Lyme Valley House Residential Care Home

Updated 26 April 2023

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 Health and Social Care Act 2008.

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 1 inspector and an Expert by Experience on-site. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service. Two inspectors made telephone calls to relatives following the site visit.

Service and service type

Lyme Valley House Residential Care Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Lyme Valley House Residential Care Home is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post. Although the manager told us they intended to submit an application to register, they had been in post for almost 1 year at the time of our visit.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 11 people living in the service and 6 relatives. We spoke with 8 members of staff including a director, the nominated individual, the manager, senior care staff, care staff and the activities coordinator. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We looked at 3 people's care records and multiple medicine records. We looked at how medicines were stored, administered and recorded. We looked at 3 staff files in relation to recruitment. A variety of records relating to the management of the service, including building safety records, audits and accident and incident records were also reviewed.

After the inspection we continued to seek clarification from the provider to validate evidence found. We held a virtual meeting with the manager to ask further questions.

Updated 26 April 2023

About the service

Lyme Valley House Residential Care Home is a residential care home providing personal care to up to 25 people. The service provides support to older people with dementia or physical disabilities. At the time of our inspection there were 20 people living over 2 levels in 1 adapted building.

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

The provider had not always identified and reduced environmental risks, including fire and building safety risks, to people. There was a lack of assurances around safe recruitment and staffing levels. Medicines were not always safely managed. People had care plans and risk assessments in place for staff to follow. People were protected from the risk of abuse. Staff wore Personal Protective Equipment in line with guidelines to reduce the risk of people catching and spreading infections.

People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not always support this practice. Staff received training to support people, however, this was not always effective. Staff supported people in line with their care plans. People were supported to have a suitable and balanced diet. The home was being redecorated to reflect the needs of people who lived there.

Quality assurance systems were not always effective in identifying areas for improvement. People were supported in a way that was person-centred and promoted their independence. People and relatives were involved in people’s support and staff worked with other organisations to maintain and promote people’s well-being.

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

Rating at last inspection

The last rating for this service was good (published 12 December 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

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 COVID-19 and other infection outbreaks effectively.

We received concerns in relation to there being no registered manager in post and after the local authority had been to visit, we were advised the service had not been making CQC aware of concerns. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements.

Please see the safe, effective and well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Lyme Valley House Residential Care Home on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to the building safety, medicines management, unauthorised restrictions, ineffective quality assurance systems and poor governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.