The Care Quality Commission
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Archived: Leolyn Care Home

Overall: Good read more about inspection ratings

63 Pevensey Road, St Leonards On Sea, East Sussex, TN38 0LE (01424) 422063

Provided and run by:
New Century Care (Leolyn) Limited

All Inspections

18 November 2016

During a routine inspection

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.

15 and 16 October 2015

During a routine inspection

When we carried out an unannounced comprehensive inspection at Leolyn Care Home on the 10 and 13 April 2015. Breaches of Regulation were found and two Warning Notices were issued in respect of ensuring people’s safety and need for consent. As a result we undertook an inspection on 15 and 16 October 2015 to follow up on whether the required actions had been taken to address the previous breaches identified.

At this comprehensive inspection we found Leolyn had taken appropriate action to address all breaches to Regulations identified at the last inspection. The service was found to be fully compliant with all required Regulations and was establishing ongoing improvements for the benefit of people using the service. Details of previous breaches will be found under each of the five question headings.

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.

You can read a summary of our findings from both inspections on our website www.cqc.org.uk

At our last inspection in April 2015 we found that people and visitors spoke positively of the home and commented they felt safe. However we found people’s safety was being compromised in a number of areas. For example care plans did not reflect people’s assessed level of care needs and care delivery was not person specific or holistic. At this inspection we found care plans reflected people’s assessed level of care needs and care delivery was person specific and holistic. The delivery of care was based on people’s preferences. Care plans contained sufficient information on people’s likes, dislikes, what time they wanted to get up in the morning or go to bed. Information was available on people’s preferences.

At our last inspection in April 2015, the provider was not meeting the requirements of the Mental Capacity Act (MCA) 2005. Mental capacity assessments were not completed in line with legal requirements. We found there were restrictions imposed on people that did not consider their ability to make individual decisions for themselves as required under the MCA Code of Practice. At this inspection we found that the staff we spoke with understood the principles of consent and therefore respected people’s right to refuse consent. All staff working had received training on the Mental Capacity Act 2005 (MCA) and mental capacity assessments were consistently recorded in line with legal requirements. Deprivation of Liberty Safeguards (DoLS) had been submitted and there was a rolling plan of referrals in place as requested by the DoLS team.

At our last inspection in April 2015 we found that whilst people and visitors were complimentary about the food at Leolyn Care Home, the dining experience was not a social and enjoyable experience for everybody. People were not always supported to eat and drink enough to meet their needs. At this inspection everyone we spoke with was happy with the food provided and people were supported to eat and drink enough to meet their nutritional and hydration needs. People received a varied and nutritious diet. The provider had reviewed meals and nutritional provision with people, the chef and kitchen and care team. The dining experience was a social and enjoyable experience for people.

At our last inspection quality assurance systems were in place but had not identified the shortfalls we found in the care delivery. Staff had not all received training in dementia and challenging behaviour to meet people’s needs. This inspection found robust quality assurance systems in place that had ensured improvements in care delivery. Staff training had been provided and was specific to the needs of the people who lived in Leolyn Care home.

At this inspection in October 2015, a registered manager was in post. Senior managers of the organisation supported the registered manager and had spent time in Leolyn observing care delivery and have fed back to the manager and staff. Staff said that this was really positive. One staff member said, “The staff team is really supportive and available.” Another said “I feel valued.” Staff confirmed there was always someone to approach with any concerns or worries.

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.

People we spoke with were very complimentary about the caring nature of the staff. People told us care staff were kind and caring. 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 and meal times and were seen to enjoy the atmosphere and stimulation.

Activity provision was provided throughout the inspection and was in line with people’s preferences and interests. Staff had worked together to provide an environment that was comfortable and safe. There was visual and interactive stimulation available in the communal areas. We observed that people were engaged with, supported by attentive staff. Improvements had been made to the dementia unit. There was visual signage that enabled people who lived with dementia to remain as independent as possible.

Staff told us the home was well managed and robust communication systems were in place. These included handover sessions between each shift, regular supervision and appraisals, staff meetings, and plenty of opportunity to request advice, support, or express views or concerns. Their comments included “Really happy to work at Leolyn Care Home, its great here and we all get on well.”

10 and 13 April 2015

During a routine inspection

We inspected Leolyn Nursing Home on the 10 and 13 April 2015. Leolyn Nursing 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 26 people living in Leolyn Nursing Home.

Leolyn Nursing 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 Nursing Home.

A manager was in post and told us they were in the process of registering with the CQC. However we have not yet received the application. 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 and visitors spoke positively of the home and commented they felt safe. Our own observations and the records we looked at did not always reflect the positive comments some people had made.

People’s safety was being compromised in a number of areas. Care plans did not reflect people’s assessed level of care needs and care delivery was not person specific or holistic. We found that people with specific health problems such as wound care did not have sufficient guidance in place for staff to deliver safe care. Not everyone had risk assessments undertaken that guided staff to promote peoples comfort, skin integrity and prevention of pressure damage. This had resulted in potential risks to their safety and well -being. Staffing levels were stretched and staff were under pressure to deliver care in a timely fashion.

