Lowena

Updated 21 April 2022

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. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

One Inspector carried out the inspection.

Service and service type

Lowena 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 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

This inspection was announced.

We gave the service 24 hours’ notice of the inspection. This was because the service provides respite care and support and people are often out. We needed to make sure relevant staff were available and records were accessible.

Inspection activity started on 09 March 2022 and ended on 15 March 2022. We visited the office location on 10 March.

What we did before inspection

We reviewed information we had received about the service.

We did not receive a provider information return as we had not requested it. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make.

During the inspection

People using the respite service at the time of the office visit had limited verbal communication. We spent time observing their interactions between themselves and with supporting staff.

We spoke with six members of staff including the area manager, registered manager and team leader.

We reviewed a range of records. This included two people’s care records and four medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We received two emails from relatives, and one from a social care professional. All were complimentary about the service. We continued to seek clarification from the provider to validate evidence found.

Updated 21 April 2022

Lowena is a short break service run by Cornwall Council. It provides personal care to people with a learning disability and autistic people. The service provides single room accommodation for up to five people at any one time. The length of stay is up to four nights. The service also responds to temporary emergency placements when necessary.

The service was a purpose-built single storey building in its own grounds. The service is a large, bigger than most domestic style properties and larger than current best practice guidance. However, this had been responded to by reducing the living areas. This meant the environment was more inclusive for people using the respite service.

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it. This service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.

The Right support:

The model of care and setting maximised people's choice, control and independence. The service was close to the centre of town and there was good access to the local community and amenities.

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.

People were supported by enough staff on duty who had been trained to do their jobs properly. People received their medicines in a safe way. People were protected from abuse and neglect. People's care plans and risk assessments were clear and up to date.

Right Care

There was a strong person-centred culture within the staff team. Support plans had been developed for people, to understand the reasons for their behaviour, and provide guidance for staff to ensure consistent approaches were used when supporting people.

Staff knew people well and demonstrated an understanding of people's individual care, behavioural and communication needs. This helped ensure people people's views were heard and their diverse needs met.

People could communicate with staff. Staff understood their individual communication needs and were consistent in their approach and response. Care plans informed staff of any specific ways to best communicate with people.

The staff team had the appropriate levels of knowledge and skills to support people and responded to their individual needs and choices.

Right culture

People were supported by staff where the ethos, values, and attitudes of management and care staff ensured people led confident, inclusive and empowered lives. Staff created an environment that inspired people to understand and achieve their goals and ambitions.

People led lives that reflected their personalities and preferences because of the ethos, values, attitudes and behaviours of the management and staff.

People’s experience of using this service and what we found

At the previous inspection in January 2020 records did not demonstrate the service had information in a format which would support people with a learning disability or autism, to understand and enable them to communicate effectively. At this inspection we found action had been taken.

People had care plans in a format which supported their understanding of information. There were hospital passports to support people if a hospital admission was required.

At the previous inspection care plans were disorganised and information was difficult to follow. At this inspection, care plans had been reviewed. Information was in order and easily accessible. Staff told us the care plans were much clearer and easy to follow.

Care and behaviour support plans were accurate and kept under regular review, with the involvement of the person their family and external professionals if necessary. They provided staff with comprehensive guidance to ensure people's needs were met.

Risks were identified and staff had clear instructions to help them support people to reduce the risk of avoidable harm.

At the previous inspection we found the systems in place to demonstrate quality and safety was managed effectively, were not being carried out robustly to provide an accurate oversight of the service. At this inspection we found improvement in all areas. Senior staff had delegated tasks and responsibilities to carry out auditing and follow up on any issues. There was good oversight by the area manager.

Cleaning and infection control procedures had been updated in line with COVID-19 guidance to help protect people, visitors and staff from the risk of infection. Government guidance about COVID-19 testing for people, staff and visitors was being followed.

People's relatives and staff told us management were approachable and they listened to them when they had any concerns or ideas. All feedback was used to make continuous improvements to the service. They told us, “ We have always felt that [person’s name] is well monitored in the safe keeping of Lowena staff” and “As parents of a severely disabled child, we consider ourselves incredibly fortunate to have the support of Lowena both for [person’s name] and ourselves”.

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

Why we inspected

We undertook this inspection to review previous breaches of regulations found at the last inspection.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.