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Lobswood House Requires improvement

Reports


Inspection carried out on 24 April 2019

During a routine inspection

About the service: 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, 23 people were living at the home.

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

Inspection carried out on 8 November 2016

During a routine inspection

The inspection took place on 8 and 14 November 2016 and was unannounced.

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.

Inspection carried out on 7 October 2013

During a routine inspection

We spoke with two people who lived at the home. They were satisfied the care and support they received and were happy living at Lobswood House. One person told us, "It's faultless. I don't know where I would be without them (staff)". Another said, "There is something special about this place. They've got it just right". A visitor said,"The staff are very accommodating and always seem to be on hand". We noted that the home provided a wide range of social events and activities; the people we spoke with were happy with the number and variety of activities on offer.

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.

Inspection carried out on 10 May 2012

During a routine inspection

As people accommodated have dementia many of them were not able to tell us about their experiences. To help us to understand the experiences people have we used our Short Observational Framework for Inspection (SOFI) tool. This tool allows us to spend time watching what is going on in a service and helps us to record how people spend their time, the type of support they get and whether they have positive experiences. We spent 40 minutes watching care and support provided to five people in a lounge during the morning.

We also observed lunch being served and people being helped to eat their meal. We found that people had positive experiences. The care staff on duty knew what support they needed and they respected their wishes if people wanted to be left on their own.

We spoke to the relatives or friends of three people during the visit. Each of the three people we spoke with said the believed people have received good quality care.

We were informed people have been treated with respect and dignity. One person we spoke with commented, �I feel the staff here are really good. They have a lovely approach to people.�

We were also informed that choices have been provided in the food and activities available as well as in how people spent their time.

Relatives and friends we spoke with said care and support needs of people accommodated had been met. Activities were said to be provided and included exercise sessions and musical entertainment. They told us they believed people accommodated were safe.

We were informed the home�s management were approachable and that any suggestions or requests can be made. One relative commented, �The manager is receptive to any problems we may have.� Another relative referred to survey questionnaires being supplied so that people can give their views on the service provided. �I have filled in a questionnaire two or three times.�

Inspection carried out on 22 November 2011

During an inspection in response to concerns

We spoke with three people who live at Lobswood House. They told us all the staff had treated them with respect and that the care they received was good.

We spoke with three members of care staff who were on duty. They demonstrated they knew about the level of care that each person required. They also told us they were well supported by the manager and well trained so that they were able to provide good quality care.

We also spoke with a district nurse who was visiting to provide treatment to people living at the care home. They told us, �The care provided to people here is fine. I have never known anything to be wrong.�

We spoke with the manager about how the quality of service provision has been assessed and monitored.