When we visited Lee House, there were 22 people using the service. We spoke with four people who used the service. Another four people said they did not wish to speak to us about their care but that they were happy living at the home. We also spoke with the registered manager and three members of staff. We reviewed six care plans and four staff files.A single inspector carried out this inspection. The focus of the inspection was to answer five key questions: is the service safe, effective, caring, responsive and well-led?
Below is a summary of what we found. The summary describes what people using the service and the staff told us, what we observed and the records we looked at.
Is the service safe?
The home was clean, tidy and well-maintained. People commented on its cleanliness, saying 'Their standards are very high.' Infection control audits were carried out, staff had appropriate infection control training and regular cleanliness checks were carried out to ensure people were protected from the risks of infection.
People had access to portable alarms so they were able to summon help in an emergency. Fire evacuation procedures were displayed and staff were aware of how to assist people should the home need to be evacuated.
Risks were individually assessed and managed for people who used the service, even if they were relatively independent and did not require full care plans. This meant staff were aware of how to keep each person safe. Some risk assessments needed to be updated following changes in people's circumstances to ensure that this remained true for those people.
The home performed checks on all new staff to ensure people were protected against the risks of inappropriate staff being employed. Staffing levels were adjustable based on the home's needs and there were enough suitably qualified, skilled and experienced staff to keep people safe.
The Commission monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While no applications have needed to be submitted, proper policies and procedures were in place and people were free to leave the home as they pleased.
Is the service effective?
Records of care showed that the service was delivered in line with people's care plans, which meant that the needs they were assessed as having were being met. Staff received appropriate training so they were sufficiently knowledgeable to care for people to an appropriate standard.
Where required, expert input was used to ensure people's care reflected relevant research and guidance. The home made effective use of specialist services such as continence nurse services to ensure that effective care was provided.
Is the service caring?
The service encouraged people to remain as independent as possible so they were able to make choices and retain their daily living skills. People told us, 'I don't need much support: they work with me' and, 'We are all different but they do take individual needs into account.'
Care planning took into account people's likes and dislikes, life history and things that were important in them. This meant that people were supported to live as they wished to and their care package was tailored to them as individuals.
There was a wide range of activities available, which people told us was 'very good.' People were able to spend their time occupied with meaningful tasks, activities and hobbies as they wished.
People told us staff were caring. They said, 'Staff are very helpful and friendly' and 'The staff are very kind to me.' We saw staff interacting with people in a respectful and caring manner.
Is the service responsive to people's needs?
Each person who used the service had a six-week assessment period so that the service was aware of what their needs were and how to respond to them.
Referrals were made in a timely manner where required so that people's needs were met if the home was unable to meet them itself. People told us, 'I see the doctor every week, the chiropodist every six weeks and anyone else I need,' and, 'Communication with the home is very good.'
Staffing levels were adjusted where required on a short-term basis to respond to any additional needs on specific shifts. This enabled people to receive any extra support they needed, such as to attend hospital appointments.
People had the opportunity to feed their views back to the service via meetings, questionnaires and informal conversations. People said the staff listened to what they said and 'they take it on board.'
Is the service well-led?
The home had an experienced registered manager in post, who at the time of our visit was in the process of recruiting extra staff to cover long-term leave. The manager told us they employed staff on the basis of them having the right personal qualities and skills to fit with the existing skill mix of the staff team. People we spoke with said, 'The staff work very well as a team' and 'They are there for each other.' Staff told us their manager was supportive and they felt able to raise concerns.
The manager and provider regularly gathered the views of staff, people who used the service and people's relatives and used these to monitor and improve the quality of the service. Data from surveys was compared with similar services and showed that the home was performing above average. One person told us, 'They explain what they are doing and why. You can ask questions and you are very much listened to.' Data was gathered to ensure the service learned from incidents and adverse events.