Archived: Lake View Manor

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with relatives and people who used the service and speaking with staff. We also looked at records. If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

People who used the service were treated with dignity and respect by the staff.

Improvements had been made to the environment and the service was safe, clean and regular checks of equipment and hygiene were carried out. We found four windows required restrictors to prevent them from opening too wide. This was mentioned to the manager and addressed quickly.

We found there was sufficient staff to support people safely.

The service had policies and procedures to provide staff with guidance about their role and tasks.

Is the service effective?

People's health and social care needs were assessed with them and there was input from relatives. Specialist needs in relation to diet, falls, mobility and equipment were identified and planned for.

There had been improvements to the equipment used in the service. New chairs and commodes had been purchased and new carpets fitted in corridors, communal areas and some bedrooms.

Visitors told us they could see people in private and were made to feel welcome at all times.

Is the service caring?

People were supported by kind and attentive staff. We saw that staff showed encouragement and patience when supporting people.

People's preferences, likes and dislikes had been recorded and care and support was provided in accordance with people's wishes and choices. Staff demonstrated they knew people's needs and preferences.

Relatives told us they were kept informed.

Is the service responsive?

We observed staff involved people and offered each one choice in regard to their needs. The staff approach to people who used the service was respectful and friendly.

People had access to a range of health and social care professionals such as GPs, district nurses, dieticians, occupational therapists, opticians and chiropodists. There was evidence the staff team sought appropriate advice, support and guidance during emergency situations.

People told us they felt able to complain and make suggestions about the service during meetings and on a day to day basis.

Is the service well-led?

We found improvements had been made in the way the quality of the service provided was monitored and included audits and questionnaires. Records showed us that shortfalls identified during these checks were addressed. The action plans could indicate timescales more clearly and this was mentioned to the manager. A redecoration and refurbishment plan is to be sent to the Care Quality Commission so progress can be monitored.

We observed the manager to be approachable and people who used the service and their relatives spoke highly of them.

Staff told us they were well supported by the manager and received supervision meetings and annual appraisal. Staff meetings were held so information could be exchanged and views expressed. Comments included, 'Yes we have monthly supervisions that are signed. We talk about how we are getting on, how we are feeling and the service users', 'It's a good place to work' and 'We have good support; we can speak with the manager and we've been told it's an open door policy.'

The manager dealt with issues straight away to prevent them from escalating into complaints.

What people who used the service and those that matter to them said about the care and support they received.

Comments from people who used the service included: -

'I told staff I fainted in my bedroom so they called the doctor out', 'Yes, I always get my medicines on time', 'I love the meals; I'm putting weight on', 'I have an hours bed rest every day', 'They never just walk in, they always knock first' and 'I wouldn't want to go anywhere else.'

'There have been improvements in decoration, carpets, new commodes and cleanliness.'

'The staff are brilliant; I really cannot fault the staff. If you ask them or ring the bell they answer promptly or will let you know if they will be a few minutes', 'The staff are kind; yes they are very good', 'I think the carers are wonderful', 'The manager comes round and asks if everything is ok' and 'They are very friendly, I wouldn't go anywhere else.'

'They (the manager) would sort out any concerns' and 'I think the home runs very smoothly. I would be able to complain and feel confident the manager would sort it out.'

Comments from relatives included: -

'She has regular checks and they have changed tablets to liquids as she had difficulty swallowing', 'I like the home and think she is well looked after' and 'She had lots of position turns during the night but these disturbed her so they got a special mattress and she has less turns; she has no sores and is much happier.'

'There has been an improvement in the environment; it's much cleaner', 'It started going down about a year ago, the odours and cleanliness, but it's much improved' and 'There have been lots of changes. It never really smelled bad but the carpets were getting threadbare.'

'All the girls are nice, friendly and helpful; they are happy and you can have a laugh with them', 'The staff are caring; they talk to her and treat her as they would their own relative' and 'She is well looked after; I think the staff are great.'

'The manager is on the ball; they have been fabulous from the beginning and they keep us informed and let us know how she is.'

We found improvements had been made to the care plan records; people's needs in all areas had been properly assessed and detailed care plans were in place to direct staff on the care support required.

The people we spoke with told us they received the support they needed and were happy with how staff delivered their care. One person told us, 'Staff are very kind and give us the support and help we need' and another said, 'There is a lovely atmosphere in the home, very friendly and welcoming.'

The provider had made improvements to the laundry area and replaced the floor coverings in two people's bedrooms. One person's relative told us, 'I'm happy with the new flooring; the smell in the room was so strong before.'

However, we found further concerns about infection prevention and control in the service.

We had not intended to inspect outcomes relating to the environment and equipment but we also identified concerns in these areas.

We found care and treatment was not always planned in a way that would ensure people's safety and welfare. This was because care plans had not always been developed where care needs had been identified and they had not always been updated when care needs had changed. However people we spoke with were satisfied with the care they received. One person told us, 'If I need help, I just ring for the staff and they come straight away. I'm very happy with the support I receive. They will do anything for you.'

We found poor systems in place to minimise the prevention and spread of infection in the laundry area. We also found some carpets around the service were dirty and mal odorous.

There were effective recruitment and selection processes in place. Background checks had been carried out on staff before they started to work at the service to make sure they were suitable to work with vulnerable people. Staff were described as, 'Very kind and thoughtful.' People told us they were well looked after.

We saw the complaints procedure was available to people who used and visited the service. People told us they had no complaints, but said they would feel comfortable taking any concerns to the manager.

A person visiting the home at the time of the inspection commented, "I am currently considering coming to the home on a full time basis. I have been in a few times now and I think it's excellent and the nurses are brilliant, they always make me welcome.'

People told us they enjoyed their meals, they had choices and the meals were well cooked. They also said they had plenty to eat and drink throughout the day. One person told us; 'We are well looked after and fed and watered very well.'

We saw management checks of medication records which was completed by the deputy manager and observed that the home had appropriate systems to identify concerns of poor recording.

We saw that the communal areas were homely, warm and comfortable. Individual bedrooms were homely and contained personal belongings such as photographs and pictures.

We saw there was a training plan in place which ensured all staff had training updated regularly.