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Leafield Residential Care Home Good


Inspection carried out on 7 December 2018

During a routine inspection

What life is like for people using this service:

People continued to benefit from kind and committed staff. People complimented the support received and told us they formed meaningful, caring relationships with the staff. Staff knew what was important to people and ensured people had care that met their needs and choices. People’s dignity, confidentiality and privacy were respected and their independence was promoted.

People received support that met their needs and was in line with care plans and good practice. People’s rights to make own decisions were respected. People were encouraged to maintain good diet and access health services when required.

The registered manager ensured people received safe care and treatment. People complimented the continuity of care provided by skilled and competent staff. People received their medicines safely and as prescribed. Risks to people’s well-being were assessed, recorded and updated when people’s circumstances changed. The staff ensured any lessons learnt were reflected to improve the service delivery.

The service was well run by the registered manager who was supported by a team of committed staff. The provider’s quality assurance processes were effective and there was a focus on continuous improvement. Where an area for improvement had been identified there was a prompt action taken to address it.

People, staff and relatives were involved and felt listened to. The team at Leafield worked well in partnership with other agencies, social and health professionals and external organisations.

Rating at last inspection: Good (report published 13 August 2016).

About the service:

Leafield is a care home. People in care homes receive accommodation and nursing or personal care as a 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 can provide accommodation and care to 24 people. At the time of the inspection 23 people lived there.

Why we inspected:

This was a planned, routine inspection.

Follow up:

We will monitor all information received about the service to understand any risks that may arise and to ensure the next planned inspection is scheduled accordingly.

More information is in Detailed Findings below.

Inspection carried out on 29 July 2016

During a routine inspection

This inspection took place on 29 July 2016. It was an unannounced inspection.

Leafield Residential Care Home is registered to provide accommodation for up to 24 older people who require personal care. At the time of the inspection there were 21 people living at the service.

At the previous inspection on 1 June 2015 we found the home was not always ensuring that person centred care was matched to people’s preferences. We also found that people were not stimulated through a range of meaningful activities. This was a breach of Regulation 9 of the Health and Social Care Act 2008 (Regulated Activities) regulations 2014.

At this inspection we found that the home had made significant improvements to address the areas of concern and bring the service up to the required standards.

The service had a registered manager. 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 service had a part time activities coordinator and people were offered a range of activities. People received person centred care. People were cared for by a service that understood the importance of getting to know the people they supported. There was a clear focus on the importance of knowing people’s histories.

People told us they were safe. People were supported by staff who could explain what constitutes abuse and what to do in the event of suspecting abuse. Staff had completed safeguarding training and understood their responsibilities.

People received their medicines as prescribed. Staff administering medicines checked each person’s identity and explained what was happening before giving people their medicine.

There were sufficient staff to meet people’s needs. Staff were not rushed in their duties and had time to chat with people. Throughout the inspection there was a calm atmosphere and staff responded promptly to people who needed support. The service had robust recruitment procedures and conducted background checks to ensure staff were suitable for their role.

Staff understood the Mental Capacity Act (MCA) 2005 and applied its principles in their work. The MCA protects the rights of people who may not be able to make particular decisions themselves.

The service sought people’s views and opinions and acted upon them. People and their relatives told us they were confident they would be listened to and action would be taken if they raised a concern. Where risks to people had been identified risk assessments were in place and action had been taken to manage the risks. Staff were aware of people’s needs and followed guidance to keep them safe.

People had sufficient to eat and drink. Where people required special diets, for example, pureed or fortified meals, these were provided by kitchen staff who clearly understood the dietary needs of the people they were catering for.

Staff spoke positively about the support they received from the registered manager. Staff had access to effective supervision. Staff and the registered manager shared the visions and values of the service and these were embedded within service delivery. The service had systems to assess the quality of the service provided. Learning from audits took place which promoted people’s safety and quality of life.

Inspection carried out on 27 July 2015

During a routine inspection

Leafield Care Home is a residential care home without nursing that offers a service for up to 24 older people. Some people may suffer from varying types and degrees of dementia. At the time of our visit 21 people were using the service.

This was an unannounced inspection which took place on 27 July 2015. During our last inspection in October 2013 we found the provider did not satisfy the legal requirements in the areas that we looked at. A follow up to this inspection was carried out in September 2014 and we were satisfied that the home had taken the appropriate action surrounding our concerns.

A registered manager was employed by the service. 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 service did not always manage the administration of people’s medicines safely. There were not always photographs on people’s medicine administration records. This protocol is designed to ensure that medicines are being given to the right person.

People were not always protected from untoward events and emergencies, we observed on the day of our inspection evacuation plans were not easily accessible.

