Archived: Lawford House Residential Home

Updated 17 May 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

We made an unannounced inspection on 11 April 2017. The inspection team consisted of two Inspectors and one Expert 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. They had knowledge and experience of care for older people.

We asked the local authority if they had any information to share with us about the care provided by the service. Due to ongoing concerns regarding the care people receive, a local authority action plan was in place with the provider.

We spoke with five people who use the service and two relatives. We spoke with manager, the providers, and four members of staff. We also spoke with two healthcare professionals. We looked at two care records, which included risk assessments, capacity assessments and healthcare information. We looked at the medication administration records, two staff pre-employment checks and quality assurance audits.

Updated 17 May 2017

Lawford House is located in Ross-on-Wye, Herefordshire. The service provides personal care for up to 15 older people. On the day of our inspection, there were ten people living in the home.

The inspection took place on 11 April 2017 and was unannounced.

There was no registered manager at this service, and there had been no registered manager in post since March 2015. However, a manager had been appointed and was in the process of registering with the Care Quality Commission. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered providers and registered managers 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 our previous inspection on 18 and 22 November 2016, we found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These were in relation to staffing, safeguarding service users from abuse or improper treatment, person-centred care, dignity and respect, meeting hydration and nutrition needs, and good governance. As a result, we asked the provider to complete an action plan to detail the steps they would take to improve the quality of care provided to people. The home remained in special measures, meaning significant improvements were required, or enforcement action would be taken.

People and relatives expressed concern over staffing levels and deployment of staff. The physical environment was not conducive to people's safety. Staff did not always sign to confirm they had given people their medicine , so it was not always possible to know people had received their medicines safely and as prescribed.

Health professionals had not always been consulted when people were in need of medical attention. People’s dignity was not always maintained, and terminology used was not always respectful.

People's preferences and interests were not always taken into account, or known by staff. Where people had expressed interest in a particular hobby, this had not always been pursued by staff.

There was no registered manager in post. The registered providers had not taken action when risks and concerns were brought to their attention. Staff felt unsupported in their roles by the providers, and the manager was not given guidance or direction.

Staff had received training which was relevant to their roles and had enhanced their understanding of people's needs. Staff understood the legislation underpinning their daily practice, and what this meant for the people they cared for.

People enjoyed a variety of food and were given choices in what they wanted to eat and drink. People's weight was monitored and action taken where concerns were identified.

People's individual communication needs and styles were known by staff. People's independence was promoted as much as possible.

People could enjoy group outings and more in-house entertainment was provided. People's and relatives' views were sought, and there was a system for capturing and acting on complaints.

The overall rating for this service is 'Requires Improvement.' However, we are placing the service in special measures. We do this when services have been rated 'Inadequate' in any key question over two consecutive comprehensive inspections. The 'Inadequate' rating does not need to be in the same question for each of these inspections for us to place services in special measures.

.