Lakeview

Updated 25 January 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by 3 inspectors.

Service and service type

Lakeview is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Lakeview is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since our last inspection. We sought feedback from professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 3 people and 5 relatives about their experiences of the care and support provided. We also spoke with 9 staff members, including the registered manager, clinical nurse managers, team leaders and unit managers, nursing and support staff and health care assistants. We reviewed a range of records. This included 6 people's care records and records relating to medicine administration and associated documentation. We also looked at other records relating to the management of the home, care provided to people and risk management. We looked at safety information and certificates, staff rotas, accident and incident monitoring, meeting minutes and audit and governance information. We spoke with professionals who worked closely with the service.

Updated 25 January 2023

About the Service

Lakeview is a residential care home providing personal and nursing care to up to 30 people. The service provides support to people with complex needs, people living with dementia and people living with a brain injury. At the time of our inspection there were 30 people living at the service.

People's experience of using this service and what we found

People and their relatives generally felt care was provided safely. Risks relating to the provision of people's care were generally well managed in practice; however, some people’s risk assessments contained inconsistencies. Medicines were administered safely; however, some improvement was needed in relation to medication records and the storage of people’s topical creams. We raised this with the registered manager who responded immediately; however, we identified minor recording issues at our last inspection and found similar concerns again. Staff and management had a good understanding of safeguarding and how safeguarding incidents should be managed. Staffing levels were sufficient to meet the needs of people safely and recruitment processes included appropriate checks to ensure staff had the right skills and suitability to work with vulnerable people. We have made recommendations that good practice in reporting accidents and incidents is carried out by all staff and people’s risk assessments and support plans are reviewed to ensure information is consistent. We have also recommended improvements made in relation to medication records and storage of medicines are maintained.

The volume of auditing and governance systems was substantial. However, when utilised, audits had not always identified the same areas for improvement as we did at this inspection. Staff were supported in various ways with a robust programme of supervision and sessions which empowered staff to share their thoughts, feelings and ideas about the service. This information was then used to create team meeting agendas. The provider worked well with colleagues from partners across health and social care and worked holistically to meet all of people's needs. The provider and registered manager understood their responsibilities in relation to duty of candour and informed relatives, professionals and relevant bodies when things went wrong. However, some relatives felt a minority of staff could improve their communication when accidents and incidents occurred. We have made recommendations the provider utilises audits effectively.

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 and update

The last rating for this service was good (published 15 July 2022)

Why we inspected

This inspection was prompted in part due to concerns received about falls and risk management and the registered manager and providers timeliness in seeking support from external professionals. As a result, we undertook a focused inspection to review the key questions of safe and well-led.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

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.

We found no evidence during this inspection that people were at risk of harm from this concern. However, we have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Lakeview on our website at www.cqc.org.uk.

Recommendations

We made recommendations relating to safe care and treatment and good governance.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.