We carried out a review of the data available to us about Lavender House and Primrose Lodge on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Lavender House and Primrose Lodge, you can give feedback on this service.
Lavender House and Primrose Lodge is a care home across two buildings on the same site. The service is registered to provide accommodation and personal care for up to 11 people. At the time of the inspection there were 11 people living at the service. The service provides specialist support to people with learning disabilities, physical disabilities, autism and complex needs.
People’s experience of using this service and what we found
We reviewed the safe management of medicines for people in response to a high number of medicine errors reported to CQC. We found that these errors were responded to appropriately.
We raised areas of improvement relating to the security and storage of medicines and the disposal of a person's medicine following their expiry date. The provider took immediate action to address these concerns during the inspection.
Staff had received training to administer medicines and their ongoing competencies were reviewed. We observed the administration of medicines and saw this was completed appropriately.
Monthly medicines audits were being completed. A medicines policy was available to support staff in administering medicines.
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the guidance CQC follows to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.
The principles of right support, right care, right culture were not assessed at this inspection as not all Key Lines of Enquiry were inspected.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 20 March 2019).
Why we inspected
We undertook this targeted inspection due to concerns received about the safe management of medicines. A decision was made for us to inspect and examine those risks.
CQC have introduced targeted inspections to follow up on Warning Notices or to check specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Lavender House and Primrose Lodge are two residential care homes on the same site, registered to provide personal care for up to 11 people. At the time of the inspection there were 10 people living at the service.
People’s experience of using this service:
People received safe care. There were risk assessments in place and staff understood what measures were needed to reduce the likelihood of risks to people’s safety occurring.
Staff were knowledgeable about safeguarding and how to identify abuse. They felt confident in reporting concerns to the registered manager and knew they could report concerns to the local authority, police and CQC.
Medicines were managed safely. Medicine records were up to date. Medicine stock checks corresponded with the expected amounts.
We identified that the temperature in the medicines storage room in Primrose Lodge regularly exceeded the maximum recommended storage temperature of 25 degrees Celsius. The registered manager took action regarding this with immediate effect.
There were support protocols in place for people with epilepsy. These were stored in people’s support plans, as well as in their bedrooms and in their day bags. This meant staff had access to protocols in the event of a seizure and could take prompt action to support the person.
Staff were well trained to meet people’s needs. Specific training had been sourced when people’s needs changed. For example, training in catheter care.
People’s needs were assessed, and person-centred support plans were created. People also had health plans, documenting their health-related support needs. Some of the information was duplicated in the different plans. This meant ensuring the information remained up to date throughout the plans was not always consistent.
Staff knew people and their needs well. Staff spoke with fondness about the people they support, and we observed kind and caring interactions.
People chose how and where they wanted to spend their time and people were supported to form friendships between the two houses.
The principles of the Mental Capacity Act 2005 (MCA) were applied to the care planning, with consideration for consent and capacity throughout. There were mental capacity assessments in place for specific decisions, such as having the flu vaccination and to consent to invasive health checks.
People were provided with information in an accessible format and the service worked in accordance with the principles of the Accessible Information Standard 2016.
The service met the characteristics of Good in all areas. More information is in the full report.
Rating at last inspection: The previous inspection took place in March 2016 and the service was rated as Good in all areas and Good overall.
Why we inspected: This was a scheduled comprehensive inspection.
Follow up: We will monitor all intelligence received about the service, to inform when the next inspection should take place.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
A registered manager was 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.
Support plans and risk assessments described the person’s ability to manage aspects of their care for themselves and the assistance needed from the staff. However, some support guidance lacked a person centred approach. For example, daily routines did not state the person’s preference for getting up and how staff were to deliver care in their preferred manner.
The people we spoke with said they felt safe living at the home. Some people named the staff while others said their relatives made them feel secure. Members of staff were aware of the safeguarding of vulnerable adults from abuse procedures. They knew the types of abuse and the expectations placed on them to report alleged abuse. The staff we asked were knowledgeable about whistleblowing procedures and their responsibility to report any form of abuse they may witness from other staff.
Risk management systems promoted people’s safety and enabled people to take risk safely. Staff were aware of the actions they must take to minimise risk, including measures to support people in managing their care.
People said they had the attention they needed from the staff. Members of staff said where there were vacancies new staff were recruited to the vacant posts.
Medicine management systems were safe. Staff signed medication administration records (MAR) charts to show they had administered the medicines. Protocols were developed for administering “when required” medicines.
People said the staff knew how to care for them. The staff said the organisation provided essential training to ensure they had the skills needed to meet people’s specific needs. The training matrix in place showed 92 percent of the 33 staff working at the home had attended essential training.
Staff benefited from one to one meetings with their line manager. They said at these meetings they discussed issues of concern and the people living at the service.
People’s capacity to make specific decisions was assessed. Mental Capacity Act (MCA) assessments described the best interest decisions reached and who were the decision makers. Members of staff had a good understanding of the principles of the MCA 2005 and enabled people to make day to day decisions. These staff knew their role included helping people to develop skills and where the person had capacity, to assist them to become independent and leave the home without support from the staff.
People were supported with their ongoing health. People had annual health checks and regular check-ups with a dentist and optician. Referrals for specialists such as neurologists were made where people needed healthcare expertise input.
The people we spoke with said the staff were caring and by spending time with people the staff built relationships. One person said the staff showed them they mattered. Staff said support guidelines and relatives gave the additional information about people’s preferences about their care.
We saw the staff support people to participate in community based activities. For example, hydrotherapy and shopping trips.
The staff said the team worked well together and the registered manager was approachable. Quality assurance systems were effective. Audits were in place to assess the standards and where shortfalls were found action plans were developed to meet the standards.