Archived: Lakelands Residential Care Home

Is the service safe?

Is the service effective?

Is the service caring?

Is the service responsive?

Is the service well led?

This is a summary of what we found-

Is the service safe?

We looked at the staff training matrix and saw staff members had completed training related to safeguarding procedures. The provider had systems in place to learn from accidents, incidents or any complaints that had been received. A whistleblowing process was also in place at the care home which helped ensure the safety of all people who used the service.

Deprivation of Liberty Safeguards (DoLS) become important when a person is judged to lack the capacity to make an informed decision related to leaving the home safely. The provider told us an application was made for a DoLS in December 2013. We looked at the required paperwork and noted it had been completed appropriately. The Care Quality Commission had been notified in line with requirements.

Is the service effective?

We looked at five care plans and all had been signed by the person who used the service. This showed they had been involved in writing up their care plans. Specialist dietary needs had been recorded in the care plans and we saw reference had been made to any allergies the person had which helped ensure the health and welfare of the person.

People`s needs were taken into account with the signage and the layout of the environment. This enabled people to move around the care home safely and freely. A family visitor told us, "We can call in anytime, there`s never a problem. We are always offered a drink and that's nice."

Is the service caring?

People who used the service, their family members, staff members and professionals who attended the care home completed annual surveys related to the quality of service being provided at the care home. We observed positive comments had been made and a high satisfaction rating had been recorded.

We spent time in communal areas and observed staff who cared for people in a patient, unhurried manner. We saw people with limited mobility being helped between rooms. Staff members were present at lunch time and offered assistance to people where they thought it was necessary.

Is the service responsive?

We spoke to a community nurse who had attended the care home in response to a call that had been made by a staff member. The nurse told us, "I enjoy coming here. It`s one of the better homes I go to. Any problems they always call us."

We spoke with two family members who were visiting the care home. One told us, "I have been coming here for quite a while now and never had to make a complaint. If I needed to, I know I could just go in and see the manager."

Is the service well led?

The provider had procedures in place that monitored the quality of service being provided to people who used the service. This included regular internal and external quality assurance checks. Weekly and monthly audits had also been undertaken which helped ensure the quality of service continued to improve.

We saw meetings were held regularly for staff and family members and people who used the service. Emergency procedures were continually monitored at the care home. We noted an annual review of fire procedures was completed in June 2014 which helped ensure the safety of all people who used the service.

During our visit we spoke with a range of people about the home. They included the registered manager, staff, relatives and people who lived at the home.

Everyone who commented spoke positively about the home and the staff members working there. Comments included; 'very nice', 'can't fault the staff', and 'it's my home'.

We found that the home had made improvements and addressed the issues previously identified in the areas of suitability of staffing; assessing and monitoring the quality of service provision and storage of records. We also noted that the home had addressed our previous concerns regarding the management of medicines however during this inspection we found other areas for improvement.

People living there were positive about the service and support provided by staff. They told us they were given various choices regarding how they wanted to be supported. We spoke with people who used the service and they said:

'I am satisfied' 'I like the food' 'I like it here' 'It is alright. I wouldn't change anything' 'It is quite comfortable here' 'Everyone is friendly' 'Food is good' 'I can't grumble about anything' 'Staff are lovely' 'I enjoy being here' 'Staff are very good'.

People told us that on most occasions they did not wait a long time when they asked for help. They understood that on some occasions they had to wait because staff were busy.

Relatives stated that the home has an 'upbeat feel' but added that they felt there was not enough staff.

District nurses stated that stated people in the home were given good care and she had no concerns. If she asked staff to carry out tasks to support the nursing care, it was usually completed as she requested.

We found however that people were not protected against the risks associated with medicines because the provider did not have appropriate arrangements in place to safely manage them.

Whilst the home had sufficient numbers of care staff, on the day of inspection we found there to be no senior manager present.

We found that whilst the home had robust audit processes in place it was not always effective in demonstrating that improvements had been made.

We also found that service user identifiable information was not stored securely.

We looked a three care records and saw that they contained relevant information including personal preferences, medical and health information, risk assessments, monitoring charts and a social history. We saw that the care records had been regularly reviewed and updated as required.

The people we spoke with told us they had choice in relation to how they spent their day. Some of the comments were; 'I get up and go to bed when I want'. 'I like to go on the trips and outings'. 'The food is very good we have a choice at mealtimes'. Another person told us, 'It's a big decision to have to leave your home but I think I will be happy here. I could not manage on my own anymore and the staff are very good'.

We spoke with two visitors to the home. They told us, 'We have no complaints, the care seems very good'. They told us that their relative had not been at the home for a long time but had settled well.

Regular monitoring of the services and facilities provided were in place to help protect people against the risks of inappropriate or unsafe care.