We carried out a review of the data available to us about Larchmere House Nursing 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 Larchmere House Nursing Home, you can give feedback on this service.
At the last inspection on 23 June 2015, the service was rated as Good. At this inspection, we found the service remained Good.
There was a registered manager in post who was registered with the CQC. 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.
The provider had systems in place to protect people against abuse and harm. The registered provider had effective policies and procedures that gave staff guidance on how to report abuse. Staff demonstrated good knowledge of the safeguarding policy and procedures.
Risks to people's safety had been assessed and actions taken to protect people from the risk of harm. Risk assessments were personalised to people's needs and reviewed on a regular basis and when required.
Staff recruitment practices ensured that staff were safe to work with vulnerable adults. There were enough staff on duty to provide safe personalised care.
Trained competent staff managed medicines safely. There were regular audits carried out by trained staff to identify any areas for improvement and to ensure there were sufficient levels of stock.
Staff were well trained with the right skills and knowledge to provide people with the care and assistance they needed. Staff received regular supervisions and yearly appraisals.
The principles of the Mental Capacity Act 2005 (MCA) were adhered to for more complex decisions. People's mental capacity was being assessed appropriately and meetings took place to make decisions on people's behalf and in their best interests, when they were unable to do so. People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.
The CQC is required by law to monitor the operation of Deprivation of Liberty Safeguards (DoLS) which applies to care homes. Appropriate applications to restrict people's freedom had been submitted and the least restrictive options were considered as per the MCA.
People were assisted with their nutrition and hydration needs. Staff were completing fluid and eating charts for those that need it. People were involved with improving the food service and menu through weekly surveys carried out by the chef.
People who were at risk of pressure sores had appropriate assessments in place that identified methods to mitigate risk. These were being followed by staff. People were being referred to health professionals when required.
People told us they were very satisfied with the care staff and the support they provided. Relatives told us they were happy with the service their loved ones received.
People and their relatives told us they were involved in the planning of their care. Care plans were being reviewed on a monthly basis by staff. There was a yearly meeting with people and relatives to discuss the care plan and any other concerns they may have.
People at the service had access to a wide range of activities that were designed for their individual needs. People told us they were very happy with the amount of activities on offer at the service.
Staff respected people's privacy and dignity at all the times. The provider had ensured that people's personal information was stored securely and access only given to those that needed it.
The provider had ensured that there were effective processes in place to fully investigate any complaints. Outcomes of the investigations were communicated to relevant people.
The registered manager was approachable and took an active role in the day to day running of the service. Staff felt confident to approach the registered manager with any concerns they may have. The registered manager encouraged people, relatives and staff to voice their opinions of the service through regular meetings and surveys. The registered manager used effective auditing systems to identify any areas of improvement within the service.
The inspection was carried out on 23 June 2015 by two inspectors and an expert by experience. It was an unannounced inspection. The home provides personal care and accommodation for a maximum of 33 older people. There were 33 people living there at the time of our inspection, eight of whom lived with diagnosed dementia. Most of the people living in the home were able to express themselves verbally.
There was a manager in post who was registered with the Care Quality Commission (CQC) on 17 February 2011. 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 registered manager was also a qualified Matron.
Staff were trained in how to protect people from abuse and harm. They knew how to recognise signs of abuse and how to raise an alert if they had any concerns. Risk assessments were centred on the needs of the individual. Each risk assessment included clear measures to reduce identified risks and guidance for staff to follow or make sure people were protected from harm.
Accidents and incidents were recorded and monitored to identify how the risks of reccurrence could be reduced. There were sufficient staff on duty to meet people’s needs. Staffing levels were calculated and adjusted according to people’s changing needs. There were safe recruitment procedures in place which included the checking of references.
Medicines were stored, administered, recorded and disposed of safely and correctly. Staff were trained in the safe administration of medicines and kept relevant records that were accurate.
All fire protection equipment was serviced and maintained.
