Archived: Home Lea House

Home Lea House 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.

Home Lea House provides accommodation and personal care for up to 29 older people which includes two respite spaces. Bedrooms are single occupancy and the majority have en-suite toilet facilities. Communal lounges, a dining room and bathing facilities are provided.

There was a registered manager in post. 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 legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People and family members told us staff were exceptionally caring and had gone the "extra mile" to provide outstanding care. Staff treated people with dignity and respect, and enabled people to maintain their independence.

People, their relatives and staff were very proud of the home they lived and worked in. People and their families had been fully involved in the care planning process and their care plans were kept continually under review to enable staff to provide responsive care to meet people’s changing needs.

People felt safe and fully supported by staff who knew them well. Person centred care planning was evident throughout our inspection and a high level of engagement with people about their previous life experiences and hobbies. Staff took time to ensure activities in the home were planned and focused around people's experiences and interests. People were actively encouraged to share their life experiences with others and the service worked closely with other services and organisations in the local wider community to enhance people's lives.

Staff were well trained and demonstrated the skills, knowledge and experience to care for people effectively. For example, staff had the knowledge and skills required to meet the needs of people who lived with dementia. This training was evident in all staff interactions with people.

The provider had a robust recruitment process in place which ensured that qualified and experienced staff were employed at the home. Staff received support and had a good understanding of how to keep people safe, identify signs of abuse and report these appropriately.

There were enough staff working at all times to ensure people's needs were fully met. People received their medication safely as prescribed and the records were of a good clear standard. Staff had been trained in the prevention of infection and there were sufficient domestic staff employed to ensure the home was clean. The environment was well maintained, kept clean and was safe and hygienic.

People were appropriately supported where they needed help with meals and drinks. The service accommodated people's individual preferences and had prepared meals to order to ensure that people had sufficient, appetising food that suited their taste. Staff ensured people's healthcare needs were met and worked well in partnership with other professionals to ensure that people received the best possible healthcare. Health care professionals were highly complementary on the care and support people received in the home.

The provider worked in line with other legislation such as the Mental Capacity Act 2005 (MCA) to ensure that people had as much choice and control over their lives as possible. People were supported to maintain their independence whilst staff ensured they were kept safe by minimising risks. Where people were deprived of their liberty for safety reasons the service had completed the appropriate forms and had authorisations in place to do so.

A robust system of governance in the service meant people received safe and effective care. The system fully involved people and the actions taken by the service showed that all staff and management were quick to make the improvements. The registered manager felt strongly that the only way to continually improve the service for people was to ensure that they were at the heart of it.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people who used the service, the staff supporting them and from looking at records.

Is the service safe?

The service was safe, generally clean and hygienic. One person we spoke with said, "They are always cleaning." We observed the home had no malodours and most areas of the home were visibly clean.

Staff had attended several training courses which took into account the needs of the people who used the service. This ensured that people's needs were met.

Is the service effective?

People's health and care needs were assessed where possible with them or their relative. Specialist dietary, mobility and equipment needs had been identified in care plans where required.

Is the service caring?

Care staff were attentive and spent time talking with people and making sure their needs were being met. People commented, “It’s great here, the staff can’t do enough for you.”

People who used the service, and other professionals involved with the service had completed satisfaction surveys.

Is the service responsive?

People knew how to make a complaint if they were unhappy. People told us they had never needed to make a complaint but if they did they thought that complaints would be investigated and action taken as necessary.

Is the service well led?

The service worked well with other agencies and services to make sure people received their care in a joined up way.

The service had a quality assurance system. Records seen by us showed that identified shortfalls were addressed promptly. As a result, the quality of the service was continually improving.

On our previous visit in April 2013 we were told by people who used the service and staff that there were very few activities for people to engage in. People we spoke with at this inspection were animated in their descriptions of activities they had taken part in.

During our last inspection in April 2013 we found a high proportion of agency staff were being used, this was still the case, however, we were told by the Deputy Manager that Home Lea House were able to request the same agency staff. One member of staff said, "Staffing is much better now, the agency staff we use are just like one of the team. They know the residents, and the residents know them."

We were told by the management team all audits and reviews were up to date. We asked for and received documentation which evidenced this. For example, we looked at five care plans which all had up to date reviews in place. We saw the homes audit programme which was also up to date.

We were told at our last inspection that the home was in the process of making changes to the assessment and care planning documentation. The home was still updating all their care plans and the concerns raised last time were still evident this time.

Some people raised concerns about staffing levels and the use of agency staff. One person who used the service said “There is not enough staff, they are just too busy.” We were told that activities did not happen on a regular basis anymore because of the use of agency staff. One staff member told us that they had planned to take residents to Rothwell but that it had to be cancelled at the last minute because there were not enough staff to take people.

During our inspection we found some of the auditing and review systems in place to identify, assess and manage risks relating to the health, welfare and safety of service users were ineffective or inconsistent.