We carried out a review of the data available to us about Lawton Rise Care Home on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Lawton Rise Care Home, you can give feedback on this service.
Lawton Rise Care Home is a nursing home providing personal and nursing care to up to 62 people. The service provides support to older people, some of whom were living with dementia. At the time of our inspection there were 55 people using the service. There were two floors and two units on each floor.
People’s experience of using this service and what we found
Infection control measures were in place to keep people safe. There was mixed feedback about the visiting arrangements the provider had in place. Following the inspection, the provider amended their visiting policy to align with government guidance at the time. There were enough safely recruited staff to support people, although there could be busy times for staff. Risks to people were assessed and planned for to try and support people safely. People were protected from abuse by staff who understood their responsibilities and knew how to recognise abuse. Medicines were managed safely. Lessons were learned when things went wrong and this was shared with staff.
Systems were in place to effectively monitor the quality and safety of care to people. There was a positive culture and people, relatives and staff were able to contribute and feedback about their experiences of the care. The management team were proactive, and people, relatives and staff felt positively about the registered manager and their approachability. The registered manager understood their duty of candour. There was a process of continuous learning and improving. The home worked in partnership with other professionals and those in the community.
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 27 March 2019).
Why we inspected
We undertook a targeted inspection to follow up on specific concerns which we had received about the service. The inspection was prompted in part due to concerns received about visiting arrangements. A decision was made for us to inspect and examine those risks.
We inspected and found there was mixed feedback about these visiting arrangements, so we widened the scope of the inspection to become a focused inspection which included the key questions of safe and well-led.
We found there was mixed feedback about visiting arrangements; however, no one had come to harm as a result of this. The provider amended their visiting arrangements during our inspection to reflect guidance at the time. Please see the safe section of this full report.
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 remained the same, good. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Lawton Rise Care Home on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
Lawton Rise accommodates 62 people living with dementia across four separate units, each of which have separate adapted facilities. At the time of the inspection 55 people were using the service
People’s experience of using this service:
At the last inspection in December 2017, the service was rated as Requires Improvement overall, with breaches of the regulations in relation to staffing. The provider wrote to us to tell what action they would take to comply with these regulations. At this inspection, we found that the provider had made considerable improvements and there were no longer breaches of the regulations. The home had improved and is now rated as Good.
People's care was not always responsive to their needs. One person did not always receive the support they needed and improvements were needed to support people living with dementia. People had the opportunity to participate in activates they enjoyed. There was a complaints procedure in place.
The care people received was safe. Individual risks were considered. Safeguarding procedures were in place. Medicines were managed in a safe way. There were enough staff available for people. Infection control procedures were implemented. Lessons were learnt when things went wrong in the home.
The care that people received was effective. They 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. Staff received an induction and training that helped support people. People received support from health professional when needed. People enjoyed the food and were offered a choice. The environment was adapted to meet people’s needs.
People and relatives were happy with the staff and supported in a kind and caring way. People were offered choices, remained independent and their privacy and dignity was maintained.
There were audits in place which were effective in continually developing the quality of the care that was provided to them. There were systems in place to ensure staff, people and relatives could give feedback on the service.
More information is in the full report.
Rating at last inspection:
Requires Improvement (Last report 13 December 2017). We issued a Warning Notice in relation to Regulation 18 of the Health and Social Care Act (Regulated Activities) regulations 2014.
Why we inspected:
This was a planned inspection based on the rating at the last inspection. However, we had received information of concerns about the service.
Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.
Lawton Rise is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
Lawton Rise accommodates 62 people living with dementia across four separate units, each of which have separate adapted facilities. At the time of the inspection 62 people were using the service.
There was a new manager in post who was in the process of registering with us. 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.
There were insufficient numbers of staff available to meet people's needs and reduce risks of harm and people's medicines were not always managed and administered safely.
Staff did not always follow national guidance in delivering care that met people's needs in an effective way. The provider was not following the principles of the MCA and ensuring that when people lacked the mental capacity to agree to their care they were supported to do so in their best interests.
