We carried out a review of the data available to us about Landscore House on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Landscore House, you can give feedback on this service.
At our last inspection in January 2016 we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.
At this inspection we found the service remained Good.
Why the service is rated Good
People felt safe at the home. People told us there was enough staff to meet their needs and to spend time socialising with them. One person said “There are plenty of staff here. I leave my door open and they are always waving and stopping for a chat”. Risk assessments were carried out to enable people to retain their independence and receive care with minimum risk to themselves or others. People received their medicines safely.
People received effective care because staff had the skills and knowledge required to support them. Staff monitored people's healthcare needs and advice and support was sought from healthcare professionals when needed. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People enjoyed their meals at the home and were offered a wide variety of foods. One person said “The food is great. I get three roasts a week. I can always choose from the menu. If I didn’t like anything, I could ask for anything else”.
Staff provided a caring service to people. People told us, and we observed, that staff were kind, caring, and patient. Comments included “All the staff are lovely” and “If there’s anything I want I ask”. The atmosphere in the home was warm and welcoming and we saw laughter and warmth between people and staff. People were involved in decisions about the care and support they received.
Staff were responsive to people's individual needs. Care and support was personalised to each person which ensured they were able to make choices about their day to day lives. As the provider and registered manager were always visible in the home, people were able to talk with them if they had any concerns. Each person we spoke with told us they were happy with everything and didn’t need to complain about anything.
The service was well led. People and staff told us the management team were open and approachable. The registered manager and provider sought people's views. Comments included “5 stars plus” and “This is such a lovely home, we cannot think of any way it could be better.” The registered manager and provider had monitoring systems which enabled them to identify good practice and areas of improvement.
Further information is in the detailed findings below.
The inspection was announced and took place on 30 January 2016.
Landscore House is a small family run care home providing care and support to up to 14 people. At the time of this inspection there were 13 people living at the home. People living at the home were older people, some of whom had physical care needs related to the ageing process. Some people were at the home for a short period of recuperation or respite while others had chosen to make it their permanent home.
Landscore House has a registered manager. 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.
Feedback we received from people about Landscore House was very positive. People spoke highly of the registered manager and staff, and of how they received the care they wanted when it was needed. Staff told us this was a happy home, and they had confidence in the management. There was a positive atmosphere, and people were involved in having a say about the care and quality of their experiences. Quality management systems were in place to ensure people received a consistent high quality experience
People at the home had the capacity to make and communicate decisions for themselves, but this was being kept under review. One record regarding a best interest decision that had been made for a person was not recorded in line with the Mental Capacity Act 2005 framework, but the person was not being disadvantaged by this, as the home had taken appropriate actions to protect their rights.
People received safe and effective care that met their needs and wishes. Systems were in place to ensure that risks to people’s safety and wellbeing were identified and addressed. People had confidence in the home and told us they felt safe and secure when receiving support. People’s medicines were managed safely, and risks from the environment were assessed and minimised.
Staff were provided with training and support to ensure they had the necessary skills and knowledge to meet people’s needs, and people said they were cared for well. Changes in people’s needs were quickly recognised and prompt action taken, including the involvement of external professionals where necessary. One person told us they had improved so much since being at the home they were like “a different person”. People were supported with their health and dietary needs. They told us they enjoyed the meals which were home cooked and served with fresh vegetables.
Everyone that we spoke with told us they were treated with kindness and compassion by the providers and staff who supported them. People told us “I really can’t fault it – you hear such awful things but this place is really wonderful” and “Staff are very good. They always know what I need”. A relative told us “I have never heard a bad word said about this place. The girls do a really good job”. There were enough staff to care for people in a safe and consistent manner, and safe recruitment procedures were in place to help ensure that people received their support from suitable staff.
People told us they felt the service was based on their personal wishes and preferences. There was a programme of activities provided that met people’s interests and wishes. People had a good relationship with the staff supporting them. People had been asked about their care choices and wishes for the end of their life.
People were confident that any complaints or concerns would be managed well. Records were well maintained, including care plans, policies and procedures.
The safety of people who used the service was taken seriously and the registered manager and staff were well aware of their responsibility to protect people’s health and wellbeing. There were systems in place to ensure that risks to people’s safety and wellbeing were identified and addressed.
The registered manager ensured that staff had a full understanding of people’s care needs and the skills and knowledge to meet them. People received consistent support from care workers who knew them well. People felt safe and secure when receiving care.
People had positive relationships with their care workers and were confident in the service. There was a strong emphasis on key principles of care such as compassion and respect. People who used the service felt they were treated with kindness and said their privacy and dignity was always respected.
