Archived: Lelant Nursing Home

Updated 10 March 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 28 November 2016 and was unannounced. The inspection was undertaken by one adult social care inspector, one specialist advisor with a background in older people’s nursing 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.

Prior to the inspection the provider completed a provider information return (PIR). This is a form that asks the provider to give some key information about the service, what they do well and improvements they plan to make. We also reviewed information we held about the service. This included notifications we had received. A notification is information about important events, which the service is required to send us by law.

During the inspection we spoke with eight members of the staff team. This included management and care staff as well as the cook and domestic staff. We were supported throughout the inspection by the managers We also spoke with six people who lived at Lelant, six relatives and a professional who was visiting the service. After the inspection we contacted four health and social care professionals who were employed externally.

During the inspection, we looked around the building and observed interactions between people and staff. We looked at training records for all staff. We looked at six records relating to people’s care. We also viewed a range of policies and procedures, minutes of meetings, documentation relating to the maintenance of the building, quality assurance and audits and information relating to complaints.

Updated 10 March 2017

This inspection took place on 28 November 2016 and was unannounced. Lelant Nursing Home is registered to provide nursing and personal care for forty older people. At the time of the inspection, there were 22 people living at the service.

There was a registered manager in post. 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.

This service is owned by a company that is in administration. The service is therefore under the ultimate management of the Administrators, who are licensed insolvency practitioners (IP) and were appointed by the company’s director. More information about this can be found on the Companies House website. The Administrators have utilised the services of specialist operators to assist in their management of the care home, and have regularly updated people, their relatives and the Care Quality Commission about this process.

Without exception, people and their relatives told us the service was very caring. One relative said; “They go above and beyond their duties all the time”. Staff were extremely caring and treated people with kindness, compassion and affection. The service was committed to delivering outstanding end of life care, in which people’s end of life wishes were respected and where people experienced a pain free, dignified death.

There was a strong focus on delivering innovative, personalised activities for people. The registered manager was committed to forging links with the local community and ensuring that people remained visible and were active inside and outside of the service. People had taken part in a highly creative and original piece of work which helped them to share their life histories with the wider community and to learn about other generations and their experiences. There was a focus on inclusivity and empowerment.

Relatives were made to feel important and were always warmly welcomed at the service. Staff and managers were considerate towards them and ensured that they felt looked after and valued. They were treated with kindness and respect and were enabled to spend quality time with their loved ones. Relatives were kept informed of any changes and were able to have an open and honest dialogue with staff and managers. Relatives felt able to approach the managers with any issues and their feedback was sought and was highly valued.

The service was extremely well led. The registered manager valued their staff, paid attention to detail and led by example. Lelant had recently been presented with “The dignity and respect care home of the year” award, in recognition of its commitment to providing an outstanding service. There was a clear focus on sharing best practice and the management team attended a number of forums in order to learn from others. The registered manager strived towards excellence and was committed to continuous improvement and development. All of the staff said they felt valued and supported by their colleagues and the managers. Other agencies were very positive about the leadership of the service and said the staff team listened to and embraced ideas.

Systems were in place to deal promptly and appropriately to any complaints or concerns. The registered manager promoted the ethos of honesty, learning from mistakes and admitted when things had gone wrong. This reflected the requirements of the Duty of Candour. The Duty of Candour is a legal obligation to act in an open and transparent way in relation to care and treatment. Feedback on the service was sought in creative ways to ensure that everybody had their voices heard and that there was a focus on continuous learning.

The provider had a robust quality assurance system in place and gathered information about the quality of the service from a variety of sources including people who used the service, relatives and other agencies. Learning from quality audits, incidents, concerns and complaints were used to help drive continuous improvement across the service.

People were kept safe within the service, they had their medicines as prescribed and on time. People were cared for by staff who had undergone checks to ensure they had the correct characteristics to work with vulnerable people. Staff understood their role in safeguarding people and in recognising and reporting signs of abuse.

People were supported by staff who were skilled. They had received training to carry out their roles which was regularly updated and refreshed. Staff were supported by an ongoing programme of supervision, competency checks and an appraisal.

People’s consent was sought prior to staff providing them with any assistance. Staff had a sound knowledge of the Mental Capacity Act (MCA) and understood how to apply this to the care and support they provided to people. Staff understood that capacity could change over time and was decisions specific and this was reflected in people’s care records and observed in the way they interacted with people.

People’s health and social care needs were addressed holistically through access to a range of health and social care professionals. There was a structured and comprehensive approach to conditions such as diabetes and pressure care and people’s health issues were seen to improve as a result of the care they received. People’s care records were extremely personalised, contained the correct guidance for staff and recognised the person as a whole, including their social history, choices, aspirations and goals.

The service was visibly clean and infection control practices were robust. The environment was comfortable and people’s bedrooms were spacious, bright and personalised to suit their preferences. People enjoyed the meals and were offered choice. People had enough to eat and drink and feedback on the meals was extremely positive, from both people and their relatives.