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Archived: Lound Hall Good

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Reports


Inspection carried out on 4 September 2015

During a routine inspection

Lound Hall is a care home providing nursing care to a maximum of 43 people. At the time of our visit there were 38 people using the service.

The inspection was unannounced and took place on 4 September 2015.

The home had a registered manager in place. 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 requirements in the Health and Social Care Act 2008 and associated regulations about the service is run.

People told us they felt safe and secure living at the service and one person said the staff made them feel, “Comfortable,” and, “Secure.” There were systems in place to reduce the risks to people and protect them from avoidable harm.

The service had in place robust recruitment procedures which ensured that staff had the appropriate skills, background and qualifications for the role. People told us they were confident in the skills and experience of staff. There were enough suitably trained and supported staff available to support people during our inspection.

People told us they received their medicines when they needed them. There were robust systems in place to ensure that medicines, including controlled drugs, were stored and administered safely.

Staff told us they felt supported by the manager of the service and the managing director. They said that the training they received provided them with a good understanding of topics such as the Deprivation of Liberty Safeguards (DoLS). People spoke highly of the staff and told us they were, “Completely comfortable,” raising concerns or issues with them.

The service was complying with the requirements of the Mental Capacity Act (2005) and the DoLS. Appropriate DoLS applications had been made where required, and assessments of people’s capacity were completed appropriately.

People were supported to engage in meaningful activity which they enjoyed individually. At the time of inspection the service was recruiting a new staff member to coordinate activities within the service.

People were positive about the care they received from staff. People and their relatives had input into the planning of their care. Staff demonstrated they knew people they cared for well.

There were systems in place to monitor the quality of the service and to identify shortfalls or areas for improvement. There was an open culture at the service. People using the service, their relatives and staff were given the opportunity to express their views and these were acted on by the service. There was a complaints procedure in place and people told us they knew how to make a complaint if they weren’t happy.

Inspection carried out on 19 August 2013

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

We carried out this inspection to see whether changes the provider told us they would make to address concerns found at our inspection on 24 April 2013 had been made.

We found that the improvements that they told us about had been introduced.

We saw that good guidance on cleaning different areas was in place. When we checked toilets and commodes we found these to be clean.

We found that a move to a new pharmacist had resolved the problem of excessive stocks of some medicines. Guidance had been put in place regarding the administration of medicines that were needed on an occasional basis. The deputy manager confirmed that risk assessments would be carried out, and records put in place when there were people who managed some of their own medication.

We looked at care records for people with diabetes and found that they were all complete. Guidance was in place for supporting people who became anxious or agitated with the strategies that worked best for each person being clearly laid out.

Inspection carried out on 24 April 2013

During a routine inspection

As part of our inspection we spoke with six people who used the service and three people’s relatives.

One person told us, “They could answer the bell a bit quicker but the staff are very good.” Another person told us, “They’ve been very good to me and looked after me well but I don’t like not having a toilet in my room.” One person’s relative said, “All of the staff seem very happy in their work.”

We found that people expressed their views and were involved in making decisions about their care and treatment. We also found that people’s needs were assessed and care and treatment was planned and delivered in line with their individual care plan.

There were not always effective systems in place to reduce the risk and spread of infection.

Appropriate arrangements were not always in place in relation to the risks associated with the unsafe use and management of medicines. However we also found that there was evidence that learning from incidents and investigations took place and appropriate changes were implemented.

During our review of care records in relation to people with diabetes we found that people did not always have proper information about their care and treatment recorded.

Inspection carried out on 10 December 2012

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

We conducted our inspection to follow up on issues we raised during our inspection visits of 26 June 2012 and 16 October 2012 when we issued a warning notice in relation to medicines management.

During this inspection we looked at how information in medication administration records and care notes for people living in the service supported the safe handling of their medicines. We found there to be improvements since the previous inspection and that the requirements of the warning notice had been met. However we highlighted areas the provider should note for further development in relation to the management of medicines.

Inspection carried out on 12 November 2012

During a routine inspection

We spoke to four people using the service and four visitors. They all told us that they or their relative were being well cared for in Lound Hall. One person said: "My relative used to need a hoist when they were first admitted, but now they can walk around the room and take themselves to the toilet." Care plans had been improved since our last scheduled inspection to ensure that information about changes to a person's needs was carried forward to all aspects of their care plan. There were opportunities for people to make choices about their care, their meals, their activities and whether they stayed in their room or not. One person told us: "I choose to stay in my room. It suits me."

Care needs were assessed and action taken when changes were needed. Outside specialists were asked for advice, for example if a person showed a pattern of falls.

The provider had safeguarding policies and training to ensure people were protected from abuse.

Staffing numbers were appropriate for the current needs of those in the service. The provider had made changes to staffing to reflect the needs of the service.

Records were up-to-date and kept secure and confidential.

Inspection carried out on 16 October 2012

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

We found the provider had made some progress in putting in place arrangements to ensure medicines are managed safely for people living at the service. However we found that an audit put in place to monitor medication records and administration was inaccurately completed and so ineffective. We conducted an audit of medicines against records of their receipt and administration and found there to be numerical discrepancies where we could not account for medicines. Therefore records did not confirm that people were being administered their medicines in line with the intention of prescribers.

Inspection carried out on 26 June 2012

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

We did not talk to people about their medicines during this inspection visit.

Inspection carried out on 25 June 2012

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

People told us that they liked living at Lound Hall. A person staying there for respite care said "I would not come back if I did not like it." One person told us that they went up to their room at 4pm "As I like to get ready for bed then, but I do go to bed until about midnight." Two people told us that the food was good and there was plenty of it.

Inspection carried out on 25 January 2012

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

During a visit to the home people who use the service told us that they enjoyed there. One person told us that they had been looked after very well and nothing was too much trouble. During the visit we spoke with three people using the services. One person told us that they liked “very much” being at the home and that they would not want to improve anything about living there. Another person told us that staff were “always very nice to me”, that they “get on with other residents” and were “very happy” living at the home.

Inspection carried out on 26 April and 15 September 2011

During a routine inspection

People who use the service that were spoken with told us that they generally feel safe in the home and that staff are kind and helpful.

They told us that there are some activities planned but they are not individualised and at times do not happen. They stated that they do not go out on trips, but they have television but no access to Sky DVD's or videos.

They confirmed that the food is very nice. They stated that the staff do not go through their individual care programmes with them.