Lobswood House

Lobswood House is a residential care home that provides accommodation and personal care for up to 26 people living with dementia or mental health needs. At the time of our inspection, 20 people were living at the home.

People’s experience of using this service and what we found

Since the last inspection the management team and the staff have made improvements which has raised the standard of care people received and the overall governance of the home. The manager was reviewing and updating care plans, to ensure they accurately described how each person should be supported. Staff were knowledgeable about people's needs and people's safety had not been impacted.

People were protected from avoidable harm as risks to people's health and safety were identified and assessed. People were protected from the risk of abuse and staff were aware of their safeguarding duties and how to report concerns. People and their relatives told us they felt safe and were cared for by staff who knew them well. A relative said, “I can’t tell you how pleased I’ve been. [Person] is absolutely safe.” Medicines were managed safely, and people received their medicines as prescribed. People and their relatives told us there were enough staff with the appropriate skills and training to meet their needs. A relative said, “There is enough staff and I see the same faces when I visit, they have managed it so well (the transition from moving from their own home to a residential home.”

People were treated with kindness, dignity and respect. Staff interactions with people were warm and caring. A person said, “They (staff) are kind. Which is really important because I'd love to stay in my own house, not a care home. But I’d struggle. I know this. I have to be in a care home and what makes it bearable is having nice, kind staff.” A relative said, “[Person] is happy and quite pleased (with the quality of care). Staff look after [person] well and understands [person].” Another relative said, “[Person] is cared for really well. Staff are so supportive, the change in [person] is amazing.” The service provided a homely environment and people were supported to drink enough and maintain a balanced diet.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 11 June 2019) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations. The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.

Why we inspected

This inspection was prompted by a review of the information we held about this service. We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

People’s experience of using this service: People told us they were happy and felt safe living at Lobswood House; One person said, “I like living here the staff are nice.” However, we found people were not always protected from risks associated with their environment.

The provider did not have sufficient oversight of the service. Quality assurance systems were not always effective as they did not identify the issues we found at this inspection. These included concerns relating to the management of risk for example, falls from height and ensuring that the home was working within the principles of the Mental Capacity Act 2005 (MCA).

There was a risk that people's rights were not protected because staff did not always act in accordance with the Mental Capacity Act 2005 (MCA). Where people's capacity was in question MCA assessments were not always taking place and best interests decision processes had not always been followed.

People received personalised care from staff who knew them well and understood how to meet their needs. Care plans contained information about individual preferences and what was important to people such as interests and activities.

People’s medicines were managed, stored and administered safely and appropriately by staff who had been trained and assessed as competent to do so

People's privacy and dignity was respected, their independence promoted, had access to healthcare professionals when required and were supported to maintain a balanced healthy diet.

People were supported by staff who had completed a range of training to meet their needs. Staff told us they felt well supported by the management team. The management team monitored staffs’ practice through regular observation and formal supervision.

People were treated kindly and compassionately and supported to express their views and make decisions about their care. People and their relatives felt comfortable raising complaints and were confident these would be listened to and acted on.

Rating at last inspection: Lobswood House was previously rated as ‘Good.’ The report was published on the 22 December 2016.

Why we inspected: This was a planned inspection that was scheduled to take place in line with Care Quality Commission scheduling guidelines for adult social care services.

Enforcement: We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Please see the ‘action we have told the provider to take’ section towards the end of the report.

Follow up: We will continue to monitor the service through the information we receive until we return to visit as per our re-inspection programme.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Lobswood House is a residential care home registered for up to 26 people living with dementia or mental health needs. At the time of our inspection, 24 people were living at the home. Lobswood House is situated in a residential area of Littlehampton. The majority of bedrooms are of single occupancy and some have en-suite facilities. Communal areas include a large sitting room, smaller sitting room, dining room and an outdoor patio area with tables and chairs.

A registered manager was 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.

People were protected from avoidable abuse and harm by trained staff who knew what action to take in the event of suspected abuse. Risks to people were identified, assessed and managed safely. Staffing levels were sufficient to meet people’s needs appropriately and staffing rotas confirmed this. New staff were recruited according to a robust recruitment process which the provider had in place. Medicines were managed safely.

Staff completed training in a range of areas and new staff followed the Care Certificate, a universally recognised qualification. Staff had regular supervision meetings and attended team meetings where items were discussed including staffing and residents' needs. Handover meetings enabled staff to discuss people’s care and support needs and any issues that staff coming on shift should be aware of. Staff understood their responsibilities under the Mental Capacity Act (2005) and associated legislation, Deprivation of Liberty Safeguards, and put this into practice. People had sufficient to eat and drink and menus provided people with a choice of food. Healthcare professionals supported people to maintain good health and a range of services was available. Rooms generally were personalised and recent redecoration of parts of the home had been completed, with further planned improvements in the next 12 months.

Staff knew people well and positive, kind and caring relationships had been developed. People and their relatives spoke highly of the care and staff at Lobswood House. People were supported to express their views and in decision making about their care. Relatives were also involved in care planning. People were treated with dignity and respect and they were encouraged to maintain their independence.

Care plans were comprehensive and provided detailed information to staff about people’s care needs and how they wished to be supported. A range of activities was planned to provide entertainment to people, some from external entertainers. Staff also supported people in activities such as arts and crafts and reminiscence. The provider had a complaints policy in place and no formal complaints had been received within the last year.

People were asked for their views about the home through conversations with the registered manager. Relatives gave their feedback through questionnaires and the results were positive. Staff felt the home was well managed and that the registered manager was accessible and approachable. A range of quality assurance systems was in place to measure and monitor the standard of care, including health and safety audits.

We saw that people's privacy and dignity were respected and that they were involved with their care as much as practicable. We observed that the care given was safe and appropriate and based on effective care planning and risk assessments. This meant that people's individual needs were met and their preferences were taken into account.

People were protected from the risks associated with poor medication management. We saw that medicines were properly handled and administered in line with the providers policy. We noted that there were sufficient numbers of experienced staff to provide good care. We also found that systems were in place for people and relatives to make a complaint about the service if necessary.