The building and environment required improvement to meet people's needs in relation to their dementia. We have made a recommendation to offer staff further training in dementia care.
Staff had limited time to spend with people at mealtimes to ensure it was a dignified dining experience and people did not always receive personalise that met their individual needs and preferences due to a lack of available staff and routines.
The provider had a complaints procedure, however some relatives did not feel able to raise their concerns.
People had not always been consulted with about changes to their care routines and some relatives and some staff felt that the manager was not approachable.
People were safeguarded from the risk of abuse and lessons were learned following incidents that had resulted in harm.
Infection control procedures were followed to prevent the spread of infection.
People were supported and encouraged to engage in hobbies and entertainment and offered social stimulation.
People's wishes were gained as to how they wished to be cared for at the end of their life and people and their relatives were involved in their care planning and treated with dignity and respect.
People's right to privacy was upheld and respected.
People's needs were assessed and when their needs changed or they became unwell the appropriate health care support was gained in a timely manner.
People who used the service received a holistic service and were supported by staff who were trained and effective in their roles.
People were supported to eat and drink sufficient amounts to remain healthy.
The provider recognised the needs to improve the quality of care for people and was implementing new systems to bring about the improvements in a timely manner.
Staff worked alongside other agencies to ensure that a holistic approach was taken to people's care.
Audits and analysis of accidents and incidents were effective as lessons were learned and the quality of care was improved when concerns were raised.
We inspected this service on 18 March 2015. This was an unannounced inspection. This was the service’s first inspection under their registration of a new provider.
The service was registered to provide accommodation and nursing care for up to 62 people. People who used the service were living with dementia.
At the time of our inspection 62 people were using the service.
The service had a registered manager. 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.
There was a very positive atmosphere within the home and people were very much at the heart of the service. People and their relatives were enabled to be involved in the care and staff implemented the service’s core values to ensure people had a meaningful and enjoyable life.
The registered manager and provider regularly assessed and monitored the quality of care to ensure national and local standards were met and maintained. Continual improvements to care provision were made which showed the registered manager and provider were committed to delivering high quality care.
All of the staff received regular training that provided them with the knowledge and skills to meet people’s needs in an effective and individualised manner. Dementia training was also offered to people’s relatives to help them to understand the condition.
People’s health and wellbeing needs were closely monitored and the staff worked very well with other professionals to ensure these needs were met and to prevent hospital admissions. The home had been recognised by a national agency because they had demonstrated they provided high quality and effective end of life care.
A flexible approach to mealtimes was used to ensure people could access suitable amounts of food and drink that met their individual preferences. This helped people to maintain healthy weights.
Staff sought people’s consent before they provided care and support. However, some people who used the service were unable to make certain decisions about their care. In these circumstances the legal requirements of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS) were being followed. Where people had restrictions placed upon them to keep them safe, the staff ensured people’s rights to receive care that met their needs and preferences were protected. Where people were legally restricted to promote their safety, the staff continued to ensure people’s care preferences were respected and met.
The environment was designed to enable people to move freely around the home. There was a parlour room, a pub and outside space that people could freely access. These areas were also used to enable people to participate in social events.
People and their relatives were involved in the assessment and review of their care. Staff supported and encouraged people to access the community and participate in activities that were important to them. Innovative ideas, such as; ‘Magic minutes’ and a ‘wishing well’ were used to ensure people received high quality that was meaningful and personal to them.
Feedback was sought and used to improve the care. People knew how to make a complaint and complaints were managed in accordance with the provider’s complaints policy.
People’s safety risks were identified, managed and reviewed and the staff understood how to keep people safe. There were sufficient numbers of suitable staff to meet people’s needs and promote people’s safety. Systems were in place to protect people from the risks associated from medicines.
People were treated with kindness, compassion and respect and staff promoted people’s independence and right to privacy. The staff were highly committed and provided people with positive care experiences. They ensured people’s care preferences were met and gave people opportunities to try new experiences.