Archived: The Leys Residential Home

The Leys accommodates up to 20 older adults in one adapted building. There were 18 people living there at the time of the inspection, most of whom were living with dementia.

What life is like for people using this service:

• People enjoyed living at The Leys and felt safe and reassured by the support they received from staff they knew and liked.

•Staff understood how to protect people from abuse and how to report their concerns. Staff recognised the risks to people's health, safety and well-being and how to support them safely.

•People were supported by sufficient staff when needed.

•Staff recruitment processes included a check of their background to review their suitability to work at the home.

•People received support with their medicines. Regular checks were undertaken to ensure people received the correct support from staff who were competent to support them. Checks also included how the medicines were stored.

•Staff understood and practised infection control techniques.

•The registered manager ensured people's care was based on best practice and staff had the correct training to meet people's needs.

•Training was reviewed to ensure staff training was in line with current best practice.

•Staff were offered guidance and support with supervision and staff meetings.

•People were offered choices at mealtimes and staff understood which people required support and ensured they received this.

•People were supported to attend healthcare appointments. Healthcare professionals were assured that advice was correctly followed by staff and incorporated into people’s care.

•People were treated with dignity and respect and their independence was promoted.

•People and their families were involved in planning their care with support from staff.

•Staff supported people to enjoy a range of activities which reflected people's individual interests.

•People and their families understood how to complain, but felt they had not needed to complain.

•Staff felt supported within their working environment and felt part of a close knit team.

•Staff worked together with the registered manager and registered provider to ensure people's care was continually monitored, reviewed and reflected people's needs.

• The manager and staff worked with other stakeholders to improve people's experience of care.

• We found the service met the characteristics of a "Good" rating in all areas; For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection: Good (Report published March 2016)

Why we inspected: This was a planned inspection based on the rating at the last inspection. The service remained rated Good overall.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our inspection programme. If any concerning information is received we may inspect sooner.

This inspection took place on 5 February 2016 and was unannounced.

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.

People had no concerns about their safety. Risks to their safety had been identified and staff had training in how to recognise and report abuse. The registered manager reviewed accidents and incidents to look for opportunities to improve staff practices for the future.

Staff were recruited in a safe way and had relevant training and support to develop their skills in meeting people’s needs. People were cared for by staff who knew them well and responded to their needs.

People had their medicines when they needed them and staff had been trained to manage medicines safely. Staff had written guidance to support people with their medicines so that they were administered safely at the right times and in the right way.

People were able to access a range of healthcare professionals when they required specialist support and they were provided with meals which met their nutritional needs.

Staff were aware of the importance of seeking people’s consent before care was carried out. We saw staff respected people’s choices. Where people had their liberty restricted in order to keep them safe the registered manager had made sure they had acted in accordance with the law.

Staff cared for people in a kind, warm and friendly way. People and their relatives were involved in planning the care and support provided. Staff listened to people and understood and respected their needs. Staff reflected people’s wishes and preferences in the way they supported people with their care needs.

People had access to spontaneous activities. The registered provider and registered manager told us that further work was in hand to improve the regularity of fun and interesting things for people to do which were personalised to meet their individual recreational interests.

People told us that they were happy living at the home. They knew how to raise any concerns if they needed to and we saw arrangements were in place to listen and act upon any concerns. The registered manager had an open and inclusive way which encouraged staff to speak out if they had any concerns. Quality monitoring systems were in place and the registered manager had made improvements so that the home was run in the best interests of the people who lived there.

There was a registered manager who provided good leadership and supported the staff. During our inspection the registered manager took time to check that staff were alright and that people's needs were met.

We spoke with five people who lived at the home and two family members who visited on the day. We also spent time observing the care and support that people received to meet their different needs over the course of the day.

At this inspection we looked at the communal areas of the home which included the toilets, bathrooms, dining and lounge areas and on invitation from some people, their rooms.

The registered manager, deputy manager and three members of staff who told us about people's care and life at the home spent some time with us during the day.

We also looked at the care records of two people who lived at the home and various management records. These records were used to review, monitor and record the improvements made to the quality of care and support that people received.

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask:

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well led?

This is a summary of what we found.

Is the service safe?

People who lived at the home and their relatives told us that they felt safe and staff responded to their needs with minimum delays. One person told us: 'When I need them (the staff) they are there." A family we spoke with was complimentary about the care and support provided and felt that staff at the home kept their relative safe.

