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Lester Hall Apartments Requires improvement

We are carrying out a review of quality at Lester Hall Apartments. We will publish a report when our review is complete. Find out more about our inspection reports.

Inspection Summary


Overall summary & rating

Requires improvement

Updated 21 August 2018

This inspection visit was carried out on 28 June 2018 and was unannounced.

At the last comprehensive inspection in February 2017 the service was rated as Good.

Lester Hall Apartments 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 service cares for people with mental health needs. At the time of our inspection there were 30 people using the service.

There were two registered managers in post who job shared. 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.

Systems and processes did not ensure the safe management of medicines and people could not be confident they were supported to take their medicines as prescribed.

There was a lack of systems to monitor the quality of the service and identify where improvements were needed to ensure people received safe, good care as a minimum.

Procedures for controlling the risk of infection were not embedded in staff working practices and were not effective in supporting the prevention of infection for people.

Where people were at risk of poor nutrition or dehydration, records were not completed accurately or correctly to show people had received nutrition and fluids in line with their assessed needs. People were positive about the quality and choice of meals provided.

Records did not reflect that all potential risks to people had been assessed appropriate, and did not include the detail and guidance regarding the measures staff needed to take to reduce risks. Staff demonstrated a good understanding of actions they needed to take to keep people safe.

Care plans were not always updated in a timely manner and records did not consistently provide the detail and information staff needed to meet people's needs. The registered manager was in the process of reviewing and updating care plans and records.

People were protected from the risk of unsuitable staff because the provider followed safe recruitment procedures. There were enough staff available to meet people's needs as assessed in their care plans.

Staff had completed a range of training to provide them with the knowledge and skills they needed to meet people's needs. Training records were not maintained accurately or fully completed to support the effective analysis and monitoring of staff training.

People were supported to access a range of health professionals to maintain their health and well being. The service worked in partnership with other agencies to ensure people received the care and treatment they needed.

People's needs were assessed prior to them using the service. People were supported to make choices and decisions about their care. Staff understood the principles of the Mental Capacity Act 2005, sought consent before providing care and respected people's right to decline care and support.

People were treated with kindness, respect and compassion and were given emotional support when needed. Staff supported people to achieve as much independence as possible and protected people's right to privacy and dignity.

People and their relatives were involved in planning their care and were able to make changes to how their care was provided.

People had access to a range of varied activities and were supported to be involved in their local community. People maintained contact with their friends and family and were therefore not isolated from those people closest to them.

People understood how to raise concerns and complaints and were confident these would be listened to and acted on.

The registered manager and the registered prov

Inspection areas

Safe

Requires improvement

Updated 21 August 2018

The service was not always safe.

Improvements were needed to the management and administration of medicines to ensure people received their medicines safely and as prescribed.

Risk assessment records did not always include the detail and guidance staff needed to mitigate potential risks.

Systems and processes to manage the risk of infection were not robust and not consistently followed by staff.

Staff had an understanding of abuse and their responsibilities to act on concerns.

Staff were deployed in sufficient numbers to keep people safe and meet their needs in a timely manner.

Effective

Requires improvement

Updated 21 August 2018

The service was not consistently effective.

People were able to make choices and decisions about their life and staff had an understanding of the Mental Capacity Act 2005. Further improvements were needed to demonstrate how people's mental capacity was assessed and reviewed.

People were positive about the meals and drinks provided. Further improvements were needed to ensure records supported the effective monitoring of people's nutritional needs and protected people from the risk of poor nutrition.

Staff felt supported and skilled to provide effective care. Records did not always demonstrate staff had received the training they needed to meet people's needs.

Caring

Good

Updated 21 August 2018

The service was caring.

People and their relatives were involved in their care and supported to make decisions and choices.

Staff understood the importance of maintaining people's independence where possible.

People's dignity was maintained and respected.

Responsive

Requires improvement

Updated 21 August 2018

The service was not consistently responsive.

Care plans did not always included the detailed guidance staff needed to meet people's needs. Records were not consistently reviewed in a timely manner to ensure they reflected people's current needs.

People were supported to pursue a range of hobbies and interests and chose how they spent their time.

People felt confident to raise concerns and complaints.

Well-led

Requires improvement

Updated 21 August 2018

The service was not always well-led.

People could not be certain the quality of the service would be maintained because improvements that were needed to the service were not being identified.

People and relatives were positive about the culture and leadership of the service. People and staff were supported to share their views about the service.