Lytham Court Nursing Care Home

Lytham Court Nursing Home is a residential care home providing nursing and personal care for up to 33 people, who were living with dementia. At the time of our inspection 31 people were living at the home.

People’s experience of using this service and what we found.

Staff kept the building clean and tidy and maintenance checks were in place and up to date. Recent improvements to the environment were taking place with minimum disruption for the people living there. One person said, “It’s nice they keep doing the place up.” Recruitment procedures were in place and were thorough. One staff member said, “Everything was checked it was a good process to go through.” There were sufficient staff to care for people. Safeguarding training was mandatory, staff were aware of the processes to follow should they witness any abuse. Risks were assessed in detail and monitored to ensure individuals safety and promoted their independence within a risk framework. People received their medicines safely.

The management team at Lytham Court Nursing Home had auditing systems to maintain ongoing oversight and make improvements when required. Quality assurance processes ensured people were able to give their views of the service.

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 09 July 2018)

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Follow Up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Lytham Court Nursing Care Home is a residential care home providing nursing and personal care for up to 33 people, aged 65 and over who were living with dementia. At the time of our inspection, 31 people were living at the home.

People’s experience of using this service and what we found

The provider had introduced enhanced control measures in response to the covid-19 pandemic. Staff managed risks well and had plans to follow in case of emergencies. The service had systems to protect people from the risk of abuse and improper treatment.

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 7 July 2018).

Why we inspected

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to coronavirus and other infection outbreaks effectively.

We carried out this targeted inspection to follow up on specific concerns which we had received about the service. The inspection was prompted in part due to concerns received about how risks related to behaviour which may challenge were managed. A decision was made for us to inspect and examine those risks.

We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe section of this full report.

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

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Century Healthcare Ltd is registered to provide nursing care to a maximum of 33 people living with dementia at Lytham Court Nursing Care Home. The accommodation consists of 26 single and 5 double bedrooms. Communal areas include a large lounge with a dining area, a conservatory and a sensory room. There is a well-established safe garden area to the rear of the property and a garden at the front.

Lytham Court Nursing Home is a ‘care home.’ People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

At the last inspection in March 2016, the service was rated ‘Good’. At this inspection we found the service remained Good and met the all relevant fundamental standards.

We found the registered provider continued to provide a good standard of care to people who lived at the home.

At the time of inspection, 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.

The service had systems to record safeguarding concerns, accidents and incidents and took action as required. The service carefully monitored and analysed such events to learn from them and improve the service. Staff had received safeguarding training and understood their responsibilities to report unsafe care or abusive practices. The registered provider had reported incidents to the commission when required. One relative told us, “[Family member] is safe because she’s well looked after.”

People told us staff were caring and respectful towards them. Staff we spoke with understood the importance of providing high standards of care and enabled people to lead meaningful lives. One person told us, “Staff listen, make you comfortable.”

We found there were sufficient numbers of staff during our inspection visit. They were effectively deployed, trained and able to deliver care in a compassionate and patient manner. One relative commented, “The staff are always about and always checking.”

Staff we spoke with confirmed they did not commence in post until the management team completed relevant checks. We checked staff records and noted employees received induction and ongoing training appropriate to their roles. One staff member told us, “The induction training included shadowing staff. It helped me get to know the residents and their routines.”

Risk assessments had been developed to minimise the potential risk of harm to people during the delivery of their care. Care records showed they were reviewed and any changes had been recorded.

We looked around the building and found it had been refurbished, maintained, was clean and a safe place for people to live. We found equipment had been serviced and maintained as required. Staff wore protective clothing such as gloves and aprons when needed. This reduced the risk of cross infection.

Medication care plans and risk assessments provided staff with a good understanding about specific requirements of each person who lived at Lytham Court Nursing Home.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. Policies and systems in the service supported this practice.

We only received positive comments about the quality of meals provided. One person commented, “Excellent; you’re never short of food.” A second person told us, “They’re [staff] always bringing drinks around.” We observed lunch time and noted people had their meal in the dining room where they sat or in their bedroom. People told us it was their choice.

We observed only positive interactions between staff and people who lived at Lytham Court Nursing Home. We observed humour used to foster positive relationships. There was a culture of promoting dignity and respect towards people. We saw staff took time and chatted with people as they performed moving and handling procedures in communal areas.

There was a complaints procedure which was made available to people and visible within the home. People we spoke with, and visiting relatives, told us they were happy and had no complaints. One relative commented, “A very good service. I’m at ease when I’m at home knowing [family member] is well looked after.”

The management team used a variety of methods to assess and monitor the quality of the service. These included regular audits, staff meetings and daily discussions with people who lived at the home to seek their views about the service provided. In addition annual surveys were carried out for people who lived at Lytham Court Nursing Home, their relatives and staff.

Further information is in the detailed findings below.