People received a service that was based on their personal needs and wishes. Changes in people’s needs were quickly identified and their care package amended to meet their changing needs. The service was flexible and responded positively to people’s requests. People who used the service felt able to make requests and express their opinions and views.
The registered manager was very committed to continuous improvement and feedback from people, whether positive or negative, was used as an opportunity for improvement. The registered manager demonstrated a good understanding of the importance of effective quality assurance systems. There were processes in place to monitor quality and understand the experiences of people who used the service. The registered manager demonstrated strong values and a desire to learn about and implement best practice throughout the service.
Staff were very highly motivated and proud of the service. They said that they were fully supported by the registered manager and a programme of training and supervision that enabled them to provide a high quality service to people.
Below is a summary of what we found. The summary is based on our observations during the inspection, speaking to people using the service, staff supporting them and from looking at records. If you want to see the evidence supporting our summary please read the full report.
Is the service safe?
People were treated with dignity and respect by the staff. People told us they felt safe. Safeguarding procedures were robust and staff understood how to safeguard the people they supported.
Systems were in place to make sure that the managers and staff learnt from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduced the risks to people and helped the service to continually improve. The home had proper policies and procedures in relation to the Mental Capacity Act, Deprivation of Liberty and Safeguards although no applications had needed to be submitted. Relevant staff had been trained to understand when an application should be made and how to submit one. This meant that people were safeguarded as required.
The Registered Manager set the staff rotas, they took people's care needs into account when making decisions about numbers, qualifications, skills and experience required. This helped to ensure that people's care needs were always met.
Recruitment practice was safe and thorough. No staff had been subject to a disciplinary action. Policies and procedures were in place to make sure that unsafe practice was identified and people were protected.
Is the service effective?
People's healthcare needs were assessed with them and they were involved in writing their care plans. Specialist dietary, mobility and equipment needs had been identified in care plans where required. People said they had been involved in writing them and they reflected their current needs.
Is the service caring?
People were supported by kind and attentive staff. We saw that care staff showed patience and gave encouragement when supporting people. People commented, 'The staff are always happy and helpful. They encourage me to maintain my independence which helps my confidence'.
People using the service, their relatives, friends and other professionals involved with the service completed annual satisfaction surveys. Where shortfalls or concerns were raised these had been addressed.
People's preferences, interests, aspirations and diverse needs had been recorded and care support had been provided in accordance with people's wishes.
Is the service responsive?
People regularly completed a range of activities in the home. Only one person enjoyed having trips out, other people were offered the choice of outings but declined.
People knew how to make a complaint if they were unhappy. No one we spoke to felt the need to make a complaint as they were very happy with the service they received. We looked at how complaints had been dealt with and found that the responses had been open, thorough and timely. People could therefore be assured that complaints were investigated and action was taken as necessary.
Is the service well-led?
The service worked well with other agencies and services to make sure that people received their care in a joined up way.
The service had a quality assurance system, records seen by us showed that identified shortfalls had been addressed promptly. As a result the quality of the service was continually improving.
Staff told us they were clear about their roles and responsibilities.
We spoke with four of the eleven people who lived at Landscore House, together with five staff which included two care workers, the two owners who were also the managers, and the cook.
The people who lived at Landscore House were positive about their lives at the home. One person told us 'It's very good here'. People had clear assessments of their needs and plans and strategies were in place to meet them.
We saw that staff interacted with people in a relaxed, friendly and respectful manner. Staff worked at the pace of each individual and encouraged their independence. People had access to activities such as music and movement, games, quizzes and gardening.
During our visit we toured the communal areas of the home and looked at some of the bedrooms. We saw that people's rooms were tastefully decorated, many with new carpets, clean, warm and individualised with personal effects.
We found that staff had been provided with employment contracts and declarations of fitness for their roles. Appropriate background checks had been completed on staff.
We spoke with seven of the 14 people who lived there. We saw that people were supported to carry out activities and maintain their independence.
We saw that staff involved people in their care in a relaxed, friendly and respectful manner. Staff were skilled and experienced and enjoyed warm interactions with the people who lived at the home.
During our visit we toured the communal areas of the home and looked at some of the bedrooms. We saw that people's rooms were clean and warm, tastefully decorated and individualised with personal effects.
People told us that they felt safe there. Staff had completed safeguarding training and knew how to detect and report any concerns.
Appropriate background checks had been completed on staff. However, we found that the provider did not have staff employment contracts in place or confirmation that staff were physically and mentally fit for their roles.
There were sufficient staff on duty to meet people's needs. Most records were up to date, accurate and securely stored.