We carried out a review of the data available to us about Lakeview Care Home on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Lakeview Care Home, you can give feedback on this service.
People’s experience of using this service: People were safe at Lakeview and protected from harm. People’s risks were assessed and there was sufficient numbers of staff to meet people’s needs. People received their medicine by trained staff and the environment was managed to limit the possibility of infection. Lessons were learnt when things went wrong.
People’s consent to their care was sought and best interest meetings were held when needed. People’s care needs were continually assessed and staff training arranged to ensure staff could meet people’s needs. People were supported to have a balanced diet and sufficient access to drinks. Staff worked with other agencies and people were supported to access healthcare outside of the service. The building was adapted to meet the needs of the people living there.
People were treated with kindness and encouraged to express their views about their care. People’s privacy and dignity was maintained
People received personalised care and they knew how to raise a concern or complaint. People’s end of live wishes had been considered.
The provider promoted person centred care and staff were aware of their individual roles. People, their relatives and staff were engaged in discussions about the service and action taken when needed. The service had a dedicated team that looked at continuous learning and the home worked in partnership with others.
More information is in the full report
Rating at last inspection: At the last inspection we rated the service as requires improvement (Report Published 3 October 2017)
Why we inspected: This inspection was a planned inspection in line with our methodology.
Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If concerning information is received we may inspect sooner.
Lakeview has seven units which are situated across the two storey building or in a separate unit. The home offers a wide range of support on the different units, care, nursing, dementia care and care for behaviours that may challenge. The home can accommodate 151 people. On the day of inspection 113 people were using the service.
The service did not have a registered manager in post. There was a manager in post who was in the process of registering with us. 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.
When people lacked capacity to make decisions for themselves, capacity assessments had been completed however these were not always specific to the decision being made. Further work was needed when decisions were made in people’s best interests. The systems in place to monitor the quality of the service were not always effective in ensuring improvements were made.
People felt safe and staff knew how to recognise and report potential abuse. There were enough staff available to support people in a timely manner. Risks to individuals were assessed and managed in a safe way. Medicines were managed to ensure people were safe from the risks associated to them.
Staff received an induction and training that helped them offer support to people. Staff knew people well and people’s cultural needs were considered. People enjoyed the food available and were offered a choice.
People were supported in a caring way by staff they liked. People’s privacy and dignity was upheld. People were encouraged to be independent and make choices how to spend their day. Relatives felt updated by the home and people felt involved with their care. People were given the opportunity to participate in activities they enjoyed.
Staff felt listened to and had the opportunity to raise concerns. The manager understood their responsibilities around registration with us and notified us of significant events that occurred within the home. People and relatives had the opportunity to raise concerns and suggested improvements, we saw these were considered.
Our last inspection visit took place in June 2015 and we found some improvements were needed. We found people were not always supported in line with the Mental Capacity Act 2005. We also found there were not always enough staff to meet people’s needs and people’s dignity was not always promoted. There were not always activities and entertainment available for people to participate in and the quality monitoring systems that were in place did not always pick up areas for improvement. The provider sent us an action plan in October 2015 stating what action they were taking to address the concerns identified.
At this inspection we found improvements had been made, however some further improvements were needed.
Lakeview has six units which are situated across the two storey building or in a separate unit. . The home offers a wide range of support on the different units, care, nursing, dementia care and care for behaviours that may challenge. The home can accommodate 151 people. On the day of inspection 120 people were using the service.
The service had 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.
Mental capacity assessments and best interest decisions had been completed where people were unable to consent; however these had not been reviewed and updated when changes had occurred. When people had cultural needs this had not been fully considered by the provider. When people needed specialist diets, we found this was not always provided as recommended by health professionals. There were systems in place to manage the quality of the service; however this information was not always effective or actioned to make improvements.
Staff knew how to recognise and report potential abuse and when needed safeguarding procedures had been followed. Risks to people were identified and managed in a safe way. There were enough staff available for people and they did not have to wait for support. The provider ensured staff that work in the service had checks to determine their suitability to work with people. Staff received training and an induction that helped them to support people. People received their medicines as prescribed.
People and relatives were happy with the care they received and were treated in a kind and caring way. People’s privacy and dignity was promoted. They were encouraged to remain independence and make choices about their day. People felt involved with their care.
We found people enjoyed the food and choices were available to them. When needed people had support from health professionals. There were a range of activities and pastimes for people to participate in if they chose to. Relatives felt welcomed and were free to visit at any time.
The provider sought the opinions of people who used the service and used this information to make changes. Staff felt supported and listened to and had the opportunity to raise concerns. People knew who the management team were and the registered manager understood their responsibility around registration with us and notified us about significant events that occurred within the home.
The inspection took place on 17June 2015 and was unannounced.
Lakeview has six units spread across the ground and first floors. The home offers care and nursing care, dementia care, and care for behaviours that challenge. The home can accommodate 151 people.
A manager was in post who was in the process of applying to become registered manager. 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’s risks were assessed in a way that kept them safe from the risk of harm but these did not always reflect people’s current needs. There was not always enough staff around to ensure that people were supervised and/or that people’s needs were met.
