time and weekend spot checks were carried out to make sure people received good quality care. Staff said they enjoyed working at the home and they received good training and support from the manager.