This was an unannounced inspection which took place on 23, 24 & 25 January 2017. The service was last inspected June 2015 and rated as ‘good’. A comprehensive inspection was carried out in January 2017 as there has been a change of legal entity for the service.Lakeside View is a care home located in a residential area of Southport, near to the town centre. The aim of the service is to provide nursing care for people who are living with dementia and enduring mental health needs. All floors are accessed by a passenger lift and on the mezzanine level there is a stair lift. There is car parking space to the front of the home and a terraced garden.
The service had a newly appointed 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 HSCA and associated regulations about how the service is run.
When looking round the home we saw there were some adaptions to promote an environment suitable for people with dementia.
We recommend however that further consideration needs to be given to further developing the environment in accordance with ‘best dementia practice’ to support people’s physical/ emotional wellbeing and promote their independence.
Staff sought consent from people before providing support. When people were unable to consent, the principles of the Mental Capacity Act 2005 (MCA) were followed, in that an assessment of the person’s mental capacity was made and decisions made in the person’s best interest.
The registered manager had made appropriate referrals to the local authority applying for authorisations to support people who may be deprived of their liberty under the Deprivation of Liberty Safeguards (DoLS). DoLS is part of the MCA and aims to ensure people in care homes and hospitals are looked after in a way that does not inappropriately restrict their freedom unless it is in their best interests. Applications were monitored by the registered manager.
The staff we spoke with described how they would recognise abuse. Staff received safeguarding training and understood their responsibilities to report any concerns.
Staff were recruited safely, with appropriate background checks to ensure people who were barred from working with vulnerable people were not employed.
Staff were present in sufficient numbers to enable people's care and support to be provided in a timely manner. Appropriate intervention was provided by the staff when people needed support. Changes were, however being made regarding the deployment of staff to ensure more staff were available in the lounges/dining room as key times.
People had a plan of care which recorded their care and support needs. Care was organised so any risks were assessed and plans put in place to maximise people’s independence whilst minimising risks to their safety.
We saw relative involvement with the plan of care and care documents were kept up to date through regular care reviews.
Appropriate referrals were made to external health professionals for advice and support to ensure people’s health and wellbeing.
There were systems in place to make sure medicines were given safely in the home. Management undertook checks of records to ensure medicines were managed safely.
A varied programme of social activities was offered to people living at the home based on individual need and preference. This helped to promote people’s social independence.
Staff received an induction and worked with more experienced staff. Staff received training and support to ensure they had the skills and knowledge to undertake their job role effectively.
Staff were polite, patient and caring in their approach. Staff had a good knowledge of people’s care needs and how they wished to be supported.
People’s nutritional needs were managed in accordance with their dietary requirements. People were offered a good choice of hot and cold meals and drinks.
Risks within the environment were assessed to help maintain a safe environment for people to live in.
We found the home clean on our inspection though following our visit concerns were raised regarding some cleanliness issues and the provider will be providing a written response.
A complaints procedure was in place and relatives we spoke with were aware of how they could complain. We saw that a record was made of any complaints and these had been responded to.
Quality assurance systems and processes were in place to help assure the service. This included a number of audits and also obtaining feedback from people who used the service and their relatives. This was obtained via daily discussions, meetings and surveys. We saw some actions were taken to improve practice and to drive forward improvements.