Lewin House

Updated 28 September 2018

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.

Our inspection took place on 12 July 2018 and was unannounced.

Our inspection was completed by three adult social care inspectors 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.

We reviewed information we already 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. We also requested information from local authorities, clinical commissioning groups (CCGs) and other health or social care professionals. We checked records held by the Information Commissioner’s Office (ICO), the Food Standards Agency (FSA) and the local fire inspectorate.

We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.

We spoke with eight people who used the service and received feedback from eight relatives.

We spoke with the registered manager, deputy manager, three registered nurses and eight care workers about people’s care. We also spoke with the kitchen assistant, chef, housekeeper and activities coordinator and two cleaners. We received written feedback from the clinical commissioning group, local authority and a commissioner.

We looked at eight people’s care records, staff personnel files, the medicines administration charts and other records about the management of the service. After the inspection, we asked the registered manager to send us further documentation and we received and reviewed this information. This evidence was included as part of our inspection.

Updated 28 September 2018

Our inspection took place on 12 July 2018 and was unannounced.

Lewin House is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. We regulate both the premises and the care provided, and both were looked at during this inspection.

The service can provide nursing care and treatment for up to 70 adults. At the time of our inspection, the service accommodated 64 people across four separate units, each of which had separate adapted facilities. Some of the units specialised in providing care to people living with dementia.

The provider is required to have a registered manager as part of their conditions of 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. At the time of our inspection, there was a registered manager in post.

At our last inspection on 10 and 11 August 2016, we rated the service “good”. At this inspection we found the evidence continued to support the rating of “good” and there was no information from our inspection, or 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.

Why the service is rated good:

We found people were protected against abuse or neglect. There were personalised risk assessments tailored to people’s individual needs. Sufficient staff were deployed to provide support to the person and ensure their safety. Medicines were safely managed. There was appropriate infection prevention and control.

At our last inspection, we found a breach of the regulations regarding obtaining and recording people’s consent to care and treatment. The service was now compliant with the requirements of the Mental Capacity Act 2005 (MCA) and associated codes of practice. People were assisted 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.

Staff received appropriate induction, training, supervision and support. This ensured their knowledge, skills and experience were relevant to their role. Access to other community healthcare professionals ensured the person could maintain a healthy lifestyle.

Staff had developed positive relationships with people who used the service and their relatives. There was complimentary feedback from people, relatives and other healthcare professionals about staff and the service. People’s privacy was respected and they received dignified support from staff.

The service provided person-centred care to people. We made a recommendation about equality, diversity and human rights training. People’s care plans were detailed and contained information on how staff could provide the right care. There was a satisfactory complaints system in place. Care of people with dementia was a strength of the service, and staff were passionate to develop this area to an outstanding level.

The service was well-led. There was a positive workplace culture and staff felt that management listened to what they had to say. The management had appropriate methods in place to measure the safety and quality of care.

Further information is in the detailed findings below.