People’s bedrooms were personalised to reflect their individual tastes and personalities.
Staff knew each person well and understood how to meet their support needs. People told us, The staff are wonderful because they know me so well and they help me.”
Staff’s training was renewed annually, was up to date and staff had the opportunity to receive further training specific to the needs of the people they supported. All members of care staff received regular one to one supervision sessions and were scheduled for an annual appraisal. This ensured they were supporting people to the expected standards.
The Care Quality Commission (CQC) is required by law to monitor the operation of Deprivation of Liberty Safeguards (DoLS) which applies to care homes. Appropriate applications to restrict people’s freedom had been submitted and the least restrictive options were considered as per the Mental Capacity Act 2005 requirements.
Staff sought and obtained people’s consent before they helped them.
The service provided meals that were in sufficient quantity and met people’s needs and choices. Staff knew about and provided for people’s dietary preferences and restrictions.
Staff communicated effectively with people, responded to their needs promptly, and treated them with kindness and respect.
People were satisfied about how their care and treatment was delivered. One person told us, “Everyone is always so happy I wouldn’t want to be anywhere else, the care workers are lovely.” A member of staff said, “We are all part of a good team with one common goal, to keep residents well and happy.”
People were involved in their day to day care. People’s care plans were reviewed with their participation and relatives were invited to attend the reviews and contribute.
Clear information about the home, the facilities, and how to complain was provided to people and visitors. Menus and the activities programme were provided for people in a suitable format which made them easy to read.
People were able to spend private time in quiet areas when they chose to. People’s privacy was respected and people were assisted in a way that respected their dignity.
People were promptly referred to health care professionals when needed. Personal records included people’s individual plans of care, life history, likes and dislikes and preferred activities. The staff promoted people’s independence and encouraged people to do as much as possible for themselves.
People’s individual assessments and care plans were reviewed monthly with their participation and updated when their needs changed.
People were involved in the planning of activities. A broad range of activities and outings was available.
The service took account of people’s feedback, comments and suggestions. People’s views were sought and acted on. The registered manager sent annual satisfaction questionnaires to people’s relatives or representatives, analysed the results and acted upon them. Staff told us they felt valued under the registered manager’s leadership.
The registered manager notified the Care Quality Commission of any significant events that affected people or the service. The registered manager kept up to date with any changes in legislation that may affect the service and carried out comprehensive audits to identify how the service could improve. They acted on the results of these audits and made necessary changes to improve the quality of the service and care.
People said they were happy at the home and their needs were met in the ways they preferred. People appreciated that staff respected the choices they made and that they liked to be as independent as possible. People said that there were enough staff on duty to meet their needs and staff had time to spend with them individually. People said the home was 'excellent'.
People told us staff were kind, caring and respectful, they told us 'you cannot fault them', 'I'm very well looked after 'and 'they pop up from downstairs and are very kind and helpful'.
People had the equipment they needed to help them to maintain as much independence as possible and keep them safe.
People and relatives knew who to speak with if they had any concerns or complaints. The home had a clear complaints policy and any concerns were recorded and addressed.
People's needs were assessed, monitored and met. One person told us 'I couldn't walk when I came in and now they've got me walking.' People's preferences about their end of life care were respected. People were assessed for any risks associated with the care they received, equipment was provided to prevent any reoccurrence of falls.
The welfare of people who used the service was promoted by social activities. People told us 'When I was at home I couldn't get out of the house, but now I really enjoy the company' and 'There is usually something on in the afternoons, like entertainment or a quiz.'
Staff received training and support, which helped them to meet people's needs. A visitor told us 'Staff have such energy and do genuinely care.' The staff we spoke with explained what they would do if they suspected abuse and how they would protect people. A visitor told us '[My relative] feels safe here.'
People who used the service, their representatives and staff were asked for their views about their care and treatment and these were acted on. One person told us 'It's very nice here ' everything is OK.'