About the service Loxley Hall is a care home providing regulated activities personal and nursing care to up to 40 people. The service provides support to older people. At the time of our inspection there were 35 people using the service.
People’s experience of using this service and what we found
Risk assessments were not always in place to guide staff on how to safely support people with specific health conditions and medicines were not always managed safely. Information regarding some agency staff was not always available and the information provided to agency staff on how to provide people with safe care was not always up to date.
There were a range of audits completed by the provider and manager, however some aspects of the care service needed to be reviewed following this inspection.
Feedback received from relatives was positive regarding the care being delivered to people living in the home. It was observed during the inspection that people were comfortable and happy in the presence of staff who interacted with them in a caring and patient manner.
Systems and processes were in place to safeguard people from the risk of abuse. Relatives told us they felt their loved ones were safe with staff. GPs and other healthcare professionals were contacted for advice about people’s health needs whenever necessary and in a timely manner.
Accidents, incidents and complaints were managed appropriately and monitored. Infection prevention and control standards were also monitored and managed appropriately. A family member told us “They’ve done really well over Covid.”
Staff were recruited into their roles safely and there were enough staff available to safely meet people's day to day needs.
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.
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 4 September 2019).
Why we inspected
We undertook this inspection as part of a random selection of services rated Good and Outstanding.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
Enforcement and Recommendations
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.
We have identified breaches in relation to risk management, medicines management and governance at this inspection.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.