Larchfield House

Updated 16 May 2019

The inspection: We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team: The inspection was carried out by two inspectors and one expert by experience on the first day and one inspector on the second day. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type: Larchfield House 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. The home accommodates up to 75 people across four separate units, known as communities, each of which has separate adapted facilities.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection: The inspection was unannounced on 26 March 2019. We informed the registered manager we would return on 28 March 2019.

What we did: Our inspection was informed by evidence we already held about the service including notifications we received about significant events. We checked for feedback we received from members of the public, local authorities, records held by Companies House and the Information Commissioner's Office (ICO). We did not ask the provider to update their Provider Information Return for this inspection. This is information providers must send us to give us key information about the service, what it does well and improvements they plan to make.

We spoke with seven people who use the service and ten relatives. We observed staff supporting people at lunch time in the dementia suite and in the main dining room. We observed staff interactions with people throughout our visit and during structured activities. We spoke with the registered manager, two care workers, three team leaders, four nurses, the chef, the governance, clinical services, wellbeing and administration managers. We spoke with two healthcare practitioners and a commissioner and received email feedback from the safeguarding local authority, quality monitoring team and the clinical commissioning group (CCG).

We reviewed parts of twelve people's care records including care plans, risk assessments and medicines administration records and other records about the management of the service. After our inspection, we asked the registered manager to send us further documents which we received promptly and reviewed as part of our inspection.

Updated 16 May 2019

About the service: Larchfield House provides purpose-built accommodation and personal care with nursing to 75 people in four separate units, known as communities. The home provides a service to older people and people living with dementia. At the time of our inspection there were 74 people using the service.

People's experience of using this service: The service met characteristics of Good in all areas. The provider was following safe protocols for the receipt, storage, administration and disposal of medicines. The service ensured care plans with regards to medicines were up-to-date and accurate. Staff were recruited safely and there were enough staff rostered and deployed to meet peoples needs safely. The service completed checks and remedial work to ensure the environment was safe.

Care planning documentation identified people’s diverse needs, preferences and choices. The service responded to people’s changing needs and involved relatives and other professionals where relevant. Complaints were investigated, outcomes shared and apologies issued to people when things went wrong. Where people were at the end of life, their wishes were identified and respected by staff.

The registered manager understood their duty to be open and transparent and notified other agencies of events and issued apologies where relevant. The service had quality assurance processes to measure, document, improve and evaluate the quality of care. The registered manager provided strong leadership to a motivated staff team who felt valued.

The home had undergone refurbishment and replaced flooring and created a café which improved the environment and social opportunities for people using the service. Staff received appropriate training and support to ensure they could carry out their roles effectively. 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.

Staff demonstrated compassion and respected people’s preferences and decisions. People and their relatives were valued and involved in people’s care and the development of the service.

Rating at last inspection: At the last inspection the service was rated Requires Improvement (21 March 2018). Following the last inspection, we met with the provider and asked them to complete an action plan to show what they would do and by when to improve the key questions Safe, Responsive and Well-led to at least Good. At this inspection we found these key questions had improved to Good.

Why we inspected: This was a scheduled inspection based on the previous rating.

Follow up: We will continue to monitor the service to ensure that people receive safe, high quality care.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk