The Care Quality Commission
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Archived: Cheshire East Council Lincoln House Short Breaks

Overall: Good read more about inspection ratings

Samuel Street, Crewe, Cheshire, CW1 3WH (01270) 375341

Provided and run by:
Cheshire East Council

All Inspections

4 January 2018

During a routine inspection

Cheshire East Council Lincoln House Short Breaks is a 'care home'. People in care homes receive accommodation and nursing or 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 service is registered to provide respite accommodation for up to five people who require support and care with their daily lives. The service is situated near the centre of Crewe.

At the last inspection in October 2015 the service was rated good. At this inspection we found the service remained good.

The care service had been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. We saw that people with learning disabilities and autism who used the service were able to live as ordinary a life as any citizen.

We spoke with two people who used the service and three relatives who all gave positive feedback about the service and the staff who worked in it.

Staff spoken with and records seen confirmed training had been provided to enable them to support people with their specific needs. We found staff were knowledgeable about the support needs of the people that came into the service for respite care.

We found medication procedures at the home were safe. Staff responsible for the administration of medicines had received training to ensure they had the competency and skills required. Following one minor medication error, robust procedures had been followed to minimise any further errors.

The staff understood the requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). This meant they were working within the law to support people who may lack capacity to make their own decisions. We saw that people were supported to make their own decisions and their choices were respected.

Care plans were person centred and developed with the people who came for respite care in the service. They detailed how people wished and needed to be cared for. They were regularly reviewed and updated as required.

The outcomes coordinator and registered manager used a variety of methods to assess and monitor the quality of the service. These included regular audits of the service and staff meetings to seek the views of staff about the service. The staff team were consistent and long standing. They demonstrated that they were committed to providing the best care possible for the people accessing the service.

The future of the service was uncertain as they had been informed that they were under review by Cheshire East Council and that the current accommodation would be changing in the next year. This impacted on everyone and all of the people we spoke with; people using the service, their relatives and the staff were worried about this. The relatives told us that they were dependent on the service and were worried about the negative impact on their relatives and themselves if the service changed or closed.

07 October 2015

During a routine inspection

We carried out an unannounced inspection of Lincoln House Community Support Centre on 7 October 2015.

The home is purpose built and provides support and accommodation for up to 42 people. There are five units within the centre. Four provide social care on a respite or transitional basis for adults with diverse and complex needs. For example, people with learning difficulties, dementia, and physical infirmity. There are a number of transitional beds for people who have been discharged from hospital but are not yet ready to return home. The fifth unit provides adult day care and is not regulated by the Care Quality Commission (CQC). At the time of the inspection there were 22 people staying in the home. The service provided at Lincoln House was being reduced. Cheshire East Council were in the process of negotiating contracts with the private sector to provide most of the services in the future and next year will only be providing respite care for people with learning disabilities.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 our last inspection we found that the provider was not fully compliant with the safe management of medicines, which had resulted in a minor impact on people who used the service. The provider submitted an action plan telling us how they would address this and had provided further training for the staff and carried out regular audits. During this inspection we found that people received their medication in a safe manner.

Prior to this inspection we received feedback from a GP and a district nurse who regularly visited the service. The GP said the service was “excellent” and the district nurse said it was “very good”. During the inspection we spoke to a podiatrist who regularly visited. This person said “It’s the best home I visit, nothing is ever too much trouble and the staff are always willing to help people in any way they can”.

The experiences of people who lived at the home were positive. People told us they felt safe living at the home, staff were helpful and the care they received was good. Relatives and other visitors told us they had no concerns about the way people were treated. Everyone expressed regret that the service was reducing and many said “I don’t think it’ll be as good somewhere else”.

People’s needs were assessed and enablement plans were developed to identify what care and support people required to improve their health and wellbeing and maintain their independence.

People were protected from abuse and felt safe at the home. Staff were knowledgeable about the risks of abuse and reporting procedures. We found there were sufficient staff available to meet people’s needs and that safe and effective recruitment practices were followed.

Some people who used the service did not have the ability to make decisions about some parts of their care and support. Staff had an understanding of the systems in place to protect people who could not make decisions and followed the legal requirements outlined in the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS).

