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Inspection carried out on 2 January 2020

During a routine inspection

About the service

Larks Leas is a residential care home providing personal and nursing care to 21 people aged 65 and over at the time of the inspection. The service can support up to 22 people.

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

People felt safe living at Larks Leas and their relatives expressed confidence in the quality of care their family members received. People had personalised risk assessments to help reduce risks in their lives and general risk assessments were undertaken to help ensure the safety of people and visitors. There were enough staff on shift to meet people’s needs in a timely way. People received their medicines on time and as prescribed from staff with the relevant training and ongoing competency checks.

People were supported to access healthcare services when required. A health professional told us staff made appropriate referrals and followed their guidance. This helped to maintain people’s overall health and well-being. People’s dietary needs and preferences were known and met. Where there were concerns about people’s dietary intake this was closely monitored and support sought from GPs and dieticians. People told us they enjoyed the food with relatives encouraged to join family members at meal times.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. Staff consistently sought people’s consent before offering and providing support.

Staff had time to get to know people well which contributed to personalised care. Care was responsive to people’s changing needs. People and, where appropriate, relatives and advocates were involved in care review meetings. This helped ensure people could make decisions and influence the care they received.

People and relatives spoke positively about the approach taken by staff; conveying their view that staff were always kind and caring. Our observations confirmed staff engaged with people with patience and were attentive to their individual needs. People were encouraged to live their lives as they chose and to be as independent as possible.

People had the opportunity to take part in a range of group and one to one activities which recognised their abilities and interests. Relatives, friends and pets were actively encouraged to visit the home. Relatives told us they were always made to feel welcome and involved.

People were supported by staff who enjoyed their jobs and working at the home. Staff were encouraged to develop professionally and given the necessary support to achieve this. The registered manager was seen as supportive, approachable and a good listener. Staff were valued and recognised by the registered manager and directors.

The home had recognised the benefits to people of being an active part of the local community. The management had established and maintained links with a local college, pre-school and dementia alliance. This demonstrated the home’s recognition of the part it could play in supporting access to the care industry, inter-generational understanding and creating dementia friendly communities.

For more details, please see the full report which is on the CQC website at

Rating at last inspection

The last rating for this service was good (published 6 July 2017).

Why we inspected

This was a planned inspection based on the previous rating.

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.

Inspection carried out on 15 May 2017

During a routine inspection

Larks Leas care home is located on the edge of Blandford Forum town centre. The home provides accommodation and personal care for up to 24 people. At the time of the inspection there was 20 living at the home. At the last inspection on 4 December 2015 we rated the home as good.

There was no registered manager in post but a manager had been appointed and was applying for registration. 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.

We observed that staff had a good rapport with the people they supported. People appeared comfortable with staff and able to ask for their support. One person told us “ I wouldn't go anywhere else", "I am very happy here", "they (staff) always ask us what we want to do". Staff received the training required to meet people’s needs

The staff we spoke with demonstrated they knew people’s social, emotional and support needs well. They were able to tell us about people’s individual support needs, their life history, people important to them and their likes and dislikes. People told us there were sufficient numbers of staff to met their needs.

People told us they were offered a varied choice of meals and staff confirmed the arrangements for offering choice at meal times. One person told us “ There is always plenty of food as well as tea and biscuits. The menu changes all the time and we decide in advance what we would like"

The provider had systems in place to protect people from the risks associated with medicines. Medicines were managed in accordance with best practice. Medicines were stored, administered and recorded safely. People told us that staff explained what the medicines were for before dispensing them.

People were supported to access external health professionals, when required, to maintain their health and wellbeing. The other risks that people faced had been assessed and measures were in place to minimise these individual risks.

People were supported by staff who had a clear knowledge and understanding of their personal needs, likes and dislikes. Care plans were personalised to each individual and contained information to enable staff to provide consistent support. People living at the home told us they were happy with the care and support provided.

Most people who lived at the home were able to make decisions about what care or treatment they received. Where people lacked capacity to make some decisions, the staff were clear about their responsibilities to follow the principles of the Mental Capacity Act (MCA) when making decisions for people in their best interests.

The service remained 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. There was a varied programme of activities.

The service had a complaints policy and procedure which was available for people and visitors to view. People said they were aware of the procedure and knew who they could talk with.

There were systems in place to monitor the quality of the service provided by way of audits. The management had produced an action plan detailing where improvements would enhance the service provided.

Inspection carried out on 4 and 5 December 2014

During a routine inspection

People felt safe at the service and this was confirmed by comments made by people using the service and their relatives. Staff understood how to keep people safe and were well informed how to protect and safeguard people from abuse. They told us about the whistle blowing policy and how risks to people were regularly assessed and reviewed. We saw plans showing how people were kept safe in an emergency.

There were sufficient staff on duty to care for people and support their individual needs. This was confirmed by the many comments we received from staff, people who used the service and their representatives.

Medicines were administered safely and we observed staff checking that people received the correct medicine at the correct time according to their prescriptions and medicine administration records (MAR).

Staff were aware of the Mental Capacity Act 2005 and how this affected the care people received. They described how agreement was sought from people and or their representatives and understood the importance of gaining agreement t before carrying out care or treatment. The registered manager had knowledge of the Deprivation of Liberty Safeguards (DoLS). These safeguards aim to protect people living in care homes and hospitals from being inappropriately deprived of their liberty. They understood the procedure and application process involved when requesting an assessment for DoLS and were aware of how to uphold these decisions.

Staff were knowledgeable about the support needs of people living at the home. We observed staff communicating effectively when talking with people and their families. Staff commented on how they were supported through induction and spoke about the training they received which helped them to understand people’s needs. Records showed that staff met with the registered manager to discuss their skills, learning needs and performance.

