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Inspection carried out on 6 December 2017

During a routine inspection

This inspection took place on 6 and 7 December 2017 and was unannounced. This meant the staff and provider did not know we would be visiting.

Lindisfarne Care Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Lindisfarne Care Home accommodates 61 people in one adapted building across three separate floors. Some of the people using the service were living with dementia. On the days of our inspection there were 60 people using the service.

The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like 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.

We last inspected the service in October 2015 and rated the service as ‘Good.’ At this inspection we found the service remained ‘Good’ and met all the fundamental standards we inspected against.

Accidents and incidents were appropriately recorded and risk assessments were in place. The registered manager understood their responsibilities with regard to safeguarding and staff had been trained in safeguarding vulnerable adults.

Procedures were in place for the safe administration and storage of medicines. However, some as required medicines were not appropriately recorded.

The home was clean, spacious and suitable for the people who used the service. Infection control audits were carried out monthly and an overall audit conducted annually, and appropriate health and safety checks had been carried out.

There were sufficient numbers of staff on duty in order to meet the needs of people who used the service. The provider had an effective recruitment and selection procedure in place and carried out relevant vetting checks when they employed staff. Staff were suitably trained and received regular supervisions and appraisals.

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. However, some mental capacity assessments were blank or were not decision specific. Some of the consent to care and treatment records were not signed by people or their representatives.

People were supported with their dietary needs. Care records contained evidence of people being supported during visits to and from external health care specialists.

People who used the service and family members were complimentary about the standard of care at Lindisfarne Care Home.

Staff treated people with dignity and respect and helped to maintain people’s independence by encouraging them to care for themselves where possible.

The service supported people to access local advocacy services but no-one was currently using advocacy services at the time of our inspection visit.

Care records showed that people’s needs were assessed before they started using the service and care plans were written in a person-centred way. Person-centred is about ensuring the person is at the centre of any care or support plans and their individual wishes, needs and choices are taken into account.

Care plans were in place that recorded people’s plans and wishes for their end of life care.

Activities were arranged for people who used the service based on their likes and interests and to help meet their social needs.

The provider had an effective complaints procedure in place and people who used the service and family members were aware of how to make a complaint.

The provider had an effective quality assurance process in place. Staff said they felt supported by the registered manager. People who used the service, family member

Inspection carried out on 19 and 23 October 2015

During a routine inspection

This inspection took place on 19 and 23 October 2015 and was unannounced. This meant the staff and provider did not know we would be visiting.

Lindisfarne Care Home provides care and accommodation for up to 61 elderly people with residential and nursing care needs. On the day of our inspection there were 60 people using the service, some of whom had a dementia type illness.

The home had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

Lindisfarne Care Home was last inspected by CQC on 13 November 2013 and was compliant.

There were sufficient numbers of staff on duty in order to meet the needs of people who used the service. The provider had an effective recruitment and selection procedure in place and carried out relevant checks when they employed staff.

Accidents and incidents had been fully recorded and analysis carried out to identify any trends.

People were protected against the risks associated with the unsafe use and management of medicines.

Staff training was up to date and staff received regular supervisions and appraisals, which meant that staff were properly supported to provide care to people who used the service.

The home was clean, spacious and suitable for the people who used the service.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that as far as possible people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible.

People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. The application procedures for this in care homes and hospitals are called the Deprivation of Liberty Safeguards (DoLS).

We checked whether the service was working within the principles of the MCA, and whether any conditions on authorisations to deprive a person of their liberty were being met. We discussed DoLS with the registered manager and looked at records. We found the provider was working within the principles of the MCA.

All of the care records we looked at contained evidence of consent.

People who used the service, and family members, were complimentary about the standard of care at Lindisfarne Care Home.

Staff treated people with dignity and respect and helped to maintain people’s independence by encouraging them to care for themselves where possible.

We saw that the home had a programme of activities in place for people who used the service.

Care records showed that people’s needs were assessed before they moved into Lindisfarne Care Home and care plans were written in a person centred way.

Risk assessments were in place where required and were regularly reviewed.

The provider had a complaints policy and procedure in place and complaints were fully investigated.

The provider had a robust quality assurance system in place and gathered information about the quality of their service from a variety of sources.

The service had good links with the local community.

Inspection carried out on 12, 13 November 2013

During a routine inspection

This was a follow up inspection where we did not collect the views of people at the home or visitors.

At our last inspection in June 2013 we found the provider was not protecting people from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were not properly maintained and easy for staff to access. At this inspection we found improvements had been made. We found people were now protected because the provider had made improvements in the way records were kept and maintained and these were available for staff to use and guide their practice.

We also found that improvements had been made to ensure that medicines were managed safely.

We also visited the home following information of concern given to CQC. The information indicated the dignity of people living at the home was not protected. We found the manager had taken successful steps to promote the dignity of people living at the home.

Information given to CQC also indicated peoples� dietary needs were not catered for. We found the manager had taken successful steps to make sure anyone who was likely to be at risk from a poor diet, had a plan in place to support them and there was evidence this was carried out and monitored by the manager, nurses and doctors where necessary.

Information given to CQC indicated there was insufficient equipment at the home. We found there was enough equipment to promote the independence and comfort of people who used the service and people were protected from unsafe or unsuitable equipment.

The provider had taken steps to make sure people at the home were protected from staff who were unsuitable to work with vulnerable people. This was because they had carried out thorough background checks.

Inspection carried out on 21, 27 June 2013

During an inspection looking at part of the service

At our last inspection in September 2012 we found the provider was not protecting people against the risks of unsafe use and management of medicines. This was because people had not received their prescribed treatments.

At this inspection we found improvements had been made. We found people were now protected against the risks of unsafe use of medicines because the provider had appropriate arrangements in place.

However we found people were not protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were not properly maintained and easy for staff to access.

This was a follow up inspection where we did not collect the views of people at the home or visitors.

Inspection carried out on 18 September 2012

During a routine inspection

During our visit we spoke with several people who used the service and with their relatives. They said staff respected their privacy and dignity. They told us staff knocked on their bedroom doors before entering and were polite with them. One person said, �I have to use a hoist now but the staff make sure my dignity is protected.�

People at the home said they felt involved in decisions about their care.

One person told us, �It�s marvellous, they care for me here really well.�

People told us they were happy with the support they received from staff.

One person told us, �They (staff) are like family friends, they are the people you see everyday who look out for you.�

People said their care was monitored by the provider and the manager to make sure that it was meeting their needs. One person said, �They (the manager and staff) keep asking but I couldn�t think of any bad things to say about the home.�

When we visited the home we found some people were unable to tell us directly about their experiences and views of their care. However, we did talk with relatives who were visiting and saw staff practices as they worked with people to meet their needs.

One person�s relative said, �We have meetings where we can say what we think � and people do. Or you can go to the manager for a quiet word if you want to mention something.�

Inspection carried out on 14 February 2012

During an inspection looking at part of the service

We did not speak with people living in the home about their medicines. We saw that medicines were given at the appropriate times and we heard care workers talking to people kindly and patiently when these were given.

Inspection carried out on 21 October 2011

During a routine inspection

When we visited the home we found that some people were unable to tell us directly about their experiences and views of their care. However, we did talk to relatives that were visiting and saw staff practices as they worked with people to meet their needs.

One person�s relative said, �They bend over backwards to keep everyone happy.�

We met with visitors who said that they liked the way that they were involved in helping staff to understand peoples� views and preferences.

One person said, �It�s going smoothly considering the homes only been open for a few months.�

Another said, �There isn�t anything they haven�t been able to sort out, which is reassuring.