Archived: Lakeside Residential Care Home

At the last inspection of November 2016 the service required improvement for four breaches of the regulations. Regulation 11 HSCA RA Regulations 2014 Need for consent, Regulation 12 HSCA RA Regulations 2014 Safe care and treatment, Regulation 13 HSCA RA Regulations 2014 Safeguarding service users from abuse and improper treatment and Regulation 17 HSCA RA Regulations 2014 Good governance. The service sent us an action plan to show how they planned to improve the service. We found the service had made the improvements at this inspection.

The service did not have a 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 a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. Since the last inspection a person had been registered but had left after a short time. The service were interviewing potential candidates but had not employed anyone at the time of the inspection.

The service used the local authority safeguarding procedures to report any safeguarding concerns. Staff had been trained in safeguarding topics and were aware of their responsibilities to report any possible abuse.

Recruitment procedures were robust and ensured new staff should be safe to work with vulnerable adults.

The administration of medicines was safe. Staff had been trained in the administration of medicines and had up to date policies and procedures to follow.

The home was clean, tidy and homely in character. The environment was maintained at a good level and homely in character.

There were systems in place to prevent the spread of infection. Staff were trained in infection control and provided with the necessary equipment and hand washing facilities. This helped to protect the health and welfare of staff and people who used the service.

Electrical and gas appliances were serviced regularly. Each person had a personal emergency evacuation plan (PEEP) and there was a business plan for any unforeseen emergencies.

People were given choices in the food they ate and told us it was good. People were encouraged to eat and drink to ensure they were hydrated and well fed.

Most staff had been trained in the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). The registered manager was aware of her responsibilities of how to apply for any best interest decisions under the Mental Capacity Act (2005) and followed the correct procedures using independent professionals.

New staff received induction training to provide them with the skills to care for people. Staff files and the training matrix showed staff had undertaken sufficient training to meet the needs of people and they were supervised regularly to check their competence. Supervision sessions also gave staff the opportunity to discuss their work and ask for any training they felt necessary.

We observed there were good interactions between staff and people who used the service. People told us staff were kind and caring.

We saw from our observations of staff and records that people who used the service were given choices in many aspects of their lives and helped to remain independent where possible.

We saw that the quality of care plans gave staff sufficient information to look after people accommodated at the care home and they were regularly reviewed. Plans of care contained people’s personal preferences so they could be treated as individuals.

Lakeside is a purpose built care home located on Smithybridge Road, leading to Hollingworth Lake. Accommodation is provided over two floors. The first floor is accessible by passenger lift. There is parking available to the rear of the building and level access. The home provides accommodation and support for up to 40 people. At the time of the inspection there were 32 people living at the home.

It is a condition of the provider’s registration to ensure that a manager carrying on the regulated activity at Lakeside Residential Care Home is registered with the Care Quality Commission (CQC). The provider has failed to comply with this condition since the last inspection in August 2016. A registered manager is a person who has registered with the 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 2008 and associated Regulations about how the service is run.

During this inspection we spoke with the new manager who had been in post approximately eight weeks. They told us they would be making an application to register. However following our inspection visit we were told a further manager had been appointed. So that the service is offered clear leadership and support the provider must ensure that the manager makes application to register with the CQC without further delay.

We have identified four breaches in regulation. You can see what action we told the provider to take at the back of the full version of the report.

Records did not clearly demonstrate if a person had the capacity to consent to their care and support or that people had been appropriately assessed as lacking capacity before decisions had been made in the person’s best interest. This meant people’s rights were not respected or protected.

People were potentially being unlawfully deprived of their liberty as authorisations had not been sought from the supervisory body (local authority) in a timely manner.

Effective systems to demonstrate the service was regularly monitored and reviewed needed to be embedded so that, where necessary, improvements were made and people received a good quality service.

The management and administration of people’s medicines needed improving to ensure people received their prescribed medicines safely.

People and their relatives were complimentary about the care and support offered by staff. Interactions were seen to be polite and respectful. Social and recreational opportunities were provided to enable people to maintain their independence and encourage their involvement.

Care records provided staff with sufficient information about the care and support people wanted and needed. Senior care staff were reviewing information to ensure records reflected the current and changing needs of people.

A programme of redecoration and refurbishment was in place to enhance the standard of accommodation and facilities provided for people. Checks were made to the premises and servicing of equipment and improvements had been made to help keep people safe in the event of a fire. Hygiene standards had been improved minimising the risks of cross infection.

We found that safe systems were in place with regards to the recruitment of staff. Staff received a programme of induction and training to help ensure they were able to deliver safe and effective care. Staff spoken with confirmed they were supported in carrying out their role.

Staff had completed training in how to safeguard people from abuse. Those staff spoken with knew what action they should take if they had any concerns.

People were encouraged to have a balanced and nutritional diet. Where people’s health and well-being were at risk, relevant health care advice had been sought so that people received the treatment and support they needed.

The registered manager had a system in place for reporting and responding to any complaints brought to their attention. People’s visitors told us the manager and staff were approachable and felt confident they would listen and respond if any concerns were raised.

Information in respect of people’s care was held securely, ensuring confidentiality was maintained.

We also spoke with a visiting healthcare professional. They told us; 'Overall they [the staff] are excellent' and 'Staff address issues in a timely manner so that people have what they need'.

Care records provided detailed information about the individual needs and wishes of people, clearly directing staff in the safe delivery of people's care and support.

Suitable arrangements were in place to ensure people's nutritional needs were met.

Further recruitment had taken place so that sufficient numbers of staff were available at all times, ensuring people received consistency and continuity in their care and support.

Arrangements for staff training and development were being developed so that staff had the knowledge and skills needed to meet the varying needs of people living at the home.

Systems to monitor and review the quality of service provided were in place to check that people received a quality service.

The home has been without a registered manager for some considerable time. The management team we spoke with were aware that this must be addressed without further delay.