Background to this inspection
Updated
6 August 2016
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This inspection took place on 11 May 2016 and was unannounced. The inspection team consisted of an adult social care inspector and an expert-by-experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service for older people.
Before the inspection we reviewed the information we held about the service. This included the notifications we had received from the provider. Notifications are changes, events or incidents the provider is legally obliged to send CQC within required timescales. We contacted commissioners from the local authorities and health authorities who contracted people's care. We spoke with the local safeguarding teams. We also contacted health and social care professionals who worked with the service. We received no current information of concern from these agencies.
During this inspection we carried out observations using the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not communicate with us.
We undertook general observations in communal areas and during mealtimes. During the inspection we spoke with ten people who lived at Lea Green Court, six relatives, the manager, two visiting health care professionals, one registered nurse, six support workers, the activities organiser and two members of catering staff. We looked in the kitchen, bathrooms, lavatories and some bedrooms after obtaining people's permission. We reviewed a range of records about people's care and how the home was managed. We looked at care records for six people, recruitment, training and induction records for five staff, five people's medicines records, staffing rosters, staff meeting minutes, meeting minutes for people who used the service and relatives, the maintenance book, maintenance contracts and quality assurance audits the manager had completed.
Updated
6 August 2016
This was an unannounced inspection which we carried out on 11 May 2016. We inspected the service to follow up on the breaches and to carry out a comprehensive inspection.
We last inspected Lea Green Court in April 2015. At that inspection we found the service was in
breach of the legal requirements in force at the time with regard to Regulations 12, 9 and 15 of the Health and Social Care Act 2008. (Regulated Activities) Regulations 2014. This was because people were at risk of unsafe care and treatment, records did not accurately reflect people's care and support needs and the premises were not well maintained.
The home provides nursing care and support for up to 45 older people, some of whom live with dementia or a dementia related condition.
A registered manager was in place. 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.
We found significant improvements had been made to the service. People and staff told us they felt safe and there were enough staff on duty at all times to provide safe and individual care to people. There was more emphasis on providing person centred care to ensure people received care and support in the way they wanted and at times they chose. Staff had time to interact and spend time with people and not just when they carried out tasks.
Risk assessments were in place and they now identified current risks to the person. People were protected as staff had received training about safeguarding and knew how to respond to any allegation of abuse. People received their medicines in a safe and timely way.
People had access to health care professionals to make sure they received appropriate care and treatment. Staff followed advice given by professionals to make sure people received the care they needed.
Records had been updated and they were regularly reviewed to reflect people's care and support requirements. Staff knew the people they were supporting well. Care was provided with kindness and people’s privacy and dignity were respected.
Staff had received training and had a good understanding of the Mental Capacity Act 2005 and Best Interest Decision Making, when people were unable to make decisions for themselves.
Staff received other opportunities for training to meet people's care needs and in a safe way. A system was in place for staff to receive supervision and appraisal.
Menus were more varied and a choice was offered at each mealtime. Staff supported people who required help to eat and drink and special diets were catered for. Some activities and entertainment were available for people. However, we have made a recommendation that more activities and stimulation should be made available for people including people who live with more severe dementia.
A complaints procedure was available. People told us they would feel confident to speak to staff about any concerns if they needed to. People had the opportunity to give their views about the service. There was regular consultation with people and/ or family members and their views were used to improve the service. The provider undertook a range of audits to check on the quality of care provided.
Staff and people who used the service said the registered manager was supportive and approachable. Communication was more effective, ensuring people, their relatives and other relevant agencies were kept up to date about any changes in people’s care and support needs and the running of the service.
Changes had been made to the environment. It was cleaner and areas had been refurbished to improve infection control.