Management review meetings were held to analyse the performance of the service and review its objectives. There was a wide range of policies and procedures in place which provided staff with clear information to guide them on good practice in relation to people’s care. We found written evidence to show that the acting manager had an appropriate system in place used to assess and monitor the quality of the service. Surveys were sent out to all the people who received a service, and other stakeholders on an annual basis. The feedback contained within the surveys showed that the service was consistently meeting its objectives. Any issues raised via the surveys had been addressed via an action plan.

The service had policies in place in relation to the Mental Capacity Act 2005 (MCA) and depriving people’s liberty, and these were put into practice. The building was found to be in a good state of repair, and the environment was found to be fit for purpose. The service had procedures in place for dealing with allegations of abuse. Staff were able to describe to us what constituted abuse and the action they would take to escalate concerns.

Employees were asked to undertake checks prior to employment to ensure that they were not a risk to vulnerable people; the records relating to these checks were complete. Risks associated with medicines management, infection control and cleanliness, and environment factors were assessed. Satisfactory control measures were in place.

People were able to express their choice in relation to meals and how they spent their time. The menu offered people a choice of meals and their nutritional requirements were met. People knew how to access the complaints process, and know who to talk to if they wanted to raise a concern. People who lived and worked at the home were fully aware of the lines of accountability at the home. Staff spoken with felt well supported by the management team. The systems operated within the home relating to how information was processed and how systems were audited was satisfactory. The systems assisted staff to identify areas of service delivery that required improvement and to mitigate risks. People were treated in a kind, caring and respectful way.

There were systems in place to ensure people were involved in their own care planning and support. The training records showed that staff had received awareness training on the subject of end of life care. If people were found to be in need of end of life care, there were systems in place to support this. Staff had access to on-going training and supervision to meet the individual needs of the people they supported. We found that measures were in place to ensure staff received update training and we saw documentary evidence to support this. We saw written evidence that staff supervision was taking place and we were satisfied that appropriate measures were in place to support the staff team.

There were systems in place to ensure people's needs were assessed, and their care planned for. The addition of one page profiles relating to each individual living at the home would allow staff to quickly see what people's needs were, the risks related to their care and what their interests were. Activities linked to people's assessed needs, abilities and interests were available.

Is the service safe? People were treated with respect and dignity by the staff. People told us they felt safe. Safeguarding procedures were in place and staff understood how to safeguard the people they supported. Systems were in place to ensure that managers and staff learnt from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. The home had policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards although no applications had needed to be submitted. Relevant staff had been trained to understand when an application should be made, and in how to submit one. The service was safe, clean and hygienic. Equipment was maintained and serviced regularly therefore not putting people at unnecessary risk. Recruitment practice was safe. Policies and procedures were in place to make sure that unsafe practice was identified and people were protected.

Is the service effective? There was an advocacy service available if people needed it, this meant that when required people could access additional support. People’s health and care needs were assessed with them, and they were involved in writing their plans of care. Specialist dietary, mobility and equipment needs had been identified in care plans where required. People said that they had been involved in writing their care plans and they reflected their current needs. People’s needs were taken into account with signage and the layout of the service enabling people to move around freely and safely.

Is the service caring? People were supported by kind and attentive staff. We saw that care workers showed patience and gave encouragement when supporting people. People at the home said that they felt their needs were very well met by the staff. One relative said that the staff were very helpful, and knew their relative very well. They added that the staff were quick to respond to requests for help. We observed the staff work with people in positive ways, giving them time to think, treating them with care and respect, and responding to their requests for help and support. We found that people's nutritional needs were met. People living at the home said that they felt safe and secure. One person said that they knew they could always turn to a staff member for help and reassurance. A relative said that they believed their loved one lived in a very safe and caring environment.

Is the service responsive? People completed various activities in and outside the service. People knew how to make a complaint if they were unhappy.

Is the service well-led? The service worked well with other agencies and services to make sure people received their care in a joined up way. The service had a quality assurance system; records showed that identified shortfalls were addressed promptly. As a result the quality of the service was continuingly improving. Staff told us they were clear about their roles and responsibilities. Staff had a good understanding of the ethos of the home and wanted to ensure it was implemented.

We reviewed the care files held for four people at Lytham Court. We found there were systems in place to ensure that people consented to the care and treatment they received. Where people were unable to give consent, we saw evidence there were some processes were in place to determine what decisions could be made in their best interests.

We saw care plans clearly identified people’s needs and included information on how they wished their care to be delivered.

People spoken with told us they received appropriate support with their medication. However we found improvements needed to be made to ensure medicines were always administered safely.

We saw evidence there were effective recruitment procedures in place to ensure that people who used the service were protected from inappropriate staff.

We found suitable arrangements were in place to manage an effective process for identifying, receiving and handling complaints for people living at Lytham Court.