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Inspection carried out on 17 January 2018

During a routine inspection

This inspection was undertaken on 17 and 30 January 2018. The first day of this inspection was unannounced and carried out by two inspectors, a medicines inspector and two Experts by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service. The second day of our inspection was announced and completed by one inspector.

Lydia Eva Court is a care home that is registered to accommodate up to 89 older people, some of whom may be living with dementia, in one adapted building. At the time of our inspection there were 84 people living within the home. People in care homes receive accommodation and 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. The accommodation is over two floors with three separate, smaller units, on each floor. There are a number of communal areas throughout the home and all bedrooms have en-suite facilities. The home also has a number of enclosed

outdoor spaces.

At our last inspection on 1 and 2 December 2016 the service was rated as requires improvement in safe, effective, responsive and well-led. The overall rating was requires improvement. We asked the provider to take action and make improvements to ensure that effective systems were in place to assess, monitor and improve the quality and safety of the service. The findings from our inspection on 17 and 30 January 2018 confirmed that appropriate action had been taken and significant improvements had been made.

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.

The management team used a number of methods to ensure the quality of the service provided was regularly monitored. All aspects of the service were checked regularly by the provider’s senior management team, the registered manager and care staff, in order to identify any areas that needed improvement. Action was taken promptly to address any identified issues.

Risks to people's safety were identified, recorded and reviewed on a regular basis. There was also written guidance for staff to know how to support people to manage these risks. Staff worked closely with healthcare professionals to promote people's welfare and safety. Staff also took prompt action to seek professional advice, and acted upon it, where there were concerns about people's mental or physical health and wellbeing.

There were enough staff working in the home to help ensure people's safety. Staff worked well together to ensure people's needs were met safely and appropriately. Proper checks were carried out when new staff were recruited, which helped ensure only staff who were suitable to work in care services were employed. Staff knew how to recognise different kinds of possible abuse and understood the importance of reporting any concerns or suspicions that people were at risk of harm appropriately.

People's medicines were stored and managed safely and administered as the prescriber intended. Staff were appropriately trained and competent to support people with their medicines.

People enjoyed their meals and were provided with sufficient quantities of food and drink. People were also able to choose what they had. If people were identified as possibly being at risk of not eating or drinking enough, staff would follow guidance to help promote people's welfare and input would be sought from relevant healthcare professionals.

Staff were trained well and were competent in meeting people's needs. Staff understood people's backgrounds and preferences and supported people effectively. New staff completed an induct

Inspection carried out on 1 November 2016

During a routine inspection

The inspection took place on 1 and 2 November 2016 and was unannounced.

Lydia Eva Court provides residential care for up to 89 older people, some of whom may be living with dementia. At the time of our inspection there were 88 people living within the home. The accommodation is over two floors with three separate, smaller units on each floor. There are a number of communal areas throughout the home and all bedrooms have en suite facilities. The home has a number of enclosed outdoor spaces.

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.

At this inspection, we found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This breach related to the governance of the service.

You can see what action we told the provider to take at the back of the full version of the report.

The risks to people who used the service had not consistently been identified, assessed, reviewed or managed appropriately. People who required specialist diets were also at risk of not having their nutritional needs met. This put people at risk of potential harm.

Although staff knew the needs and preferences of those they supported and delivered this in an individual manner, care plans were not always accurate, complete or person centred. Discrepancies within the care plans put people at potential risk of not receiving the appropriate care and support they needed to maintain their health and wellbeing. Documentation associated with each person’s care was located in various places throughout the building and this made it difficult for staff to have a full picture of a person’s health, wellbeing and care and support needs.

Fully effective systems were not in place to monitor the quality of the service and drive improvement. Although some audits had been carried out on a regular basis and were effective, others had failed to identify and rectify the issues highlighted within this report.

Procedures were in place to mitigate the risk of employing unsuitable staff and these were adhered to. These included the completion of references from previous employers and a criminal police check. The records we viewed confirmed these were in place prior to staff starting in post.

Staff received an induction, ongoing training and support in their roles.

People spoke of the caring and kind nature of the staff. They also told us there were enough of them to meet their needs. People’s dignity was maintained and their independence encouraged. Staff respected people’s privacy and understood the importance of confidentiality and supporting people with making choices.

The service had processes in place to help protect people from the risk of abuse. Staff had received training in safeguarding vulnerable people. They were able to explain to us how they helped to protect, prevent, identify and report any concerns they many have. The service had made appropriate referrals to the local authority safeguarding team and records showed that the service had followed their recommendations as required.

The risks associated with the premises and working practices had been identified and managed. These had been regularly reviewed and a comprehensive schedule of regular maintenance checks was in place and completed as required. The potential negative impacts associated with adverse events such as loss of utilities or a fire had also been identified and plans put in place in the event of such incidents.

People received their medicines as the prescriber intended and the service followed good practice in regards to the administration and management of medicines. Robust auditing of the medicines management system was in place a