We carried out a review of the data available to us about Valmar Care t/a Locharwoods of Birkdale 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 Valmar Care t/a Locharwoods of Birkdale, you can give feedback on this service.
We found the following examples of good practice:
• Staff were wearing the required levels of personal protective equipment (PPE) and they disposed of used PPE safely and in line with the relevant guidance.
• Measures were in place to minimise risk, including staff changing from their outdoor shoes at the start of a shift and uniforms laundered in the home.
• The home had a testing programme in place ensuring that people living at the home and staff were tested regularly.
• Staff supported family and friends to safely visit their loved ones, including the use of a 'cuddle wall' outdoors in warmer weather.
• Staff and people living at the home were supported to isolate when necessary.
• The layout of communal areas in the home had been adjusted to ensure social distancing could be maintained. For example, chairs in the lounge areas had been moved further apart.
• The premises were clean and hygienic. Frequent cleaning was carried out throughout the day.
• The home sought the views of family and friends through a COVID-19 feedback survey so they could use this feedback to make improvements if needed.
At our last inspection 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.
Everyone who lived in the home said they felt safe. There were robust measures in place to ensure people were safe. Risk assessments were in place for areas such as pressure care, safe environment, falls and mobility, and nutrition and hydration.
There were sufficient staff on duty to meet people's needs. Staff rotas showed a consistent number of staff were on duty each day. People told us call bells were answered within a reasonable time.
Staff had been appropriately recruited to ensure they were suitable to work with vulnerable adults. We found that staff had the skills, knowledge and experience to support people effectively and safely.
Staff were supported by the registered manager through regular supervisions, annual appraisal and regular training. Staff had attended training in subjects such as first aid, fire safety, food safety, safeguarding and medication. New staff were required to complete an induction. Staff meetings were held regularly.
Medicines were managed safely and people received their medicines as prescribed. Staff had been trained to administer medicines to ensure errors were kept to a minimum.
The home was very clean and there were no odours. The home was well maintained and in good decorative order. People's bedrooms were personalised and were decorated and furnished to a high standard.
Regular checks and tests, such as gas, electricity, water safety, fire drills, fire alarm tests and external checks of firefighting equipment, were completed to maintain safety in the home.
People's needs were assessed and reviewed regularly to reflect their current health and support needs. People were supported to maintain healthy lives; records showed that people were supported to attend medical appointments.
People were supported to eat and drink enough to maintain a balanced diet and meet their dietary requirements. Drinks were offered at various times throughout the day to ensure people's hydration needs were met. Staff understood people's individual nutrition and hydration needs and we saw that meals were provided accordingly.
Everyone living in the home was very complementary about the attitude of the staff and the way they were treated. Staff showed kindness towards the people in the home. It was clear from the banter and laughter that people were comfortable with staff and enjoyed their support.
Staff supported people to make decisions about their care, support and treatment. Staff showed a good understanding of people's likes and dislikes and preferred routines. This information was recorded in people’s care records.
People and their family members were involved in the planning of their care and family members kept up to date with matters relating to their relative's health and welfare.
There was a complaints policy in place, which was displayed in the home. No complaints had been made since the last inspection.
Activities were planned each day and took place mostly each afternoon.
Quality assurance audits were completed by the registered manager and senior care staff which included, medication and health and safety.
There was a process completed annually where people in the home and their relatives had the opportunity to voice their opinions about the service. ‘Resident/ relatives meetings’ took place regularly to enable people to meet with the registered manager on a regular basis.
There was a caring, person-centred, and open culture in the home. The manager and registered provider met their legal requirements with the Care Quality Commission (CQC). They had submitted notifications and the ratings from the last inspection were clearly displayed in the home.
Further information is in the detailed findings below.
Valmar Care t/a Locharwoods of Birkdale provides accommodation and personal care for up to 19 older people. Accommodation is provided in 19 single rooms, all of which have an en-suite facility. Communal space is provided in a lounge, conservatory and dining room. There is a small car park at the front of the building. At the time of the inspection 18 people were living at the home.
A registered manager was 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.
People’s medication was not always stored and administered in accordance with good practice. In one case we saw that some medicines had been prepared for dispensing, but had not been taken by the person. The medicines had not been safely disposed of or correctly recorded.
