Lever Edge Care Home

Updated 25 November 2021

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

The inspection was carried out by three inspectors, a medicines inspector and two Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Lever Edge Care Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a 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 a short period of notice of the inspection due to the COVID-19 pandemic to ensure we had prior information to promote safety. We announced the inspection on the afternoon of the 11 October 2021 and completed the first day of inspection on the 12 October 2021. Two additional unannounced site visits were completed on the 20 October 2021, one during the day and another visit in the evening, to complete the inspection.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We also asked for feedback from the local authority, clinical commissioning group and professionals who work with the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.

During the inspection

We spoke with eight people, four relatives and two visiting professionals about their experiences of the care and support provided. We also spoke with 14 staff members, including the registered manager, area manager, a unit manager, activities and care staff.

We reviewed a range of records. This included seven people’s care records and multiple medicine administration records and associated documentation. We also looked at other records relating to the management of the home and care provided to people.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at safety information and certificates, staff rotas and staffing tools, accident and incident monitoring, menus and meal monitoring, meeting minutes, surveys, audit and governance information. We also contacted eleven relatives by phone to seek their views on the home, care provided and how well the home communicated with them.

Updated 25 November 2021

About the service

Lever Edge is a residential care home which can accommodate up to 81 people. The home provides accommodation within three units spread over two floors. The Bungalow unit on the ground floor and the Turton unit on the first floor provide accommodation and support for people living with dementia. The Rivington unit on the ground floor provides accommodation for people who require support with their care. At the time of the inspection 71 people were living at the home.

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

People told us they felt safe living at Lever Edge Care Home, receiving care and support from staff who knew them well. Staff were knowledgeable about how to identify and report safeguarding concerns and had reported any issues appropriately. Staffing levels were based on people’s needs and enough staff were deployed to support people safely. Accidents, incidents and falls had been documented and reviewed to look for trends and help prevent a reoccurrence. The home was clean, with effective cleaning and infection control processes in place. People received their medicines safely by staff who were trained and assessed as competent.

People and relatives felt staff had the necessary skills and knowledge to carry out their roles. Staff completed a mixture of online and classroom-based training sessions, received regular supervisions and an annual appraisal. 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’s health and welfare needs were being met, with access to professionals as required. Equipment was in place to support people to stay well. Referrals had been made timely to professionals when any issues had been noted or concerns raised. People spoke positively about food and drinks provided, with choices available at each mealtime, along with snacks should they want them.

Staff were described as kind, caring and supportive. A relative told us, “The care mum gets is fantastic. We are very, very grateful that she is safe, loved and being looked after.’’ People were treated with dignity and respect and encouraged to do as much for themselves as they could.

Care files provided information about people’s life history, likes, dislikes and how they wanted to be cared for. People and relatives had been involved in the care planning process and updated about any required changes. Peoples’ social and recreational needs were met through a weekly activities programme, facilitated by activity co-ordinators and staff members. The complaints process was clearly displayed within the home, people told us they knew how to raise concerns, but had not needed to.

The home used a range of systems and processes to monitor the quality and effectiveness of the service provided. Actions had been identified and added to the home’s improvement plan, which was regularly reviewed. Staff spoke positively about the management team and the support they provided. People and relatives were also complimentary. One relative stated, “[Registered manager] is very approachable and level headed; they listen to everything which is extremely important.”

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

Rating at last inspection and update

The last rating for this service was requires improvement (published November 2020). No breaches of regulation were identified at that inspection and improvements were noted, however, as it was a focussed inspection, which looked only at the safe, caring and well-led key questions, the overall rating could not be changed, as we did not inspect all key questions. At this inspection we found improvements had been made in all key questions.

Why we inspected

The inspection was prompted in part due to concerns received about staffing levels, staff support and oversight, management of falls and incidents, medicines management, management of deprivation of liberty safeguards (DoLS) and care and support provided to people. A decision was made for us to inspect and examine those risks.

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 coronavirus and other infection outbreaks effectively.

We found no evidence during this inspection that people were at risk of harm from these concerns. Please see the safe, effective, caring and well-led sections of this full report.

You can read the reports from both the focussed inspection and our last comprehensive inspection, by selecting the ‘all reports’ link for Lever Edge Care Home on our website at www.cqc.org.uk.

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.