Background to this inspection
Updated
16 August 2023
The inspection:
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Inspection team
The inspection was carried out by 1 inspector.
Service and service type
Laburnum Cottage 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.
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was a registered manager in post.
Notice of inspection
The inspection was unannounced.
The inspection took place on 28 June 2023 and 4 and 5 July 2023. The first day of inspection was unannounced. On 4 July we contacted relatives of people who live at the service and professionals.
Before the inspection
We reviewed notifications received from the service in line with their legal obligations. We looked at information the provider had sent us about the service in the Provider Information Return (PIR). We asked the local authority to give us feedback about the service.
During the inspection
We looked at 3 people’s care records and checked records relating to people's medicines. We checked audits and quality assurance reports, incident, and accident records, as well as 3 recruitment records for staff. We walked around the service and observed care people received at various times. We spoke with 4 relatives by telephone, 2 people who used the service and 3 professionals. One person invited us to visit them in their flat.
We spoke to 4 staff, including the registered manager, nominated individual, and 2 care staff.
Updated
16 August 2023
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. 'Right support, right care, right culture' is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
About the service
Laburnum Cottage is a residential care home, providing accommodation and personal care to seven people with different health and care needs at the time of the inspection. The service specialises in the care for people with autism and/or learning disabilities, as well as people with mental health conditions. Laburnum Cottage is one of the provider’s several homes on the New Hall campus in Fazakerley, a short walk away from local shops and public transport.
People’s experience of using this service
Right Support
Some people’s individual risk assessments were not always reflective of the support they were receiving and did not always take additional measures to keep people safe putting people at risk of harm. Some audits and checks did were not always robust enough to identify when some improvements were needed to records. People received safe care and they were supported by staff who knew how to protect them from harm. Staff supported people to take their prescribed medicines and to access healthcare services when needed. Recruitment of staff was safe and robust. People could choose how they wanted to spend their time, whether they wanted to be in their own flats or in communal areas with other people.
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.
Right Care
People had dedicated 1-1 time to ensure opportunities for social engagement took place. There was a relaxed atmosphere in the home. Staff spoke and engaged with people respectfully. Personal care was delivered in people’s own flats, to ensure privacy and dignity. People were involved in choices around their care and support.
Right Culture
Staff advocated for people to ensure they had equal access to services, such as employment or education. Staff told us they liked working at the home, and enjoyed supporting people.
Rating at last inspection
The last rating for this service was good (published 30 October 2018).
Why we inspected
The inspection was prompted in part due to concerns received about incidents at the service and staffing levels. A decision was made for us to inspect and examine those risks.
This inspection was a focused inspection to review the key questions of safe, effective and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from good to requires improvement, that is based on the findings of this inspection.
We have found evidence that the provider needs to make improvements. Please see the safe and well led sections of this full report.
You can see what action we have asked the provider to take at the end of this full report
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.
You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Laburnum Cottage on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.