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Lee Beck Mount Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 11 October 2018

A comprehensive inspection of Lee Beck Mount, took place on 19 June and 4 July 2018. This was unannounced on day one but announced on day two as we needed to make sure the registered manager was available.

Lee Beck Mount is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

At the time of registration, the care service had not been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. However, the service is now working towards developing the provision in line with these principles. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

Lee Beck Mount is situated in the Lofthouse area, near Wakefield and provides care and support for up to 13 people with learning disabilities. Local shops and community facilities are a short distance away. Accommodation is provided over two floors and with single occupancy rooms. There were 11 people living at the home on a permanent basis at the time of our inspection.

The home had 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.

In August 2016 the home was rated as requires improvement. We found the provider did not ensure people’s nutritional and hydration needs were met, medicines were not always safely managed and they did not have effective systems in place to monitor the quality of the service. We told the provider they needed to take action; we received an action plan telling us what they were going to do to ensure they were meeting the regulations. At this inspection we found the provider was still in breach of regulations for the management of medicines and good governance. We also found additional areas of concern.

Some areas of medicines were not always well managed. Quality management audits were in place but were not always effective. The audits did not identify the concerns found during this inspection, which included, areas of the care plans were not always accurate and staff had not received annual appraisals during 2017/2018. Accidents and incidents were not analysed in a way which enabled trends to be identified.

Regular safety checks took place, although, prior to our inspection the gas safety certificate had expired and the home did not have a fire risk assessment in place. Plans and evacuation equipment were in place to safely evacuate people in the case of emergencies.

Staffing levels were sufficient, although, at times one person did not receive their allocated one to one hours and an increase in staffing numbers was not put in place to cover some recent planned absence. Staff were recruited safely and completed an induction when they started work. A range of training courses had been completed by staff but, it was not always clear how often these should be renewed. Staff received regular supervision during 2018 but annual appraisals were not conducted in line with the registered provider’s policy.

The registered provider had a safeguarding policy in place and staff had a good understanding of safeguarding vulnerable adults and knew what to do to keep people safe. Risks to people had been assessed. Advocacy services were available if people, so wished.

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.

We found the home was clean, tidy and well maintained. Bedrooms had been personalised and communal areas were comfortably furnished. The home was small with ramp access and wide door areas. People were familiar with the layout of the building.

Throughout our inspection people were treated with kindness and staff had a good rapport with people. Staff clearly knew people well and worked together as a team to provide appropriate support. People’s dignity and privacy was respected and they were encouraged to maintain their independence and relationships with people who were important to them. We saw people spent time and stayed with family members both during the week and at weekends. People had access to a range of activities, both within the home and in the local community such as, going to day centres, excursions and nights out. The registered manager told us they had strong links with the local community. They said people visited the local pubs and café next to the home.

People received appropriate support for their nutrition and hydration needs to be met. People’s physical, mental health and social needs had been recorded in care plans and the registered manager told us they worked with local healthcare professionals such as, doctors and consultant psychiatrists to make sure people healthcare needs were met. They told us they attended local authority forums to share good practice to provide direction for staff to ensure care was provided in line with current guidance.

Overall, care plans contained person-centred information, although, some information was difficult to find and some required updating. We saw ‘My personal plan’ was in pictorial format and some sections had been signed by the person. We saw relevant information was shared between the staff team which, helped to ensure people received continuity of care.

There were lots of pictorial information for people to see and use and care plans we looked at recorded if people required specific communication needs. There had been no recent complaints but there was a system in place for handling complaints.

The registered provider had not ensured their rating from our last inspection was on display on their website. We dealt with this outside the inspection process.

We made a recommendation in relation to how staffing numbers were determined and the support people received and found a repeat breach of the regulation relating to good governance of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Inspection areas

Safe

Requires improvement

Updated 11 October 2018

The service was not always safe.

Some minor concerns were noted with the safe management of medicines. It was not always clear if people medicines had been administered as prescribed. which included.

Risks to people were identified, assessed and managed safely. However, some safety checks of environment required strengthening. There were no concerns with infection prevention and control. People were protected from abuse.

We saw there were sufficient numbers of staff to ensure people's care needs were met, although, one person did not always receive their allocated hours. There were effective recruitment procedures in place.

Effective

Requires improvement

Updated 11 October 2018

The service was not always effective.

Certificates showed staff had completed a range of training, but there was no guidance on when training should be refreshed. Although, staff were knowledgeable about the care and support people required. Staff received supervision during 2018 but annual appraisals had not been carried out during 2017.

People’s nutrition and hydration needs were met and people liked the food. People had access to healthcare professional when needed.

The principles of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS) were followed. Information was made available to people in accessible formats.

Caring

Good

Updated 11 October 2018

The service was caring.

We observed positive interactions between staff and people who lived at the home.

People’s privacy and dignity was respected and they were supported to be independent.

Staff involved people and/or family members in the care planning process, although, this was not always recorded.

Responsive

Requires improvement

Updated 11 October 2018

The service was not always responsive.

Care plans included information relating to people’s likes and dislikes as well as their care needs. However, some information was difficult to find and some required updating.

People were encouraged and enabled to maintain contact with those important to them and to access the local community. Activities and daily pastimes were planned in a way to match people’s interests and preferences.

There had been no recent complaints but there was a system in place for handling complaints.

Well-led

Requires improvement

Updated 11 October 2018

The service was not always well-led.

Quality systems were in place, although, these were not effective.

Regular ‘residents’ and staff meetings were held.

People knew the registered manager well and staff spoke positively about the management team.