Medication systems were in place to ensure that people received their medication safely. Some staff were unfamiliar with the computerised medication recording system.
People felt there was not always enough staff around who knew how to meet their needs. The provider was in the process of recruiting more staff to work at the home.
A staff training programme was in place to ensure that staff were trained to carry out their role and the provider had plans in place for updates and refresher training.
Staff were aware of their role in safeguarding procedures and told us they would report poor practice. Staff received training to ensure they could meet people’s needs including training in how to keep people safe.
The Mental Capacity Act 2005 and the DoLS set out the requirements that ensure where appropriate, decisions are made in people’s best interests when they are unable to do this for themselves. Not everyone who needed a mental capacity assessment had got this in place and staffs knowledge around MCA and DoLS was variable. This meant that decisions had been made for some people without gaining appropriate consent.
People were supported with their nutritional needs but it was not always clear if people had received enough to drink. Where people had significant weight loss referrals to healthcare professionals were not always made in a timely way.
People’s health care needs were monitored and where people were at risk of developing pressure ulcers there was a plan in place to minimise the risk. However where people were receiving treatment for pressure ulcers these had not always been consistently followed by nurses.
On Kendal and Keswick unit’s staff understood people’s needs. Care was delivered with a person centred approach. On another unit care was delivered in a more task driven way and people did not always receive care and support at the time and in the way they preferred it.
Some staff displayed a more caring and interactive approach with people than others. People’s dignity was not always promoted but people’s privacy was upheld and people were treated with respect.
There was an activities programme in place but people had limited opportunities to be involved in hobbies and interests that were important to them.
The provider had a complaints procedure available for people who used the service and complaints were appropriately managed. People who used the service and their families felt able to raise any concerns they might have with the manager or other staff members.
Not all staff felt that the atmosphere of the home was open and inclusive. Some staff felt that they were not always listened to. Where there was a unit manager in place (Kendal and Keswick) the unit ran more smoothly and people received more consistent care and support.
The registered manager had systems in place to monitor the service but this was not always effective in bringing about improvements. Recent user surveys highlighted a need for improvements in several areas. The manager and operations director were developing an action plan for this.
We found that care plans were person centred and individualised with care planned to meet each person's needs. We saw that people were able to enjoy the gardens and the sensory garden. We saw flower pot people that the people who lived at the service had made to decorate the garden.
We found that each dining room was nicely presented with table clothes and a dining experience for the people who used the service. Food was hot, looked appetising and there was choice of a second cooked meal.
We found that the home was clean and tidy throughout. People's individual space was clean and staff took care to replace personal items as people wanted them to be arranged.
Medication was received into and stored within the building safely. We found that medications were safely administered and staff were supported with an electronic system for the recording of medications. This system was designed to reduce the risk of medication errors.
We found that the home carried out suitable audits for the health, safety and welfare of the people who lived at the service.
We saw that some people who lived there were visiting the hair salon during our visit. One person told us, "I put my coat on and bring my bag down it's just like the real thing".
We found that people's care plans were personalised, and clearly showed what care and support each person required and had received. One relative told us, "They involve us as a family and X is included as much as possible".
We saw that people who used the service were protected from the risk of abuse. We found that the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.
We saw that staff had suitable opportunities for training and were told about two experiential training opportunities that staff had been offered. The training gave staff experiences that people living in the home could experience, so that the staff could better understand the people's needs and experiences. These experiences were staff being helped to eat, and being lifted with a hoist.
The manager showed us very detailed audits that were used to monitor the quality of the care provided by the home, and of the way the home was run. We were shown the frequency of these audits and a plan of future improvements to be made in 2013.
We involve people who use services and family carers to help us improve the way we inspect and write our inspection reports. Because of their unique knowledge and experience of using social care services, we have called them experts by experience. Our experts by experience are people of all ages, from diverse cultural backgrounds who have used a range of social care services.
An expert by experience took part in this inspection and talked to the people who used the service. They looked at what happened around the home and saw how everyone was getting on together and what the home felt like. They took some notes and wrote a report about what they found and details are included in this report.
During the visit we spoke with people living at Lakeview, visitors, staff members, health professionals and the manager. We were told by a person living at the home, 'It is comfortable here'. A relative told us, 'I am happy with the care my relative receives, the staff know them well'. Another said, 'I can visit anytime and I am happy with the care, staff always kept informed with what is going on. I can go home confident'.
Our expert by experience said 'The home was clean, bright and in an attractive setting. The ground floor was more like a home compared to the first floor, which was more clinical'.
Some of the people using the service we spoke with said they were not happy with the quality of food. One person said, 'It was good when I first came here but it's gone downhill'. Another told us that breakfast was good. The meal time we observed on one unit, within the home, was not a positive experience for people using the service.
There were notice boards displayed around the home giving information on past and future events, for example there were photographs displayed showing recent trips. Newsletters were also available to keep people informed. We saw an information board in the reception area to give advice on care for older people with mental health needs.