Lake View Manor

At our last inspection we rated the service Good overall. At this inspection we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

We found the service had improved their rating to Outstanding in the key question: Is the service responsive? by demonstrating they provided highly flexible support that was tailored to meet people's individual needs and preferences.

Lake View Manor is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

The service accommodates a maximum of 26 older people, some of whom may be living with dementia. It is located in Pearson Park, a residential area to the north of the city of Hull. At the time of our inspection 23 people were living at the service.

The service had a registered manager who is also the registered provider. 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.

People received care and support that was extremely responsive to their individual needs and preferences. The staff were motivated and committed to provide people with personalised experiences.

Staff worked collaboratively with other professionals to ensure people received care that enabled them to live as full a life as possible, particularly where their skills had deteriorated. A healthcare professional spoke highly of the service provided.

We saw examples where staff and the management had gone that extra mile to support people to grow in confidence and regain as much independence as possible.

The registered manager and staff looked for original ways to ensure people's needs were met, which ensured any obstacles were overcome when possible. The management team and staff were very proud of the support they provided and the positive outcomes that people had achieved.

People felt safe at the service and staff and the registered manager were aware of their responsibilities for ensuring that people were kept safe. Risks were assessed and managed. Staffing was suitable to meet the needs of people who used the service. Medicines were managed safely.

A suitable system for staff recruitment, induction and training was in place. This enabled the staff to support people effectively and safely.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

The environment was warm, clean and comfortable on the days we visited. Suitable equipment was in place to support people with their mobility.

We observed patient and kind support being provided. Staff knew people and their visitors very well.

Effective quality assurance audits were in place to monitor the service. The service regularly sought feedback from the people who lived there, their visitors, staff and other professionals. Staff had supervision and were invited to team meetings.

We undertook this unannounced inspection on the 19 and 20 January 2016. There were 22 people using the service at the time of the inspection. This is the first inspection since the provider registered with the Care Quality Commission (CQC) on 31 March 2015.

The service had a registered manager in post. A registered manager is a person who has registered with the CQC 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 improvements were required in some areas of medicines management to ensure that recording was accurate and stock control was efficient. People received their medicines as required although there had been some occasions when staff could have contacted their GPs to seek advice.

There were policies and procedures to help guide staff in how to keep people safe from the risk of harm and abuse. Staff were knowledgeable about the different types of abuse and knew how to raise concerns. Although we found staff recorded when incidents occurred between people who used the service, the registered manager had not used the local authority safeguarding matrix tool which helped to gauge risk and the action required.

People had risk assessments in place which helped to guide staff in how to minimise the reoccurrence of incidents. However, we found two instances when risk assessments could have been improved. We found the environment was safe and clean; equipment used in the service was maintained.

We found staff were recruited safely and full employment checks were carried out before new staff started work. Staff received an induction and had access to training, supervision and support to help them to develop and feel confident when caring for people and carrying out their roles.

We found people’s health care needs were met. They had access to a range of health professionals and staff were clear about how they monitored people’s health in order to seek medical attention quickly. Comments from health professionals who visited the service were positive about the staff team.

People told us they liked the meals provided to them. The menus were varied and had choices and alternatives for each meal; we observed drinks and snacks were served between meals. People’s weight was monitored and referrals to dieticians made when required.

We observed the staff approach was caring and considerate. People’s privacy and dignity was maintained and care plans were written in a way that reminded staff about this. Staff supported people to make their own choices and decisions. We found that when people had been assessed as not having the capacity to do this, the registered provider worked within the law.

People had assessments of their needs and plans of care were produced; these showed us people and their relatives had been involved in the process. We observed people received care that was person-centred. They were able to bring in items from home to make their bedrooms feel homely.

We found people participated in meaningful activities in the service and had access to local community facilities during trips out, especially in the warmer weather.

People knew how to make complaints and told us they had no concerns about raising issues with the staff team.

We found the culture of the organisation was open and focussed on improving the quality of life for people who used the service and also on developing staff. There was a quality assurance programme which consisted of seeking people’s views and carrying out audits and observations of staff practice. This helped to identify shortfalls so actions could be taken to address them.