People told us they were offered sufficient food and drink and we observed people being supported to eat their meals and enjoy their food in comfort.

Everyone said that staff demonstrated care, kindness and compassion and the staff understood their needs. Staff helped people, displaying an empathetic approach to those they supported, encouraging people to be involved in making decisions about their preferences. Staff carried out their duties while protecting people’s dignity and respected their privacy by closing doors and knocking on doors before entering.

Staff provided examples of the personalised care they provided. People were given choices and were encouraged to be involved in activities and other events offered at the service. Relatives told us that they felt confident to talk with the registered manager if they had any concerns but all those we spoke with also talked about the high standards of care they received.

The registered manager fostered an open and honest culture at the home. Relatives felt confident to approach staff who were friendly and receptive. Staff told us they felt supported and encouraged by the registered manager and surveys were used to gain feedback on the quality of the care and service improvements. Checks were used to identify service short falls and to make the necessary changes required.

Inspection carried out on 30 October 2013

During a routine inspection

People told us that they understood the care choices available to them, and could have their views taken into account in the way their care was delivered. A person told us, "The staff and manager are all very approachable.� Another person told us, �The food is very good. We get choices.�

We found that people's needs were assessed, and care was planned and delivered to meet people's needs. A person told us, "I�ve got a care plan which I can see if I want to." People's care was regularly reviewed and their personal information was held securely.

We looked at people's medication records. We saw that people were protected from the risks associated with the unsafe use and management of medicines, as the home had medication management procedures in place that were followed in practice. A person told us, "I've never had any problems with my medication."

We saw that the home had records of when staff had received supervision�s and appraisals. Staff told us they were well supported and that they received training opportunities.

The home had systems in place to regularly assess and monitor the quality of its services.

Inspection carried out on 21 January 2013

During an inspection looking at part of the service

At our inspection of Larks Leas in October 2012 we found that records of people's weight and risk of malnutrition were not maintained properly. This put people at risk of not receiving the care they needed.

The provider wrote to us in December 2012 to tell us about the action they had taken to ensure that records about people's weight and nutrition were accurate and complete. We carried out this inspection to check that the home was now compliant with the law and accurate and appropriate records about people's care were maintained.

We found that improvements had been made to ensure there were appropriate records about people's weight and nutrition risks. Records were kept under regular review and were up to date. A system was in place to ensure the manager of the home was kept informed of any changes in people's weight or nutritional needs which helped ensure that appropriate action was taken about any concerns. This meant that people were protected from the risks of inappropriate care.

We did not speak with people who lived in the home at this inspection as the purpose of the inspection was to check that the home was compliant with the law about records. We spoke with people who lived in the home at our last inspection. Please see our previous inspection report, published on 3 December 2012, for information about what people told us about Larks Leas.

Inspection carried out on 8 October 2012

During a themed inspection looking at Dignity and Nutrition

People told us what it was like to live at this home and described how they were treated by staff and their involvement in making choices about their care. They also told us about the quality of food and drink available. This was because the inspection was part of a themed inspection programme to assess whether older people living in care homes are treated with dignity and respect and whether their nutritional needs are met.

The inspection team was led by a CQC inspector who was joined by an Expert by Experience (people who have experience of using services and who can provide that perspective). We talked with five people in the home and observed the care and support provided to them, and others. We did not use the Short Observational Framework for Inspection (SOFI) at this inspection because people we met were able to tell us about their experiences of living at Larks Leas. SOFI is a specific way of observing care to help us understand the experience of people who cannot talk with us.

We talked with five people who lived in the home. They told us that staff treated them with respect and promoted their dignity when providing their personal care. For example, one person told us: "They are always discreet. My carer closes the door and closes the curtains." Another person described how staff promoted their independence and privacy by helping them get into the bath but then leaving the room for a few minutes so they could wash by themselves.

People told us they were able to make choices about their care. One person commented that they could choose where they ate their meals: "I used to go in the dining room but I don't now. I choose to stay in my room." People also reported that they could choose how they spent their time in the home, for example, whether they wanted to participate in organised group activities or not.

All five people we spoke with reported that they had not seen the care plans that had been written by the home about their care.

People who lived in the home spoke positively about the food they were given. One person commented: "We have good food, nicely served. On the day, I pick what I want to eat. In fact, there is too much food and drink...I can't eat it all." Another person told us: "When I decide to try and lose a bit of weight, the cook gets me special meals. They are very good." People told us they were given drinks regularly throughout the day with cake or biscuits as snacks.

People who lived in the home told us that they were treated well by staff and felt safe living in the home. One person commented: "I was quite poorly at the weekend. Two of the carers were fantastic and they do that little bit extra for me. I feel so safe here." Another person told us: "There are no restrictions here, you can do what you want."

All five people we spoke with said they had never felt the need to complain about their care but would feel confident talking with staff if they had any concerns.

People who lived in the home told us there were enough staff to help them when they required assistance. For example, one person told us that their call bell was answered immediately by staff. Another person told us there were enough staff available to come and talk to them in their room which was important to them.

People spoke highly of the care workers who supported them. They told us that new staff were shown what to do by a more experienced care worker and were mentored until they gained confidence in their role. Their comments included: "The staff are lovely"; "They are very good"; and "The staff understand me - we have a laugh."

Although the feedback we received from people who lived in the home was positive, we identified some shortfalls in relation to record-keeping about nutrition risks for people who lived in the home. Some gaps and inaccuracies in these records meant that people were not always fully protected from the risks of inappropriate care and treatment.

Reports under our old system of regulation (including those from before CQC was created)