Archived: Leolyn Care Home

Updated 17 December 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 checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the home, and to provide a rating for the home under the Care Act 2014.

We visited the home on the 18 and 22 November 2016. This was an unannounced inspection undertaken by an inspector.

During the inspection, we spoke with 14 people who lived at the home, three relatives, eight care staff, two registered nurses, two cooks, the area manager, the manager and the activity co-ordinators. We also contacted external health professionals, such as a GP and speech and language therapists to gain their views of the service.

Before our inspection we reviewed the information we held about the home. We considered information which had been shared with us by the local authority and looked at safeguarding alerts that had been made and notifications which had been submitted. A notification is information about important events which the provider is required to tell us about by law. We also contacted the local authority to obtain their views about the care provided in the home. Before the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

We looked at areas of the building, including people’s bedrooms, the kitchen, bathrooms, and communal areas. Some people were unable to speak with us. Therefore we used other methods to help us understand their experiences. We used the Short Observational Framework for Inspection (SOFI) on the 22 November 2016. SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us. We also used communication aids that people themselves used, to communicate with them.

During the inspection we reviewed the records of the home. These included staff training records and policies and procedures. We looked at seven care plans and associated risk assessments along with other relevant documentation to support our findings. We also ‘pathway tracked’ people living at Leolyn Care Home This is when we looked at people’s care documentation in depth and obtained their views on how they found living at Leolyn Care home. It is an important part of our inspection, as it allowed us to capture information about a sample of people receiving care.

Updated 17 December 2016

Leolyn Care Home provides accommodation and nursing care for up to 34 older people who require nursing care. The top floor of the home is a designated unit for up to seven people living with a dementia type illness. On the days of our inspection there were 21 people living in Leolyn Care Home.

Leolyn Care Home is owned by New Century Care Limited and has six other homes in the South East. Accommodation was provided over three floors, with a further lower ground floor with a passenger lift that provided level access to all parts of the home. People spoke well of the home and visiting relatives confirmed they felt confident leaving their loved ones in the care of Leolyn Care Home.

There was not a registered manager in post. The registered manager left the organisation in September 2015. A manager was recruited and came in to post in March 2016 and are awaiting the disclosure and barring check. They have submitted their application to be registered as manager at Leolyn Care Home. 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.

We carried out an unannounced comprehensive inspection at Leolyn Care Home 10 and 13 April 2015. Breaches of Regulation were found and Leolyn Care Home was rated as inadequate. A further inspection was undertaken on 15 and 16 October 2015 to follow up on whether the required actions had been taken to address the breaches identified. We found that the breaches of regulation had been met but needed additional time to be embedded in to everyday care delivery and Leolyn Care Home therefore was rated as requires improvement.

This unannounced comprehensive inspection was carried out on the 18 and 22 November 2016 to see if the improvements had been sustained. We found that the improvements had been sustained.

People spoke positively of the home and commented they felt safe. Our own observations and the records we looked at reflected the positive comments people made.

Medicines were stored safely and securely so that only those authorised to do so were able to access them. However our review of the medicine administration records (MAR) charts found a number of gaps in the signatories of medicines being administered.

Staff and relatives felt there were enough staff working in the home and relatives said staff were available to support people when they needed assistance. The provider continues to actively seek new staff, nurses and care staff, to ensure there was a sufficient number with the right skills when people moved into the home. We found however that staff deployment in the communal areas was not always consistent during the inspection.

The provider had made training and updates mandatory for all staff, including safeguarding people, moving and handling, management of challenging behaviour, pressure area care, falls prevention and dementia care. Staff said the training was very good and helped them to understand people's needs. All staff had attended safeguarding training. Staff demonstrated a clear understanding of abuse; they said they would talk to the management or external bodies immediately if they had any concerns, and they had a clear understanding of making referrals to the local authority and the CQC. Pre-employment checks for staff were completed, which meant only suitable staff were working in the home. People said they felt comfortable and at ease with staff and relatives felt people were safe

Care plans reflected people’s assessed level of care needs and care delivery was based on people's preferences. Risk assessments included falls, skin damage, behaviours that distress, nutritional risks including swallowing problems and risk of choking and moving and handling. For example, cushions were in place for those that were susceptible to skin damage and pressure ulcers. The care plans also highlighted health risks such as diabetes. Visits from healthcare professionals were recorded in the care plans, with information about any changes and guidance for staff to ensure people's needs were met. Staff had received training in end of life care supported by the organisations pastoral team. There were systems in place for the management of medicines and people received their medicines in a safe way.

Nurses were involved in writing people’s care plans and all staff were expected to record the care and support provided and any changes in people's needs. The manager said care staff were being supported to do this and additional training was on-going. Food and fluid charts were completed and showed people were supported to have a nutritious diet.

Staff had a good understanding of people's needs and treated them with respect and protected their dignity when supporting them. People we spoke with were complimentary about the caring nature of the staff. Staff interactions demonstrated staff had built rapport with people and they responded to staff with smiles. People previously isolated in their room were seen in communal lounges for activities, music sessions and meal times and were seen to enjoy the atmosphere and stimulation.

A range of activities were available for people to participate in if they wished and people enjoyed spending time with staff. Activities were provided throughout the whole day, seven days a week and was in line with people's preferences and interests.

The provider had progressed quality assurance systems to review the support and care provided. A number of audits had been developed including those for accidents and incidents, care plans, medicines and health and safety. Maintenance records for equipment and the environment were up to date, such as fire safety equipment and hoists. Policies and procedures had been reviewed and updated and were available for staff to refer to as required. Staff said they were encouraged to suggest improvements to the service and relatives told us they could visit at any time and, they were always made to feel welcome and involved in the care provided.

The Care Quality Commission (CQC) is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The provider, registered manager and staff had an understanding of their responsibilities and processes of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards.

Staff said the management was fair and approachable, care meetings were held every morning to discuss people's changing needs and how staff would meet these. Staff meetings were held monthly and staff were able to contribute to the meetings and make suggestions. Relatives said the management was very good; the r manager was always available and, they would be happy to talk to them if they had any concerns.