Archived: Laywell House Limited

Updated 31 July 2019

The inspection:

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team:

The inspection team consisted of two inspectors on the first day. One inspector and an Expert by Experience on the second day, and a pharmacy inspector on the third day. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type:

Laywell House Limited 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.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection:

This inspection was unannounced.

What we did before the inspection:

Before the inspection we reviewed the information, we held about the service, including notifications we had received. Notifications are changes, events or incidents the provider is legally required to tell us about within required timescales. We also sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.

During the inspection:

We spoke with 16 people who used the service and four relatives about their experience of the care provided. We spoke with twelve members of staff including the registered manager and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

To help us assess and understand how people's care needs were being met we reviewed six people’s care records. We also reviewed records relating to the running of the home. These included staff recruitment and training records, medicine records and records associated with the provider's quality assurance systems. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

Updated 31 July 2019

About the service:

Laywell House Limited is registered to provide accommodation and personal care for up to 30 older people. At the time of our inspection, 29 people were living at the home.

People’s experience of using this service:

People told us they felt safe, supported and were happy living at Laywell House. Staff were seen to be kind, caring and provided care and support with compassion.

Quality assurance and governance systems were in place to assess, monitor, and improve the quality and safety of the services provided. However, we found the systems in place had been ineffective in identifying poor practice. For example, people were not always protected from the risk of avoidable harm. We found risks such as those associated with the environment had not been managed safely.

People received their prescribed medicines on time and in a safe way. However, where people had been prescribed medicines they only needed to take occasionally, guidance provided to staff was not always clear. We have made a recommendation in relation to medicines.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

People were protected from potential abuse by staff who had received training and were confident in raising concerns. There was a thorough recruitment process in place that checked potential staff were safe to work with people who may be vulnerable.

People were treated kindly and compassionately by staff and supported to express their views and make decisions about the care. People were encouraged and supported to lead full and active lifestyles, follow their interests, and take part in social activities.

People and their relatives felt comfortable raising complaints and were confident these would be listened to and acted on.

Laywell House was clean and people were protected from the risk and/or spread of infection as staff had access to personal protective equipment (PPE).

Rating at last inspection: Laywell House was previously rated as ‘Good.’ The report was published on 17 January 2018.

Why we inspected: The inspection was prompted in part due to concerns we received about how the service managed people’s medicines, whether people were having their nutritional, hydration and care needs met, and staffing levels. The registered manager also sent us a notification of a specific incident. Following which a person who uses the service sustained a serious injury. This incident is subject to an investigation, as a result this inspection did not examine the circumstances of the incident. A decision was made for us to inspect and examine those risks. We have found evidence that the provider needs to make improvements. Please see the Safe, Effective and Well led sections of this report.

Enforcement:

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We have also made recommendations in relation to the management of people’s medicines, care planning and staff supervision. Please see the ‘action we have told the provider to take’ section towards the end of the report.

Follow up: We will continue to monitor the service through the information we receive until we return to visit as per our re-inspection programme.

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