Staff had good relationships with people who lived at the home and were attentive to their needs. Staff respected people’s privacy and dignity at all times and interacted with people in a caring, respectful and professional manner.

People’s health care needs were met and their medicines were administered appropriately. Staff supported people to attend healthcare appointments and liaised with their GP and other healthcare professionals as required to meet people’s needs. People were appropriately supported and had sufficient food and drink to maintain a healthy diet.

Staff received suitable induction and training to meet the needs of people living at the home. Staff were well supported by the managers. This meant people were being cared for by suitably qualified, supported and trained staff.

There were systems and processes in place to monitor the quality of the service. Audits were carried out and where shortfalls were identified the provider had used the information to improve the service. This demonstrated that it was a learning organisation.

11 December 2013

During an inspection in response to concerns

During the inspection we spoke with the manager, two senior carers and a district nurse who made regular visits to people staying at the centre. We met a person who managed their medicines themself; they had stayed at the centre on three separate occasions. They said 'It is good here. I have been back three times.' The nurse told us 'The staff are very helpful. We work as a team.'

We found that appropriate arrangements were in place for obtaining and recording medicines. Staff who administered medicines received training and support for this role. However, when we watched medicines being administered we saw that people were not given their medicines in a safe or appropriate way.

21 November 2013

During a routine inspection

One person who had used the centre said 'I was definitely treated with dignity and respect. All the staff were excellent. I feel everything was excellent and I could not have been looked after better'.

Another said 'Staff are always on hand to make care seem personal. Every member of staff has the best interests of the customers at heart". They commented that the centre was 'Top class and provides a great respite for me'.

The provider had arrangements in place for all staff to receive regular training on safeguarding vulnerable adults. Policies and procedures were in place regarding the safeguarding of vulnerable adults which gave clear instructions to staff on how to respond to concerns.

During our inspection we visited each unit in the centre. We found the centre was well maintained throughout. Decor and furnishings were in good repair. The centre was warm and clean. There were no unpleasant odours.

The provider had systems in place to regularly assess and monitor the quality of service provided. People leaving the centre were given a discharge feedback form and requested to provide feedback on their experience. Administration staff also made courtesy calls to people following their stay. Feedback received was analysed and, if appropriate, changes made to improve service. The manager carried out audits to identify, assess and manage risks relating to the health, safety and welfare of people using the service.

1 February 2013

During a routine inspection

When we carried out our unannounced inspection visit to Lincoln House Community Support Centre we spoke with five people.

One person told us that they were staying for a fortnight and that as a regular visitor they looked forward to their stays saying it was 'nice'. Asked about the staff they told us that they 'like all of them'. Another person said 'they look after you alright' and asked if they were treated decently we were told 'oh aye'. A third person said staff were 'very good' and they 'couldn't wish for better treatment'.

We looked at the documentation for four people and found that they took into account each person's individual circumstances, preferences and risks and that an appropriate care plan was in place.

We looked at the arrangements for ensuring that people were kept safe from risks associated with the unsafe use of medicines and we saw that the home had effective systems for identifying and learning from errors. Staff were seen to follow the home's medicines policy and medicines administration records were completed properly.

We looked at the equipment used to support people in the home and saw that it was suitable, available in sufficient qualities and that it was properly maintained.

The home had recruitment procedures and we found that they were correctly followed and the necessary checks had been made on staff before they started work.

The home had a complaints procedure and when complaints were made they were properly investigated.

6 July 2011

During a routine inspection

When we visited Lincoln House we spoke to people who use the service about their experiences and were told staff 'break their back trying to help', 'Staff are very good' and that 'there's not a miserable one among them'. One person told us that the service was 'The right place to get you going'.

We spoke to two relatives one of whom told us their relative was 'happy here' and the other that the staff were 'very good, nice'.

When we visited the service we noted that every part of the home, including bathrooms and lavatories, was clean, tidy and odour free. We commented to staff at the time of our visit that there was a particularly "fresh" atmosphere in the home.

We observed and took part in the lunchtime meal. We saw that there was a choice of food and that it was well presented and of a good standard. Almost everyone was complimentary about the food and one person told us that you 'can't go wrong with the food here'.