Archived: Lapstone House

Updated 20 March 2021

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

As part of CQC's response to the coronavirus pandemic we are looking at the preparedness of care homes in relation to infection prevention and control. This was a targeted inspection looking at the infection control and prevention measures the provider has in place.

This inspection took place on 9 March 2021 and was announced shortly beforehand.

Updated 20 March 2021

This was an unannounced inspection that took place on 19 March 2018.

We last inspected the service in November 2015 where we found that there were not enough staff deployed at night. We judged the service to be in breach of Regulation 18: Staffing. This meant that the service was judged as requiring improvement in the safe outcome. The registered provider sent us an action plan and confirmed that staffing at night had been increased from two to three support workers. We saw evidence to support this at this inspection in March 2018. We judged the service was no longer in breach.

At our last inspection we rated the service as good overall. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Lapstone House 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. The home provides care and support to mainly older adults, but may also take people living with dementia or those living with learning disabilities.

The home accommodates 25 people in one purpose built building. The home has three separate units, each of which have separate adapted facilities. At the time of our visit only two units were routinely used as there were only 21 people in residence.

The home is situated in the town of Millom and is within walking distance of the amenities of this small town. There are good transport connections in the town. It is operated by Cumbria County Council who run similar services across Cumbria.

The home had a suitably qualified and experienced 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 staff team understood how to protect vulnerable adults from harm and abuse. Staff had received suitable training and spoke to us about how they would identify any issues and report them appropriately. Risk assessments and risk management plans supported people well. Good arrangements were in place to ensure that new members of staff had been suitably vetted and that they were the right kind of people to work with vulnerable adults. There had been no accidents or incidents reported to the Care Quality Commission but the registered manager was aware of her responsibilities if there were any issues in the home.

The registered manager and her senior team kept staffing rosters under review as people's dependency changed. We judged that there were suitable care and support staffing levels in place by day and night. There were suitable numbers of ancillary staff employed in the home.

Staff were suitably inducted, trained and developed to give the best support possible. We met team members who understood people's needs and who had suitable training and experience in their roles.

Medicines were appropriately managed in the service with people having reviews of their medicines on a regular basis. People in the home saw their GP and health specialists whenever necessary. The team made sure that strong medicines and any sedation were kept under review with the local GPs.

Good assessments of need were in place and the staff team reviewed the delivery of care for effectiveness.

People were told us they were very happy with the food provided and we saw well prepared meals that staff supported and encouraged people to eat.

Lapstone House is a purpose built home that was refurbished over twenty years ago and has been updated by the provider since then. The house was warm, clean and comfortable on the day we visited. Suitable equipment was in place to help people with things like mobility.

The staff team were aware of their responsibilities under the Mental Capacity Act 2005. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People who lived in the home told us that the staff were very caring. We observed kind, patient and appropriate care being provided. Staff knew people and their families very well. They made sure that confidentiality, privacy and dignity were maintained. People were encouraged to be as independent as possible. Staff were trained in end of life care and we saw evidence to show that this kind of care had been done to good effect for many years.

Risk assessments and care plans provided detailed guidance for staff in the home. People in the service were aware of their care plans and were able to influence the content. The management team had ensured the plans reflected the person centred care that was being delivered.

Staff could access specialists if people needed communication tools. They had been able to offer people specialist support in the past.

We learned that the home had regular entertainers, activities and parties. Staff took people out locally and encouraged people to follow their own interests and hobbies. Staff in this home were active in raising money for these activities and for adding homely touches to the environment. Local people supported the home in this.

We noted that this home had good links to the community and had a locally based culture. The registered manager ensured that staff understood the vision and values of the County Council. Staff were able to discuss good practice, issues around equality and diversity and people's rights.

The service had a comprehensive quality monitoring system in place and people were asked their views in a number of different ways. Quality assurance was used to support future planning.

There had been no concerns or complaints received but the registered manager was aware of the protocols of Cumbria County Council.

Records were well organised, easy to access and stored securely.

Further information is in the detailed findings below.