At the previous inspection we identified a breach of regulation because care records and risk assessments had not been updated following a significant incident. We saw evidence that risk was assessed and reviewed on an individual basis each month. The home was no longer in breach of this regulation.
At the previous inspection we identified a breach of regulation in relation to obtaining consent to care. This related primarily to the use of bed-rails. During this inspection we looked at care records and spoke with people living at the home. It was clear that people had been asked about the use of bed rails as part of regular, general discussions about their care. The home was no longer in breach of this regulation.
The people that we spoke with and their relatives told us that care was delivered safely. There’s always someone there keeping a check on people. During the course of the inspection we saw that staff provided care in a safe manner and were vigilant in monitoring risk. People were clear about what they would do if they were being treated unfairly.
Accidents and incidents were accurately recorded and were subject to assessment to identify patterns and triggers. Records were sufficiently detailed and included reference to actions taken following accidents and incidents.
The home had produced a personal emergency evacuation plan (PEEP) for each person living at the home and had conducted regular fire drills and fire alarm testing. Fire safety equipment was tested by external contractors annually and by the home on a regular basis. Other essential safety checks, for example, gas safety and electrical safety were completed annually. Moving and handling equipment was serviced and inspected in accordance with the appropriate schedule.
Staffing numbers were adequate to meet the needs of people living at the home. The provider based staffing allocation on the completion of a dependency tool. We were provided with evidence that this information was reviewed following incidents where new behaviours were observed which might increase or change the dependency for care. The home recruited staff following a robust procedure.
Staff were suitably trained and skilled to meet the needs of people living at the home. The staff we spoke with confirmed that they felt equipped for their role. The training records and staff certificates showed that the majority of training required by the provider was in date.
The records that we saw showed that the home was operating in accordance with the principles of the Mental Capacity Act 2005. However, the recording of decisions regarding capacity was sometimes unclear.
The food was well presented and nutritionally balanced. People’s preferences, allergies and health needs were recorded in a file and used in the preparation of meals, snacks and drinks. People gave us mixed views on the quality of the food. People told us that they were offered plenty of drinks throughout the day.
Most of the people that we spoke with had a good understanding of their healthcare needs and were able to contribute to care planning in this area. People had access to a range of community healthcare services.
Throughout the inspection we saw staff engaging with people in a positive and caring manner. Staff spoke to people in a respectful way and used language, pace and tone that was appropriate to the individual. People’s privacy and dignity were respected throughout the inspection. We saw that staff were attentive to people’s need regarding personal care.
People were involved in discussions about their care which was regularly reviewed. All of the people living at the home that we spoke with told us they received care that was personalised to their needs. We observed that care was not provided routinely or according to a strict timetable.
Quarterly meetings were held for people living at the home where important information was shared and people’s views sought. Records indicated that people had been asked for their views on the quality of care, menus and activities.
Information regarding compliments and complaints was displayed and the registered manager showed us evidence of addressing complaints in a systematic manner.
The registered manager facilitated regular staff meetings and staff told us that they were confident about speaking out and making suggestions. We saw evidence that changes had been made following these meetings.
Staff understood what was expected of them and were motivated to provide good quality care. We saw that staff were relaxed, positive and encouraging in their approach to people throughout the inspection.
The provider had systems in place to monitor safety and quality. They completed a regular audit which included information that was fed-back to the staff team. We saw that the audit process was basic and did not produce a detailed record. The audit process did not provide an opportunity to benchmark the quality of the home and monitor improvement.
Locharwoods is registered to provide residential care for up to 19 older people. Eighteen people were living at the home at the time of our inspection. Accommodation is provided in 19 single rooms, all of which have an ensuite bathroom. Communal living areas include a lounge, conservatory and dining room. There is a small car park at the front and an enclosed garden at the rear of the building. The home is situated in a residential area of Southport, close to shops, amenities and local bus and train routes.
A registered manager was 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.
People were kept safe because there were arrangements in place to protect them from the risk of abuse. People said they were supported in a safe way by staff. Staff understood what abuse was and the action to take should they report concerns or actual abuse.
CQC is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS). The manager had knowledge of the Mental Capacity Act 2005 and their roles and responsibilities linked to this. They were able to tell us what action they would take if they felt a decision needed to be made in a person’s best interests. At the time of our inspection no one was subject to a DoLS.
