Layden court Care home

Updated 2 March 2024

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

The inspection team consisted of 2 inspectors, a regulatory co-ordinator, and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Layden court is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced. Inspection activity started on 21 November 2023 and ended on 24 November 2023. We visited the home on both days.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We received feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 7 people who used the service and 11 relatives about their experience of the care provided. We spoke with 14 members of staff including the registered manager, deputy managers, nurses, senior care workers, care workers, ancillary staff, and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We reviewed a range of records. This included 9 people’s care records, medication records and weight records. We looked at two staff files in relation to recruitment and staff supervision. We reviewed a variety of records relating to the management of the service.

Updated 2 March 2024

About the service

Layden Court is a care home. The service can accommodate up to 92 people in a purpose-built building and provides personal and nursing care for older people, including people living with dementia. There were 49 people using the service at the time of the inspection.

People’s experience of the service and what we found

Risks associated with people's care were not always managed in a safe way. People's care records did not accurately reflect their needs. Risks to people had not been fully assessed and there was not always guidance for staff on how best to manage these risks.

Incidents and accidents were not always recorded in detail or investigated to reduce further risks. Medicines were not being managed safely. People were not always protected from the risk of abuse or neglect as staff were not always reporting or investigating allegations.

The registered manager completed a dependency tool and a staff rota. However, staff were not effectively deployed to meet people's needs.

Staff had received mandatory training but required further training in relation to dementia care and the management of behaviour that may challenge the service. Staff told us they felt supported, and management were approachable.

People were not always supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; we were not assured the policies and systems in the service supported this practice.

There was a lack of robust management oversight to ensure the quality of care. The provider had increased the management presence in the service and was working on making and embedding improvements. The provider operated effective and safe recruitment practices when employing new staff.

People had access to health care when needed and assessments of people's care were undertaken before they moved in. People told us they enjoyed the food served at Layden Court. Staff were kind and caring in their interactions with people, where time allowed this.

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 17 March 2023).

Why we inspected

The inspection was prompted due to concerns received from the local authority commissioners. These were regarding systems to safeguard people from abuse, safe care and support and ineffective governance and management of the service.

We undertook a focused inspection to review the key questions of safe, effective, and well-led only. For those key question not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for Layden Court on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to safe care and treatment, staffing, systems and processes to safeguard people from abuse and oversight and governance at the service.

Please see the action we have told the provider to take at the end of this report.

Full information about CQC's regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Special Measures

The overall rating for this service is 'Inadequate' and the service remains in 'special measures'. This means we will keep the service under review and, if we do not propose to cancel the provider's registration, we will

re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service.

This will usually lead to cancellation of their registration or to varying the conditions the registration. For adult social care services, the maximum time for being in special measures will usually be no more than12 months. If the service has demonstrated improvements when we inspect it, and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.