The adaption and design of the service did not always meet people needs. Where people were living with dementia the home was not decorated in a way which followed good practice guidance for helping people to be stimulated and orientated.

Staff were able to explain their understanding of how to gain consent to care and treatment. However, consent to care was not always sought before staff assisted people.

During our inspection we observed positive and caring interactions between staff and people. People, relatives and professionals said that the home was caring. However the home was not always responsive to people’s needs and preferences.

Staff protected people from the risks associated with their care. There were enough staff deployed to meet people's needs. People told us they felt safe in the home, staff had a good understanding of safeguarding and the service took appropriate action to deal with any concerns or allegations of abuse.

Staff were aware of their roles and responsibilities. Newly appointed care staff went through an induction period. Staff received the core training required by the provider, such as safeguarding, infection control, manual handling and health and safety.

Staff gave people the time to express their wishes and respected the decisions they made. Staff also ensured that people’s dignity and privacy were respected.

There was a procedure in place which outlined how the provider would respond to complaints. People and their relatives told us they knew what to do to make a complaint, and everyone we spoke with said they felt comfortable speaking with the managers. The registered manager had systems in place to monitor the quality of the service.

People and their family were regularly involved with the service and their feedback was sought by the provider and the registered manager. People’s opinions were sought via satisfaction surveys which were carried out every six months.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.

During a check to make sure that the improvements required had been made

Leafield Care Home is a residential care home without nursing that offers a service for up to 24 older people. Some people may be living with varying types and degrees of dementia. We conducted a desk based review to follow up on issues we identified at our inspection in October 2013 with regard to the safety and suitability of the environment. Our concerns were in relation to many of the windows were not double glazed that meant people who used the service feeling a draft coming through. We saw a number of areas in need of repair and some carpets were sticky underfoot. We also found some chairs in the lounge were marked and stained.

The laundry contained one washing machine and one tumble dryer, which were used for people's personal clothing and towels. All bedding was laundered by an external contractor. The laundry room was very small and clean and dirty items could not be adequately separated. This posed an infection control risk. We were sent an action plan to ensure the issues identified could be improved. Following this review we found that improvements had been made.

Inspection carried out on 16 October 2013

During a routine inspection

At the time of our visit 22 people lived at the home, we spoke with nine people supported by the service, and with six staff. We also spoke with two people�s relatives and a visiting professional. We reviewed six care files and other documents provided by the Registered Manager and other Healthcare professionals.

People and their relatives were complimentary about care provided. One person told us, �They are marvellous; they take their time to get to know people and understand their needs�. People�s records showed that care staff sought the consent of people and their relatives regarding the care they received. We observed that there was meaningful and respectful engagement between care workers and people.

During our visit we found that people�s safety and welfare was adequately protected. Staff we spoke with were able to tell us about how they meet the needs of the people they supported in detail. They showed a good understanding of people�s support needs which had been recorded in their care files.

People who used the service, staff and visitors were not fully protected against the risks of unsafe or unsuitable premises, or from the effects of fire. Some areas of the home were in need of repair and refurbishment. Many of the windows were not double glazed. During our visit we heard one person complaining of feeling cold, and another of feeling a draught. Although there are plans in place to replace these windows, the timescales involved mean that many windows will remain draughty through the winter months.

There was an effective system to regularly assess and monitor the quality of service that people received. We have asked the provider to note that there was a limited system for a person more senior than the home manager to review the quality and risks in the home.

People and people�s relatives we spoke with told us they felt able to raise concerns. One relative told us, �They are interested in what we have to say and hold resident�s relatives meetings��. Staff also felt able to raise concerns and felt supported by the manager. One care worker told us, �The manager is there for us [staff] and all these guys [residents of the service] she wants to know what we think and how we can improve�.

Inspection carried out on 3 May 2012

During a routine inspection

Three people, who lived in the home, told us or indicated by smiling and nodding that they were happy in the home. They told us or indicated that they were well looked after. People told us, or indicated by shaking their heads that they had no complaints.

Four relatives, who spoke on behalf of some of the people who lived in the home, told us that people were always treated with dignity and respect. One relative described it as ��a lovely home with superb care��. They told us that they were confident that their family members were safe in the home. Relatives told us that the home was well staffed and staff were kind and good to the people who lived there. Relatives told us that staff ��go above and beyond their normal duties to ensure people get the best care��.

Inspection carried out on 29 November 2011

During an inspection in response to concerns

People who live in the home told us that it was a �smashing� place to live and they felt safe and happy. They were happy to talk to staff if they had any concerns and were confident that they would be dealt with. We were told that people were treated with great respect.

Reports under our old system of regulation (including those from before CQC was created)