The provider was not meeting the requirements of the Mental Capacity Act (MCA) 2005. Mental capacity assessments were not completed in line with legal requirements. Staff were not following the principles of the MCA. We found there were restrictions imposed on people that did not consider their ability to make individual decisions for themselves as required under the MCA Code of Practice. We also found that one person was repeatedly trying to get out of the recliner chair placing them at risk from injury.

The delivery of care suited staff routine rather than individual choice. Care plans lacked sufficient information on people’s likes, dislikes, what time they wanted to get up in the morning or go to bed. Information was not always readily available on people’s life history and there was no evidence that people were involved in their care plan. The lack of meaningful activities for people with dementia at this time impacted negatively on people’s well-being.

Whilst people and visitors were complimentary about the food at Leolyn Nursing Home, the dining experience was not a social and enjoyable experience for everybody. People were not always supported to eat and drink enough to meet their needs.

Quality assurance systems were in place but had not identified the shortfalls we found in the care delivery. Staff had not all received training in dementia and challenging behaviour to meet people’s needs.

People we spoke with were very complimentary about the caring nature of the staff. People told us care staff were kind and compassionate. Staff interactions demonstrated they had built rapports with people and people responded to staff with smiles. However we also saw that many people were supported with little verbal interaction and many people spent time isolated in their room.

People’s medicines were stored safely and in line with legal regulations. People received their medicines on time and from a registered nurse. However we found poor recording of skin creams, dietary supplements and as required medication.

Feedback had been sought from people, relatives and staff. ‘Residents’ and staff meetings were held on a regular basis which provided a forum for people to raise concerns and discuss ideas. Incidents and accidents were recorded, but not consistently audited and investigated with a robust action plan to prevent a re-occurrence.

Staff told us they thought the home was well managed and the communication systems introduced supported them to deliver good care. Their comments included “We work well but need more staff, we can’t do everything.”

People had access to appropriate healthcare professionals. Staff told us how they would contact the GP if they had concerns about people’s health.

People were protected, as far as possible, by a safe recruitment system. Each personnel file had a completed application form listing their work history as wells as their skills and qualifications. Nurses employed by Leolyn Nursing Home and bank nurses all had registration with the nursing midwifery council (NMC) which was up to date

The overall rating for this provider is ‘Inadequate’. This means that it has been placed into ‘Special measures’ by CQC. The purpose of special measures is to:

  • Ensure that providers found to be providing inadequate care significantly improve
  • Provide a framework within which we use our enforcement powers in response to inadequate care and work with, or signpost to, other organisations in the system to ensure improvements are made.
  • Provide a clear timeframe within which providers must improve the quality of care they provide or we will seek to take further action, for example cancel their registration.

Services placed in special measures will be inspected again within six months. If insufficient improvements have been made such that there remains a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating the service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. The service will be kept under review and if needed could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement we will move to close the service by adopting our proposal to vary the provider’s registration to remove this location or cancel the provider’s registration.

We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.

23 January 2014

During an inspection looking at part of the service

There were 31 people living at the home on the day of our inspection. We spoke with seven people who lived at the home and three people visiting family members. We spoke with seven staff.

When we inspected this service on 20 August 2013 we found that people were not always included in the design of their care plans or the planning of their care. We found that care could be task oriented. We found that some care plans we looked at were not up-to-date. People did not always receive care that was suitable to their needs.

The manager wrote to us with an action plan which told us how these shortfalls would be addressed. This inspection was carried out to follow up on the progress made by the home in relation to these essential standards.

At this inspection we found that steps had been taken which demonstrated improvement in both areas.

We found that improvements had begun which ensured care plans reflected the care that people received. Care plans were seen to be up-to-date and personalised with specific guidance for staff.

People were seen to be more involved in their care and were shown dignity and respect.

20 August 2013

During a routine inspection

We spoke to 15 people who lived at the home and with six people visiting family members. We looked at five care plans. We spoke with seven staff.

We found that people were not always included in the design of their care plans or the planning of their care. We found that care was often task oriented.

We found that some care plans we looked at were not up-to-date. People did not always receive care that was suitable to their needs.

We saw that the home was clean and tidy and there were systems in place to monitor this.

We looked at staffing levels and rotas and found that there was sufficient qualified, experienced and skilled staff on duty.

We saw the home had a complaints policy and procedure.

28 May 2013

During a routine inspection

The focus of this inspection was to ensure that staff were properly trained and supervised, and had the chance to develop and improve their skills. We spoke with the registered manager and looked at the training matrix, supervision records and the year's plan of supervision.

We found that people were cared for by staff who had received the training and professional development necessary to meet their needs.

6 August 2012

During a routine inspection

We used a number of different methods to help us understand the experiences of people using the service, because some of the people using the service had complex needs which meant they were not able to tell us their experiences. We looked at records, observed care and spoke to relatives. People who were able to told us that the staff were kind, and that the food was good and tasty.

Relatives told us that they were kept informed of what was happening, that the staff were good, and they had no concerns about the care delivered.