There was a focus on people's safety and we saw that staff assessed, identified and had taken action to reduce risks so that people were protected from harm.

We saw that staff practices reduced the risks to people from the spread and or outbreak of infections. We saw that people lived in an environment that was safe, clean and hygienic.

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. At the time of our inspection the registered manager was considering an application that may need to be made. This showed that the registered manager was aware when levels of intervention or supervision may represent a deprivation of a person's liberty. During our inspection we did not observe people being potentially restricted or their liberty being deprived by staff practices.

Following our last inspection in December 2013 we saw that improvements had been made to staff recruitment procedures that ensured people were protected from harm.

Is the service effective?

Each person had a range of care plans in place that provided information about how people preferred their care and support. The plans also included information about people's health needs and interests. Staff were able to tell us about the support and care people needed to effectively meet their individual needs which matched the information in the care plans that we looked at.

People that we spoke with were able to provide examples of care and support to meet changes in their needs or when they needed some assistance due to being unwell and or had accidentally fell. One person told us, 'They (the staff) really look after me" and "If I need a doctor one would be sent for, I have no worries about that." This showed that people's needs were effectively met in the right way and at the right time.

Is the service caring?

The atmosphere at the home was relaxed and we saw interactions between staff and people were attentive and respectful. The people we talked with told us that they had no concerns about how staff treated them. One person told us, 'I am happy here and they (the staff) are all good to me."

During our inspection staff encouraged people to be as independent as possible and to make their own decisions. One member of staff told us, 'How we care for these residents is paramount. We have a good understanding of their needs and promote their independence and respect what they would like to do.'

We saw that staff showed they cared as they treated people with respect and dignity when they supported people when they were anxious or unsettled.

Is the service responsive?

Staff worked in partnership with other professionals that supported people to receive appropriate care, treatment and support to meet their different health and social care needs.

The registered manager and staff were aware of the Mental Capacity Act 2005 and how to involve people in the decision making process if a person who lived at the home lacked the mental capacity to make a decision. We saw staff demonstrated their understanding of people's behaviour when they patiently explained options to a person and gained their understanding and consent.

During our inspection we saw that there was evidence of unplanned engagements with people and staff chatting to each other as time allowed. We also saw people had opportunities of having their nails painted. The manager was reviewing activities. This included the available time staff had for the unplanned engagements with people to ensure that these continued to be improved to promote people's wellbeing.

People told us that staff listened to their views and supported them to keep in touch with people who were important to them by way of visits.

Is the service well led?

There was evidence that the registered manager provided strong and inclusive leadership.

Staff we spoke with told us that the registered manager was approachable so that staff could express any concerns or issues they had.

People who lived at the home and family members were supported and encouraged to share both their positive experiences and areas that required improvements.

There was evidence that the registered manager acted on feedback received and made changes to practices that ensured improvements were made.

We looked at the care records for four people who lived at the home and other supporting documents. People that we spoke with were very satisfied with the care they had received. One person said: 'I like it here. You don't have to worry about anything. They are great'. A relative we spoke with said: 'As a family, we have made the right choice for X (relative) to live here. I couldn't be happier'.

We found consent had been obtained from people before care and treatment had been provided. Staff we spoke with told us they respected people's individual choices and decisions. One staff member said: 'I always offer a choice and respect what people want'.

We found people received care and support as planned according to their needs. We found staff engaged positively with people throughout our inspection.

People told us that they felt safe living at the home and knew who to speak to if they had any concerns. Staff had been trained to recognise signs of abuse and knew how to report any concerns.

We looked at the recruitment process in place. We saw that appropriate checks had not been completed before staff commenced employment.

We found that the provider had an effective system in place that monitored the quality of service that people received.

We talked with two people who used the service, a group of three relatives, three members of care staff, the cook and the registered manager.

The relatives told us that they were happy with the care and support that their relative had received. Comments included, 'Pretty impressed'. Comments from people who used the service about The Leys included, 'Can't find anything wrong with it.'

We found that staff had an understanding of how they maintained people's privacy, dignity and independence. We saw that on most occasions these principals were up held by staff.

We found that since our previous inspection staff had received training to assist them to provide care to people in an appropriate way.