Archived: The Lawns

The Lawns is a residential care home registered to provide personal care to up to 41 people. The home specialises in the care of older people including people living with dementia. At the time of the inspection there were 26 people living at the home.

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

People’s medicines were managed safely, and they received them in the way prescribed.

Risks relating to infection prevention and control (IPC), including in relation to the COVID-19 pandemic were assessed and managed, and safe visiting was supported. The service was continuing to follow all current government guidance in relation to IPC and the registered manager was anticipating updated guidance from the provider.

This was a targeted inspection that considered medicines management and infection prevention and control.

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

Rating at last inspection

The last rating for this service was good (published 21 July 2021)

Why we inspected

The inspection was prompted in part due to concerns received about medicines management. A decision was made for us to inspect and examine those risks.

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.

We undertook this targeted inspection to check on a specific concern we had about medicines management. The overall rating for the service has not changed following this targeted inspection and remains good.

We use targeted inspections to follow up on Warning Notices or to check concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.

Follow up

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

The Lawns is a residential care home registered to provide personal care to up to 41 people. The home specialises in the care of older people including people living with dementia. At the time of the inspection there were 30 people living at the home.

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

People were safe at the home and looked comfortable and relaxed with the staff who supported them. Improvements had been made to how risks were identified and managed which helped to minimise risks to people.

People received their medicines safely from senior staff who had received specific training to carry out the task.

Staff had received training and were following good practice guidelines in infection prevention and control, to minimise risks to people. The home was keeping up to date with government guidance to make sure people were able to keep in touch with friends and family.

There was a stable staff team who knew people well and how they liked to be supported. Staff were happy in their roles which helped to create a warm and relaxed atmosphere for people to live in.

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. People were able to make choices in their day to day lives. We raised some issues with how people chose meals.

People lived in a home where the registered manager was open and approachable. People and staff said they would feel comfortable to raise any issues or concerns with them.

People could be confident that the home was being managed in a way that was committed to making on-going improvements. Improvements had been made in how quality was monitored and areas for improvement were identified and actioned.

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

Rating at last inspection The last rating for this service was requires improvement. (Report published 29 October 2019)

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.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

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.

We carried out an unannounced comprehensive inspection of this service on 10 September 2019. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment and good governance.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Responsive and Well-led which contain those requirements and recommendations.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Lawns on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

The Lawns is a residential care home providing personal and nursing care to 38 people the majority of whom were older people living with dementia at the time of the inspection. The service can support up to 41 people. The service is in Weymouth and is a large detached building with bedrooms on both the ground and first floors. There are fully accessible showers and assisted bathrooms available for people. There are lifts available to access the first floor of the home. The ground floor has a large lounge and dining area and people have access to a level garden to the rear of the home and use of a sensory/activities room and several quiet lounge/seating areas throughout the home.

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

Quality assurance systems were not fully effective. Some of the gaps we identified during the inspection had not been highlighted by the provider's governance systems. However, prompt action was taken by the manager and provider to address the issues.

The risks to people and the risks from the environment had not been fully assessed and planned for. Action was needed to mitigate the risks to people.

People’s care and support plans needed fully reviewing and updating to make sure they included information for staff to be able to provide personalised care and support. The manager anticipated these would all be completed by the end of October 2019.

There was a stable and established staff team who were well trained and supported by their line managers. We have made a recommendation for the provider to review the way the service assesses whether they have enough staff. This is because the layout of the building has an impact on the number of staff needed to safely meet people’s needs.

We have made further recommendations about the improved use of the capabilities of the electronic care planning system and producing personalised activity plans for people that are based on the interest and past life experiences.

There was a friendly, welcoming and relaxed atmosphere at the home. Staff cared about people and were committed to providing them with quality care and support.

There were safeguarding systems and procedures in place and staff knew how to report any allegations of abuse. People’s medicines were safely managed.

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. However, the records to support this practice were not readily accessible to staff.

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

Rating at last inspection The last rating for this service was Good (published February 2017)

Why we inspected

This was a planned inspection based on the previous rating.

We have found evidence that the provider needs to make improvements. Please see the safe, responsive and well led sections of this full report.

We have identified breaches in relation to safety and risk management for people and the environment and the governance of the service at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

The Lawns provides accommodation and personal care for up to 41 people. There were six vacancies at the time of inspection, one of these was a respite bed which was used for people who wanted to have a short stay in the home. The service is located in Weymouth and is a large detached building with bedrooms on both the ground and first floors. There are several fully accessible showers and assisted bathrooms available for people. There are lifts available to access the first floor of the home. The ground floor has a large lounge and dining area and people have access to a level garden to the rear of the home and use of a sensory room and several quiet lounge/seating areas throughout the home.

There was a registered manager 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 felt safe at the service, they were protected from the risk of harm by staff who understood the possible signs of abuse and how to recognise these and report any concerns. Staff were also aware of how to whistle blow if they needed to and reported that they would be confident to do so.

People had individual risk assessments. Staff were knowledgeable about the risks people faced and their role in managing risk. We observed that risks were identified, communicated and managed promptly.

There were enough staff available so that people did not have to wait for support. People had support and care from staff who had been safely recruited and understood their needs. Staff were consistent in their knowledge of people’s care needs and spoke confidently about the support people needed to meet these needs.

People received their medicines safely and we saw that staff checked with people where they had medicines which were ‘as required. Medicines were stored and recorded accurately.

The home had good links with health professionals and regular visits and discussions meant that people were able to access appropriate healthcare input promptly when required.

People were supported by staff who had the necessary training and skills to support them. Training was provided in a number of areas and refresher sessions were booked for certain topics on a regular basis. We identified that more specialist training would be of benefit and the registered manager arranged this promptly.

Staff understood and supported people to make choices about their care. People's legal rights were protected because staff knew about and used appropriate legislation.

Everyone described the food as good and there were systems in place to ensure people had enough to eat and drink. When people needed particular diets or support to eat and drink safely this was in place.

Staff received training in areas which were relevant to their roles and were encouraged to undertake learning and development in other areas relating to the needs of the people living at the home.

People were supported by staff who respected their privacy and dignity and told us that they were encouraged to be independent.

People were supported by staff who knew their likes, dislikes and preferences. Staff told us that they communicated well and there were regular handovers at each shift change. There were clear processes in place for each shift and staff knew their roles and responsibilities.

People had individual care records which were person centred and gave details about people’s history, what was important to them and identified support they required from staff.

People had access to a range of activity options and had opportunities for one to one time with staff if this was their preference. The home had a sensory room which was used by staff to spend time with people who had advanced dementia.

Relatives told us that they felt welcomed at the service and people and relatives said that they would be confident to make a complaint or raise any concerns if they needed to.

There was a clear management structure at the service and the registered manager was available and acted on suggestions and feedback. There was a focus on high quality care which was expected by the registered manager and shared by staff.

Quality assurance measures were regular and information was used to identify issues or trends and actions were planned and taken in response to this.