Lakeside Care Home

There were two registered managers working at the home. 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.

The service provided safe care to people. People looked at ease and comfortable in the company of staff and with each other. For example, they said, “Coming here saved my life”, “I can’t fault this place” and “I would recommend here without hesitation.” Visitors agreed with their relatives’ feedback. For example, they said, “They are very caring and the home is run in a safe a competent manner” and “The staff are approachable and friendly and they relate well to our relative. There appears to be good retention of care staff. The home is bright, clean and welcoming.”

People felt safe because there were enough staff on duty who knew how to support them. Staff were trained in safeguarding. Staff knew people well; staff worked well as a team and ensured there was a good exchange of communication which benefited people living at Lakeside Care Home.

The registered managers took the complexity of the care needs of people already living at the home into account before deciding if they could meet the care needs of new people. Where appropriate, care records identified risks in relation to falls, nutrition or pressure care.

The environment and equipment were well maintained to keep people and staff safe. The home was clean, tidy and free from persistent odours. There was on-going investment in the environment of the home, as well as the outdoor space. Visitors and people living at the home commented positively on the standard of cleanliness. Medicines were administered and managed safely.

Recruitment checks helped ensure staff were suitable to support people. People and relatives commented on the calibre of care and the welcoming atmosphere. Staff said they enjoyed working at the home, for example, they said, “Efficient team of carers, very friendly management, peaceful atmosphere to work.”

Staff provided personalised care because they knew people well. This was confirmed by feedback from people and relatives, as well as our observations of staff interactions with people.

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

People's quality of life was enhanced because the care home was well run by two approachable registered managers whose skills complimented each other. They sought feedback from people living, visiting and working at the home and records showed how they acted upon people’s responses. There were effective quality assurance systems in place to monitor the standard of care.

We found the following examples of good practice.

• The premises were clean and well maintained. Cleaning schedules were in place. High touch areas such as door handles were cleaned throughout the day. Hand sanitiser was readily available, and staff were wearing personal protective equipment (PPE) appropriately. There were clear systems in place to ensure deliveries were well managed to prevent cross infection.

• The two registered managers and staff recognised the importance of maintaining people’s well-being, with a member of staff in post to help support people’s social needs, as well as staff engagement with people to ensure they did not feel isolated.

•Two visiting pods had been established which visitors accessed through external doors rather than entering the building. These had been in regular use. Prior to the colder weather, a marquee had been set up in the grounds to enable socially distanced visiting, as well as garden visits. End of life care visits took place whilst following good infection control procedures.

• There was a clear procedure for staff to follow when arriving and leaving. For example, staff donned and doffed their uniform in a separate changing room and did not wear their uniform outside the service.

• Staff accessed weekly testing. People who used the service were also supported to access regular testing and had been offered the vaccine.

• Staff had completed infection control and prevention (IPC) training. One of the registered managers regularly worked alongside the care team. This enabled them to observe staff to ensure they followed good practice infection control guidelines.

• The registered managers were updating their infection control policy and incorporating new guidance to inform staff how to manage Covid-19. They were aware of local resources, such as the Provider Engagement Network, to update their knowledge and practice.

• There was a robust admission policy in place. The registered managers said the service was well supported by the local primary healthcare team.

We carried out an unannounced comprehensive inspection on 11 and 17 October 2018. There were 29 people living at Lakeside Care Home.

This is the first inspection since the providers have registered the service as a limited company. Apart from this change, the providers, registered manager and many of the care staff have remained the same. There was a registered manager working at the home. 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.

There were sufficient staff available to meet people’s needs. People felt safe because there were enough staff on duty who knew how to support them. Staff records showed the staff team was a mix of experienced and staff new to working in care. There was a thorough induction process and new staff shadowed experienced staff. Staff were trained in safeguarding and had a good understanding of how to respond to safeguarding concerns and to report them in a timely manner.

Staff knew people well; this meant they recognised the changes in people’s long-term health care conditions. Care records, feedback and our observation of staff practice confirmed staff responded in a responsive manner to sudden health changes or a person’s slow decline in health. Staff worked closely as a team and ensured there was a good exchange of communication.

There was a positive culture where there was an openness to learn and improve, recognising practice and good quality care was an on-going process. People told us staff were approachable and they felt confident concerns or complaints would be addressed. People built up friendships with other people at the home, which were respected. Staff were patient and kind involving people and offering choices. People benefited from a catering team who recognised their role in supporting people to keep well and healthy.

People were actively involved in the decision to move to the home, visiting it before moving in and being involved in their assessment. People’s care and support was planned in partnership with them. Care plans were written in a person-centred way. Care plans were tailored to meet people’s individual needs and were regularly reviewed.

Risks to people were recorded and reviewed with measures put in place to reduce assessed risks. Environmental checks were completed to help keep people safe. The service had good systems in place to support staff to administer medicines safely. People visiting and living at the home praised the high standard of cleanliness.

Staff demonstrated an understanding of their responsibilities in relation to the Mental Capacity Act (2005) (MCA). People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

The service was well run with a stable management team and experienced senior staff. The registered manager was due to take on the role of a senior over the care team rather than work as the manager. While the general manager and the training and administration co-ordinator were in the process of applying to register with the Care Quality Commission to job share the role of manager. The quality assurance systems helped ensure people received a consistent standard of care. Staff worked in partnership with health professionals to make sure people received support appropriate to their needs.

Further information is in the detailed findings below.