Archived: Leaholme

Some areas of the service were not well maintained. The flooring in the laundry required attention and the plinth required to be sealed to prevent transfer of infection. The flooring and walls in some of the toilets and storage areas also needed attention to ensure they could be thoroughly disinfected. Some of the woodwork in corridors had paint missing, which could allow a transfer of infection. These areas compromised infection control measures and the effectiveness of cleaning and disinfection. This could contribute to the spread of infection to people and staff. The provider had a number of these areas on an improvement plan which had been delayed due to the COVID-19 pandemic and the restrictions placed on maintenance staff.

Quality assurance audits undertaken by the provider were not effectively completed to identify the shortfalls found during the inspection.

We found the following examples of good practice.

¿ The provider ensured continual supplies of personal protective equipment (PPE). This included face masks and aprons and we saw staff used these appropriately. Staff were encouraged to change their PPE regularly.

¿ Used PPE was disposed of in foot operated pedal bins situated throughout the home. This reduced the potential for transfer of infection.

¿ Staff encouraged people to wash their hands frequently throughout the day. Where this was not possible, hand sanitiser was offered as a means to reduce the transfer of infection.

¿ The provider participated in COVID-19 testing of people and did so in line with current government guidance. Staff were also tested regularly. That ensured action could be taken swiftly to reduce the potential spread of infection if a positive test was returned.

¿ Areas were cleaned and disinfected with cleaning products approved to reduce the potential transfer of infection.

¿ Risk assessments had been completed to protect people and any staff who may be at a higher risk of contracting COVID-19, measures were in place to support them.

¿ Staff worked in set teams which lessened the potential of cross infection between shift members.

Further information is in the detailed findings below.

People’s experience of using this service:

People were happy living at the service. Staff supported people to have a meaningful life and encouraged them to be independent.

Care and support was tailored to each person's needs and preferences. People and their relatives were involved in developing and updating their planned care.

Staff had received a wide range of training. Checks were made on the ongoing competency of staff.

Staff understood how to safeguard people from abuse. The staff team encouraged and supported people to make choices about what they wanted to do.

Appropriate recruitment checks were carried out to ensure staff were suitable to work in the service.

Medicines were managed safely. Records confirmed people received their medications as prescribed.

Staff were encouraging people who were under-weight to eat fortified foods. We found a range of menu choices were available.

The registered manager ensured that all incidents were analysed and ensured lessons learnt were shared with staff.

People who lacked capacity were supported to have maximum choice and control of their lives. Policies and systems supported them in the least restrictive way possible.

Detailed risk assessments were in place to support people and remain safe.

People participated in a range of activities that met their individual choices and preferences.

The registered manager demonstrated a commitment to providing person centred care for people. Staff felt the registered manager was supportive and approachable.

Rating at last inspection: Good (report published 8 November 2016)

Why we inspected: This was a planned inspection based on the rating at the last inspection.

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 any concerning information is received we may inspect sooner.

Leaholme provides residential care to older people including people recovering from mental health issues and some who are living with dementia. Leaholme is registered to provide care for up to 17 people. At the time of our inspection there were 15 people living at the home.

A registered manager was not in post. However, the provider has been appointed a manager who is due to commence their post the week following the inspection. 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.

At the last inspection of the service in 9 & 10 June 2015 we asked the provider to make improvements in the recording when people’s medicines were administered. We received an action plan from the provider which outlined the action they were going to take. This advised us of their plan to be compliant by November 2015. At this inspection we found that improvements had been made and medicine recording was undertaken when they were administered and stored safely. The system in place to monitor care records had also improved.

At the last inspection we also asked the provider to take action to ensure there were always enough staff members around to safely meet people’s needs. We found that improvements had been made and found staffing numbers were adjusted in line with people’s needs to ensure a safe working environment for people.

At the last inspection we asked the provider to take action to ensure risks to people had not always been assessed, and where risks had been identified and assessed, these had not always been reviewed regularly. We found that improvements had been made and risk assessments were in place and reviewed regularly.

At the last inspection we asked the provider to make improvements to the audits, checks and governance in the home. We found that improvements had been made and a series of checks had been introduced that were overseen by the deputy manager and group quality manager and then referred to the provider.

At the last inspection we asked the provider to make improvements to the efficiency of communication between members of the staff team. We found that improvements had been made and saw that detailed handovers were in place, as well as regular meetings and supervision for staff.

At the last inspection we asked the provider to take action to ensure staff recorded what food and quantity of fluids where people were at risk of dehydration and malnutrition. We found that improvements had been made and found nutrition and hydration were recorded in line with instruction from health professionals, and where staff felt the person’s diet required monitoring.

At the last inspection we asked the provider to take action to ensure staff gained people’s consent prior to care being offered. We found that improvements had been made and how people were asked for their consent to care prior to their admission to the home. This was in addition to staff agreeing their actions prior to each caring intervention.

Relatives we spoke with were complimentary about the staff and the care offered to their relations. People were involved in the review of their care plan, and when appropriate their relatives were included. We observed staff positively interacted with people at lunch, where people were offered choices and their decisions were respected. Staff had access to people’s care plans and received regular updates about people’s care needs. Care plans included changes to peoples care and treatment and people were offered and attended routine health checks, with health professionals both in the home and externally.

People were provided with a choice of meals that met their dietary needs. The catering staff were provided with up to date information about people’s dietary needs, and sought people’s opinions about the menu choices to meet their individual dietary needs and preferences. There was a range of activities tailored to people’s interests provided on a regular basis. Staff had a good understanding of people’s care needs, and people were able to maintain contact with family and friends. Visitors were welcome without undue restrictions.

Staff were subject to a thorough recruitment procedure that ensured staff were qualified and suitable to work at the home. They received induction and on-going training for their specific job role, and were able to explain how they kept people safe from abuse. Staff were aware of whistleblowing and what external assistance there was to follow up and report suspected abuse.

Staff told us they had access to information about people’s care and support needs and what was important to people.

Staff were aware of the reporting procedure for faults and repairs and had access to the maintenance to manage any emergency repairs.

The provider had a clear management structure within the home, which meant that the staff were aware who to contact out of hours. The provider carried out quality monitoring checks in the home supported by the group quality manager and home’s staff. The provider had developed opportunities for people to express their views about the service. These included the views and suggestions from people using the service, their relatives and health and social care professionals.

We received positive feedback from the staff from the local authority with regard to the care and services offered to people.

We spoke with visitors who were visiting a relative and asked them for their views about Leaholme and the care the service provided. They told us: 'She's well looked after here.' The visitors told us that they had a positive relationship with the staff and that communication was effective.

We observed that people who used the services sat outside in the rear garden, whilst others walked around the garden. People were served refreshments throughout the day. People we spoke with made positive comments about the meals and our observations of the dining experience for people at lunchtime were positive.

We found staff were employed in sufficient numbers and had received the appropriate training which enabled them to meet the needs of people who used the service. People lived in an environment which was well maintained and records we viewed showed that the service used external contractors to maintain systems within the service. Records for the care and support of people who used the service and staffing records were up to date and accessible.