Landemere Residential Care Home is a residential care home providing personal care to up to 41 people. The service provides support to older people, some who may be living with dementia. At the time of our inspection there were 36 people using the service.
People’s experience of using this service and what we found
Risk management and safety monitoring had improved since our last inspection, however, there were still some gaps. The provider’s governance and oversight arrangements and related service improvements were therefore not yet consistently demonstrated as fully embedded and sustained.
Care plans did not always reflect relevant information about people’s care needs and changes to these. Proactive measures staff were to take to ensure their safety were not always recorded in people's care plans.
Overall staff were effectively trained and supported to provide people’s care. However, the provider was still working to ensure all care staff completed first aid training. Care staff worked with other agencies to help people receive the healthcare support they needed. People’s needs were assessed to help them receive effective care and people received enough to eat and drink. The premises had been adapted and personalised to help meet people’s needs.
People were supported to have maximum choice and control of their lives and were supported in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. However, records did not always show how some restrictions used to help keep people safe had been considered under the mental capacity act and best interests decision making processes.
The provider had systems in place that helped to protect people from abuse and avoidable harm. If things went wrong the provider looked to understand how things could be made better. The provider was in the process of implementing improvements to the quality and safety of its medicines management. The home was kept clean and risks from infection were reduced. There were enough staff to help keep people safe. Staff recruitment processes were followed, and checks were completed to help the provider employ staff that were suitable to work in care. People were able to visit freely.
Care staff completed other training relevant to people’s needs and staff received support from their managers. Care staff worked with other agencies to help people receive the healthcare support they needed. People’s needs were assessed to help them receive effective care and people received enough to eat and drink. The premises had been adapted and personalised to help meet people’s needs.
People’s privacy and dignity was respected, and staff supported people with their independence. People were involved in their care and their wishes and preferences were known and reflected in their care plans.
People received personalised care and staff knew them well. People’s communication needs were assessed and met. Complaints were investigated and the provider looked to learn any lessons to help improve the service and people’s experiences of care. People were supported to maintain relationships that were important to them and socialise so that the risks of social isolation were reduced. People could take part in a range of different activities that stimulated people’s interests and promoted social engagement with others. People had the opportunity to plan and discuss any advanced care plans they wished to make.
The provider operated a range of audits and checks to help ensure the quality and safety of services. The provider worked in partnership with others involved in people’s care. A person-centred approach was taken towards planning and supporting people’s care needs. The provider had a duty of candour policy in place and had shared information on events and incidents that were reportable to CQC.
For more information, please read the detailed findings section of this report. If you are reading this as a separate summary, the full report can be found on the Care Quality Commission (CQC) website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 13 July 2022).
At our last inspection we found breaches of the regulations in relation to person-centred care, safe care and treatment, the numbers of staff deployed and how the provider monitored risk and improved care. The provider completed an action plan after the last inspection to tell us what they would do and by when to improve.
At this inspection we found improvements had been made and the provider was now meeting these regulations.
Why we inspected
We carried out this inspection to follow up on action we told the provider to take at the last inspection.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
We will continue to monitor information we receive about the service, which will help inform when we next inspect.