Lomack House

We found the following examples of good practice.

A process was in place to support safe visiting at the home. This included all visitors providing a negative COVID-19 lateral flow test and proof of vaccination prior to entry to the home. In addition, screening questions were required to be completed and temperature taken and recorded by staff to be assured of COVID-19 status. Once these processes had been completed, staff would request appropriate personal protective equipment (PPE) to be worn and visitors were directed to use a dedicated entrance to the home.

Staff had received training on the safe wearing, taking off and disposal of PPE. Staff were observed wearing appropriate PPE during the inspection.

The manager told us information had been provided in a pictorial formant to support people in making decisions relating to the COVID-19 vaccination. The manager maintained a record of staff COVID-19 vaccinations and COVID-19 test results.

At the time of inspection, the home was visibly clean with no unpleasant odour. The manager told us a daily walk of the home took place which included monitoring of cleanliness and hygiene. Cleaning schedules were completed by staff and monitored by the manager.

During the COVID-19 pandemic people had been supported to maintain contact with their families and friends through the use of video and telephone calls. In addition, the staff had sent newsletters, emails and photographs to families updating them on events, celebrations and changes in COVID-19 government guidance.

Lomack House 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.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

There was a registered manager at the service. 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.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Staff knew how to keep people safe, how to respond to possible harm and how to reduce risks to people. There were enough staff who had been recruited properly to make sure they were suitable to work with people. Medicines were stored and administered safely. Regular cleaning made sure that infection control was maintained. Lessons were learnt about accidents and incidents and these were shared with staff members to ensure changes were made to staff practise or the environment, to reduce further occurrences.

People were cared for by staff who had received the appropriate training and had the skills and support to carry out their roles. People received a choice of meals, which they liked, and staff supported them to eat and drink. They were referred to health care professionals as needed and staff followed the advice professionals gave them. Adaptations were made to ensure people were safe and able to move around their home as independently as possible. Staff members understood and complied with the principles of the Mental Capacity Act 2005 (MCA). People were supported to have maximum choice and control of their lives. Staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Staff were caring, kind and treated people with respect. People were listened to and were involved in their care and what they did on a day to day basis. People’s right to privacy was maintained by the actions and care given by staff members.

People’s personal and health care needs were met and care records provided staff with clear, detailed guidance in how to do this. They were able to take part in social events and spend time with their peers. A complaints system was in place and there was information in alternative formats so people knew who to speak with if they had concerns. An end of life policy was being developed to support people and staff.

Staff worked well together and felt supported by the management team, which promoted a culture for staff to provide person centred care. The provider’s monitoring process looked at systems throughout the service, identified issues and staff took the appropriate action to resolve these. People’s views were sought and changes made if this was needed.

Further information is in the detailed findings below

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, the staff supporting them and from looking at records.

The detailed evidence supporting our summary please can be read in our full report.

Is the service safe?

Records confirmed that people's needs had been assessed before they were admitted to Lomack House. After admission to the home we found that people's needs were reassessed on a regular basis, to ensure they received the safe care they needed. Staff told us that this meant that staff had the information they needed to minimize identified risks to people.

We found that the provider had provided people with premises that were well maintained. We found effective maintenance systems and processes in place. This meant that people were cared for in an environment that was fit for purpose and safe for the people who lived there.

We saw evidence that staff had been trained in Deprivation of Liberty Safeguards (DoLS), the Mental Capacity Act 2005, and safeguarding of vulnerable adults. We found that people's mental capacity was assessed and best interest meetings, when appropriate, were held according to legal requirements. We found that associated risk assessments, with clear guidelines were in place, to ensure people remained safe and free from harm.

Care Quality Commission (CQC) monitors the operation of (DoLS) which applies to care homes. We spoke with the registered manager who demonstrated her knowledge of the procedures to follow. We saw evidence that applications had been submitted following correct procedures and proper policies relating to DoLS were in place.

Is the service effective?

People told us they were very happy with the care that they received. One person told us they were going on holiday and we found evidence to confirm this within care records and meeting minutes. Another person said, 'I always have lots to do, I am starting a new course in September at college and am looking forward to this.' We found that the delivery of care was in line with people's care plans and assessed needs.

We spoke with staff and observed some positive engagement with people. It was evident within our conversations that staff had a robust knowledge of each person's care needs and preferences.

On the day of our inspection, one person told staff that they had toothache. Staff responded to this and contacted the dental surgery, arranging an appointment for later that day. This demonstrated that the service responded in a timely manner to requests for additional health input.

Is the service caring?

We observed that staff were able to communicate effectively with people who had limited verbal communication and to meet their needs with respect and dignity.

We found that people who lived in Lomack House were supported by friendly, respectful and attentive staff. We observed staff interacting with people who used the service and noted how staff provided encouragement, reassurance and practical help, which promoted independence.

We saw that people had a choice of menu option and that if they chose not to have what was on offer, that staff would help them to find something they would enjoy. One person said, 'The food is ok here, we get to do some cooking and have a choice.'

Is the service responsive to people's needs?

Records showed that people's needs had been assessed before they moved into the home and their support plans were reviewed regularly to reflect any change in their needs. We saw that people's records included people's history, wishes and preferences and goals to be achieved. People and/or their representatives were involved with reviews of care plans and were kept informed of any changes. People had access to daily activities that included trips out, life skills (including laundry, cleaning and cooking) and holidays.

We saw that care plans and risk assessments had been updated when people's needs had changed, and that referrals had been made to other health and social care professionals when required. The service took account of individual preferences, and supported people to access a variety of activities.

Is the service well-led?

There was a registered manager in post on the day of our inspection that had support from a wide range of staff. This meant that the support systems in place facilitated staff to provide an effective level of care for people.

We found comprehensive policies and procedures that addressed every aspect of the service were in place. The registered manager operated a system of quality assurance and completed audits to identify how to improve the service. People and their relatives or representatives were consulted about how the service was run and annual survey questionnaires were sent and the results scrutinised so that actions could be taken to drive future improvement.

We observed positive engagement and interactions between staff and the person who was in the home at the time of our visit, and saw that people were treated respectfully and given choices at all times. One member of staff said. "We have choices so the people living here should."

We looked at people's care records and found these to be regularly reviewed and relevant for people's assessed needs. We spoke with three members of staff on duty who had worked at the home for a number of years. Staff were knowledgeable about people's needs and preferences.

We saw that processes were in place to safeguard vulnerable people, and staff had a good understanding about the process to take if they had concerns.

We looked at staff training and the support provided for staff and saw evidence that staff received training relevant for their role. One member of staff said, "The training gives me the skills to do the job." Staff also said they were given the opportunity to discuss issues at staff meetings.

We reviewed the quality assurance processes in place within the home and found these demonstrated the service monitored the care that was delivered to the people who used the service.

People told us they had agreed to undertake household chores to make sure the home was clean and tidy. Staff had access to training and policies on infection control practice. The premises were clean and odour free.

People said staff supported them with their medicines. We found medicines were handled safely and administered appropriately. Medication practices and records were in good order.

People told us they had a good relationship with the staff team. We found the service had an effective recruitment procedure in place to make sure staff were appropriately recruited and fit to carry out their role.

People told us they were aware of how to make a complaint. We found there was a system in place which enabled people to comment on the care they were receiving.