Each of the people who lived at the home had a plan of care. The care plans we looked at contained relevant and detailed information to ensure staff had the information they needed to support people in the correct way and respect their wishes, likes and dislikes.
A range of risk assessments had been undertaken depending on people’s individual needs. Risk assessments for the use of bed rails were in place. However, consent had not been sought from the person themselves or if lacking capacity to make a decision relatives/significant others had not been consulted regarding the use of this equipment. You can see what action we told the provider to take at the back of the full version of this report.
Risk assessments and behavioural management plans were not in place for people who presented with behaviour that challenges and staff did not have guidance to keep themselves and other people who lived in the home safe. You can see what action we told the provider to take at the back of the full version of this report.
People told us they received their medication at a time when they needed it. We observed the administration of medication by suitably trained staff. We saw that staff that ensured people took their medication by waiting with them. Medication was stored safely and securely.
People said they felt listened to and involved in the running of the home. They met with staff approximately twice a year to make decisions usually about meal and activities. We saw minutes from these meetings. The manager also produced a quarterly newsletter for people and their relatives to keep them informed of forthcoming events and changes to the home.
A variety of activities were arranged for people in the home throughout the week. These included board games, chair exercises and bingo. Some people were supported to maintain their hobbies and interests, such as reading, painting, football, card games and knitting. Some people accessed to the local community themselves or with family and friends.
During our visit we observed staff supported people in a caring manner and treated people with dignity and respect. Staff knew people’s individual needs and how to meet them. We saw that there were good relationships between people living at the home and staff, with staff taking time to talk and interact with people. People told us they were happy at the home, and our observations supported this. People we spoke with gave us positive feedback about the staff team.
A procedure was in place for managing complaints and people living there and their families were aware of what to do should they have a concern or complaint. We found that complaints had been managed in accordance with complaints procedure. A copy of the procedure was displayed in the foyer of the home.
The home was well run by the manager and the building was clean and well maintained. We found audits/ checks were made regularly to monitor the quality of care provided and ensure it was safe.
Staff had been appropriately recruited to ensure they were suitable to work with vulnerable adults. Staff were only able to start work at the home when the provider had received satisfactory pre-employment checks. People told us there was always enough staff on duty to support them as they needed.
Staff told us they felt supported in their roles and responsibilities. Staff received an induction and regular mandatory (required) training in many topics such as health and safety, infection control, first aid, fire safety, food hygiene, medication administration, moving and handling, and safeguarding adults. Senior care staff and managers had completed training in medication administration, dementia care, person centred care and the Mental Capacity Act (2005) and Deprivation of Liberty Safeguards (DoLS). Records showed us that they were up-to-date with the training. This helped to ensure that they had the skills and knowledge to meet people’s needs.
Systems were in place to check on the quality of the service and ensure improvements were made. These included surveying people about the quality of the service and carrying out regular audits on areas of practice.
We observed people taking lunch in the dining room. We found this to be a relaxed activity, with staff on hand to offer assistance when needed. People who had specific dietary requirements were having their nutritional needs met and staff were aware of clinicians in the community who could offer further specialist advice regarding nutritional support. People confirmed their feedback regarding meals was recognised. One person told us they asked staff not to put too much food on their plate and that this had been noted. This person also told us that staff asked if the portion given was enough.
We found the premises to be maintained to a good standard. However, some work in the kitchen was required and this was being planned at the time of our visit. Plans were also in place to replace a carpet in the main lounge, which showed signs of wear and tear.
We checked the complaints policy of the provider. We found this was clearly written, accessible and easy to understand. People told us they would raise any concerns with the manager if they were unhappy.
People's care was planned and delivered in accordance with their needs. People had individual care plans which were supported by a series of risk assessments and daily care records. This meant people's care could be readily monitored and evaluated.
Staff had an understanding of safeguarding procedures and knew who to contact in the event of a concern.
Staff were provided with appropriate training and received regular supervisions and an annual appraisal of their work performance. This meant the staff were well supported in their roles.
We found there were appropriate systems to monitor the quality and operation of the service, which included annual customer satisfaction questionnaires and regular residents' meetings. This meant people were able to influence the operation of the home and the future development of the service.