Lanercost House

Lanercost House is a residential care home providing personal and nursing care for to up to 82 people. The service provides support to people with physical and mental health conditions, including those living with dementia. At the time of our inspection there were 67 people using the service.

People’s experience of the service and what we found:

People were safe. Monitoring and quality assurance checks were completed, including on the care provided, the premises and equipment.

People’s medicines were managed well. We made a recommendation to further enhance this.

There were enough safely recruited staff. 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 were fully supported, and the management team were well known. The staff and management team were kind, caring and responsive and promoted a person-centred ethos.

A significant refurbishment programme was underway with a further unit to be fully decorated and modernised in the early new year. Suitable infection control procedures were followed.

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

Rating at last inspection

The last rating for this service was Good published 26 June 2018.

Why we inspected

This inspection was prompted by a review of the information we held about this service. We undertook a focused inspection to review the key questions of safe and well-led only. For those key question not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

You can read the report from our last comprehensive inspection by selecting the ‘All inspection reports and timeline’ link for Lanercost House on our website at www.cqc.org.uk.

Recommendations

We made one recommendation regarding medicines management.

Follow Up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Lanercost House provides nursing and residential care for up to 82 people. It is a purpose built single story home situated in the west of the city of Carlisle. At the time of our visit there were 77 people living there.

Lanercost House is a 'care home'. People in care homes receive accommodation and nursing or personal care as 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 had a suitably qualified and experienced registered manager. 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 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.

The staff team were aware of their responsibilities under the Mental Capacity Act 2005. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

The service provided structured activities for people as well as hiring entertainment. The service intended to develop in this area and create a broader range of activities that involved the local community in which it was situated.

The staff team understood how to protect adults from situations in which they would be vulnerable to harm and abuse. Staff had received suitable training and talked to us about how they would identify any issues and how they would report them appropriately. Risk assessments and risk management plans supported people well. Arrangements were in place to ensure that new members of staff had been suitably checked before commencing employment. Any accidents or incidents had been reported to the Care Quality Commission as necessary and suitable action taken to lessen the risk of further issues. Risk assessments and care plans provided guidance for staff in the home. People in the service were involved in the creating of care plans and were able to influence the content. The management team had ensured the plans reflected the person centred care that was being delivered.

The registered manager ensured that there were sufficient staff to meet people's needs in a timely manner, at the time of our inspection the service was looking at how better to deploy their staff. Staff were suitably inducted, trained and developed to give the best care possible. We met experienced staff members who understood people's needs. We observed kind, patient and suitable support being provided. Staff knew people well. They made sure that confidentiality, privacy and dignity were maintained. Staff were suitably skilled in providing end of life care and were able to discuss good practice, issues around equality and diversity and people's rights.

Medicines were appropriately managed in the service with people having reviews of their medicines on a regular basis. People in the home saw their GP and health specialists whenever necessary. They accessed hospital appointments as a matter of routine.

We saw that an assessment of needs was in place and that the staff team analysed the outcomes of care for effectiveness. People were happy with the food provided and we saw well prepared healthy meals that staff supported and encouraged people to eat. The home itself was clean and comfortable on the day we visited. Suitable equipment was in place to support people with their mobility.

Complaints and concerns were suitably investigated and dealt with and good records management was in place in the service and there was a quality monitoring system which was used to support future planning.

Further information is in the detailed findings below.

Lanercost House provides nursing and residential care and accommodation for up to 82 older people. The home is in a residential area of Carlisle and is purpose built being divided into two units: one for people living with dementia and the other for people with mobility and health issues. All bedrooms have ensuite toilet facilities. There are accessible gardens for people to use.

The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 and associated Regulations about how the service is run.

At the time of the inspection there were 80 people living in the home. Those we spoke with told us that they felt safe living there, that staff were “kind”, and there were enough staff available when they needed them.

The home had moving and handling equipment and aids to meet people’s mobility needs and to promote their independence. The home was being well maintained. We found that all areas were clean and free from lingering odours.

We found that there was sufficient staff on duty to provide support to meet people’s individual personal care needs. Staff knew about the people they were supporting. They were aware of the choices they had made about their care and daily lives and respected their wishes.

People had a choice of meals and drinks, which they told us were good and that they enjoyed. People who needed support to eat and drink received this in a supportive and discreet manner.

Staff had received training relevant to their roles and were supported and supervised by the registered manager and the care manager. The home had effective systems when new staff were recruited and all staff had appropriate security checks before starting work.

People were able to see their friends and families as they wanted and go out into the community with support. There were no restrictions on when people could visit the home. All the visitors we spoke with told us that the manager and staff were “approachable” and that staff were “friendly” and “available” when they wanted to speak with them.

The service followed the requirements of the Mental Capacity Act 2005 Code of practice and Deprivation of Liberty Safeguards. This helped to protect the rights of people who were not able to make important decisions themselves. The service worked well with health care professionals and external agencies such as social services and mental health services to provide appropriate care to meet people’s different physical and emotional needs.

The staff we spoke with were aware of their responsibilities to protect people from harm or abuse. They knew the action to take if they were concerned about the safety or welfare of an individual. They told us they would be confident reporting any concerns to a senior person in the home.

People were asked for their views of the home both formally, using questionnaires, and on a daily basis as staff provided support and their comments were acted on. People knew how they could raise a concern about their safety or the quality of the service they received.

The provider had systems in place to ensure the delivery of good quality care.

People we spoke with were positive about the way the staff team helped and supported them. People also made the point that the staff knew them as individuals and this included their likes and dislikes. They said things like, 'Staff ask me regularly how I am." and, 'They (the staff) know all my likes and dislikes.'

The family members we spoke with said that they were very pleased with the quality of the communication provided by the home and felt that they were part of any decisions made about the care arrangements of their relative. One relative said, 'The staff remember that my mum is a person with a life before she had dementia and treat her with dignity and respect.'

We found the home to be appropriately staffed for the needs of the people living in the home. The staff team were experienced and well trained with specialist skills in caring for people with dementia. The home had developed a good working relationship with the local healthcare teams in order to ensure people had access to expert healthcare advice.

We found that accurate record keeping ensured that people were protected from the risks of unsafe or inappropriate care and treatment.

We found the home to be appropriately staffed for the needs of the people living in the home. The staff team were experienced and well trained with specialist skills in caring for people with dementia.

One person living in the home said, 'Staff are all very good at their jobs, there's not one of them you could fault.' One person's family told us, 'We were very upset that they had to go into a home but the staff did everything to involve and include us. We feel part of a team, right from the manager to the nurses and kitchen and maintenance staff and cleaners. They all take an interest in how my relative is.'

We saw that the provider had an effective system in place to identify, assess and manage the quality of the care and the environment. This meant the home was clean, tidy and well maintained.