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Inspection carried out on 14 September 2016

During a routine inspection

La Luz Care Home is a small family run care home that provides care and support for up to 16 people. The home is registered to support people with frailty due to old age, have dementia or a variety of care and mobility needs. The home is owned and operated by Mr and Mrs Soto and Mr Soto is also the registered manager. On the day of our inspection 15 people were living in the home.

The registered manager/provider was present for the duration of our inspection. 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 and associated Regulations about how the service is run.

Medicines were managed in a safe way and recording of medicines was completed to show people had received the medicines they required.

There were sufficient numbers of staff on duty to meet people’s care needs. Appropriate checks, such as a criminal record check, were carried out to help ensure only suitable staff worked in the home.

Staff met with the registered manager on a one to one basis to discuss their work. Staff said they felt supported and told us the registered manager had good management oversight of the home.

Staff were aware of their responsibilities to safeguard people from abuse and were able to tell us what they would do in such an event and they had access to a whistleblowing policy should they need to use it.

People were encouraged and supported to be involved in their care as much as possible. People’s bedrooms had been decorated to a good standard and were personalised with their own possessions.

People had individual care plans. These were detailed and updated regularly. They also contained the must up to date information for staff to enable them to be able to respond to people’s needs effectively.

People and staff interaction was relaxed. It was evident staff knew people well and understood people’s needs and aspirations. Staff were very caring to people and respected their privacy and dignity.

People were provided with a range of nutritious foods to maintain a healthy diet. People told us the food was very good and home cooked. We saw people had access to drinks and snacks throughout the day and staff provided support for people to eat and drink when required.

People had risk assessments in place for identified risk of harm. The registered manager logged any accidents and incidents that occurred and put measures in place for staff to follow to mitigate any further accidents or incidents.

Staff had followed legal requirements to make sure that any decisions made or restrictions to people were done in the person’s best interests. Staff understood the Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards (DoLS).

Staff received a good range of training specific to people’s needs. This allowed them to carry out their role in an effective and competent way.

The registered manager operated an open door policy and we say several examples of this throughout the day when staff, relatives and people who used the service sought their support and advice.

If an emergency occurred or the home had to close for a period of time, people’s care would not be interrupted as there were procedures in place to manage this.

A complaints procedure was available for any concerns. This was displayed in a format that was easy for people to understand. People and their relatives were encouraged to feedback their views and ideas into the running of the home.

Inspection carried out on 12 September 2013

During a routine inspection

We visited La Luz to look at the care and welfare of people who used the service. We spoke with four people who used the service, two relatives, and a visitor. We spent time watching people and the interactions they had with staff and each other.

All the people we spoke with said they liked living at the home. Staff were seen to interact well with people. One relative told us “I think it is very good here. They make such an effort to look after people.” Another relative told us “It’s very caring here and like a family.”

People told us that staff always asked for their consent before carrying out care tasks. Staff had received training on mental capacity and understood their responsibilities with regards to decision making.

People who used the service and relatives had been involved in the planning of care. We saw that risks had been identified to protect the welfare and safety of people.

Staff were seen to wear appropriate protective equipment when carrying out tasks. One person who lived there told us told us “They keep the house very clean.”

People told us they felt there were enough staff to meet their needs. The manager had arrangements in place to cover for staff absences.

Staff were supported to carry out their roles. They received supervision and had regular training.

The provider had a system in place for dealing with complaints. People we spoke with said they knew how to make a complaint, and the manager took action to put things right.

During a check to make sure that the improvements required had been made

During our review we spoke with the manager and we reviewed care files that related to individual people who used the service. We also requested to see further information in relation to paperwork amendments that had been made.

We saw that the manager had made some changes to the way that people's needs were met, and saw that the manager and staff were working in co-operation with other providers. For example we saw that referrals and communication were being recorded clearly within care plans. The manager told us that this was done so that any referrals to other healthcare professionals could be identified and acted upon immediately. The manager had also reinforced to all staff the importance of recording referrals and that all contact made to other medical professionals should be recorded immediately.

We saw that the whistle blowing policy and complaints policy had been updated and a complaints book had been made available for anyone entering the property or people using the service. We also saw that the Surrey County Council Multi Agency Procedures for Safeguarding Vulnerable Adults had been printed off and made available for staff to refer to at anytime.

We reviewed all the records held by the provider in relation to incidents that needed to be reported to the CQC. We could see that all notifications relating to these incidents had been received by CQC within the timescale required and had been filled in correctly.

Inspection carried out on 13 December 2012

During an inspection to make sure that the improvements required had been made

During our inspection there were 14 people who used the service. We spoke with staff, made observations throughout the visit and we reviewed all the care files that related to individual people who used the service.

We saw that staff communicated with people respectfully and gave encouragement where needed. We also saw that there were a small range of activities available to people for example puzzles, music and television. We observed that staff interacted with the people who used the service during activity time. However we saw no evidence of any options for people to be involved in the community or get involved in activities outside the home.

We saw that there was an element of person centred care within people's care plans and saw that people had some options available to them. For example, what GP service they wanted to use. We also found that care plans did not have an up to date assessment of people's needs.

We saw that the home was very clean and tidy and we also saw that visitor's were welcome throughout the day without the need to make a prior appointment. We found that peoples care plans were up to date and concerns that related to the suitability of premises had been improved. For example, we saw a new emergency evacuation procedure had been put in place and practiced.

Inspection carried out on 10, 13, 14 November 2012

During a routine inspection

There were 15 people using the service at the time of the inspection visit. We spoke with four people and four members of staff. We also made observations throughout the visit and we reviewed four care plans related to individual people using the service.

We saw that staff were communicating with people respectfully and were giving encouragement throughout the day. People we spoke with told us that they felt they were treated with dignity and respect by the staff. One person said "They are good we have a lot of fun after lunch when we sing songs and they join in."

We saw that there was a small range of activities available to residents and the management had subscribed to a service which provided sing a long songs and a newsletter. However, there were no options to get involved in the community or get involved in activities outside the home.

We saw that there was an element of person centred care and saw that residents had options available to them. For example, what time to go to bed or get up and what G.P service they wanted to use. We saw that the home was very clean and tidy and found that people’s bedrooms had a lot of their own personal items, which made them feel at home.

We found shortcomings in relation to people’s care needs and risk assessments not being updated regularly and we also found concerns in relation to the suitability of premises and staffing which will be addressed within the report .

Inspection carried out on 10 May 2011

During an inspection in response to concerns

Consistent feedback was received by cares regarding the relaxed, laid back lifestyle the service provides. A carer commented “my mum does not want for anything, it is like a family”. A person who uses the service told us that “The only thing I would criticise is that sometimes there is not much to do”. People told us that they like the flexibility in the daily routines and the independence that was afforded them.

The vast majority of people who live at the service who were consulted continue to say that they were not interested in becoming involved in their care plan, but felt confident that they could ask to see it if they wanted to.

People who live at the service told us that they felt safe. Carers said that they had never seen any unsafe practices and all felt confident to raise any concerns they had with the provider or acting manager and felt that this would be dealt with promptly.

People living at the service told us that staff know what to do to help them and spoke about the “kindness” of staff. One person told us “Some of the girls are Spanish they seem to have been here for a long time, they are all very good and speak good English”. People told us that there is always staff around to get the help they needed when they wanted it. One person told us “If I want help I just ask and they come and help me with no fuss”.