We carried out a review of the data available to us about OSJCT Larkrise Care Centre on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about OSJCT Larkrise Care Centre, you can give feedback on this service.
Larkrise Care Centre is a care home providing personal and nursing care to 55 people aged 65 and over at the time of the inspection. The service can support up to 60 people.
People’s experience of using this service and what we found
People living at Larkrise told us they received safe care from skilled and knowledgeable staff. Staff knew how to identify and report any concerns. The provider had safe recruitment and selection processes in place.
Risks to people's safety and well-being were managed through a risk management process. There were sufficient staff deployed to meet people's needs. Staff recruitment was on-going and changes in the induction process had been made to improve staff retention. Medicines were managed safely, and people received their medicines as prescribed.
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 supported to maintain good health and to meet their nutritional needs.
People told us staff were caring. Staff consistency enabled people to receive good care from staff who knew them well. People had access to activities to prevent social isolation.
Larkrise was well-led by a registered manager who was focusing on improving people’s care. The service had a clear management and staffing structure in place. Staff worked well as a team and complemented each other’s skills. The provider had quality assurance systems in place to monitor the quality and safety of the service.
Rating at last inspection and update
The last rating for this service was requires improvement (published 11 September 2018) and there was one breach of our regulation. 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 was a planned inspection based on the previous rating.
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.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Larkrise 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 care home accommodates up to 60 people. At the time of the inspection there were 56 people living at the service. The accommodation was divided into three wings namely Park Lane which was a dementia unit, Abbey Road which was a nursing unit and The Strand which was mainly a residential unit.
There was a registered manager in place. 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.
Larkrise did not have enough staff to meet people’s needs. On the day of the inspection we saw staff worked continuously to attend to people needs. Staff told us they often worked short staffed and records confirmed planned staffing levels were not always met. People and their relatives also told us staffing levels needed to improve.
We saw the home had staff vacancies which were covered by regular agency staff to meet people's needs. Same agency staff were used to maintain continuity. The management team told us they were doing all they could to ensure safe staffing levels. The registered manager had recruited staff who were waiting to start working. The home had robust recruitment procedures and conducted background checks to ensure staff were suitable for their roles.
People living at Larkrise were supported to meet their nutritional needs. However, the dining experience varied. People on the ground floor did not receive their meals in a timely manner. Staff were poorly deployed during meal times
The service was not always well run. People, their relatives and staff had mixed views on how the service was run. Some people, relatives and staff felt the home was well run whilst others felt it was poorly run. The shortage of staff we identified had had an effect on general staff morale.
The provider had quality assurance systems in place some of which were used to drive improvement. However, dining audits were not always used effectively. We could not find evidence of audits around staffing levels and people’s experiences and views.
Risks to people’s well-being were assessed and managed safely to help them maintain their independency. Staff were aware of people’s needs and followed guidance to keep them safe. Staff clearly understood how to safeguard people and protect their health and well-being. There were systems in place to manage people’s medicines. People received their medicine as prescribed.
People had their needs assessed prior to living at Larkrise to ensure staff were able to meet people’s needs. Staff worked with various local social and health care professionals. Referrals for specialist advice were submitted in a timely manner.
People were supported by staff that had the right skills and knowledge to fulfil their roles effectively. Staff told us they were well supported by the management team. Staff support was through regular ‘trust in conversations’ (one to one meetings with their line managers) and appraisals to help them meet the needs of the people they cared for.
People told us they were treated with respect and their dignity was maintained. People were supported to maintain their independency. The provider had an equality and diversity policy which stated their commitment to equal opportunities and diversity. Staff knew how to support people without breaching their rights.
The Care Quality Commission (CQC) is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) and report on what we find. The registered manager and staff had a good understanding of the MCA and applied its principles in their work. Where people were thought to lack capacity to make certain decisions, assessments had been completed in line with the principles of MCA. The registered manager and staff understood their responsibilities under the Deprivation of Liberty Safeguards (DoLS); these provide legal safeguards for people who may be deprived of their liberty for their own safety.
People knew how to complain and complaints were dealt with in line with the provider’s complaints policy. People’s input was valued and they were encouraged to feedback on the quality of the service and make suggestions for improvements. Where people had received end of life care, staff had taken actions to ensure people would have as dignified and comfortable death as possible.
The home had established links with the local communities which allowed people to maintain their relationships.
We identified one breach of the Health and Social Care Act 2008 (Regulated Activity) Regulation 2014. You can see what action we told the provider to take at the back of the full version of this report.
The service is registered to provide accommodation for up to 60 people who are living with dementia or require nursing or personal care.
At a comprehensive inspection of this service in January 2015 we identified two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 which corresponds with two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These were in relation to the safety and welfare of people and maintaining accurate care records. The provider sent us an action plan to tell us how they would ensure the service met the legal requirements of the regulations. At this inspection in March 2016 we found the required actions had been taken. Peoples care records accurately reflected the care, support and treatment people were receiving. People had been involved in reviewing their care. People had a range of individualised risk assessments in place to keep them safe and to help them maintain their independence. People were assessed regularly and care plans were detailed. Staff followed guidance in care plans and risk assessments to ensure people were safe and their needs were met.
People thought the service was well led. There was a new registered manager at the service. 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 registered manager had driven forward the required improvements, and had a clear plan for further changes and improvements to continue to improve the quality of service people received.
People enjoyed living at the service. They told us they felt safe and staff were friendly, kind and caring. People were cared for in a respectful and dignified way. People were provided with person-centred care which encouraged choice and independence. Staff knew people well and understood their individual preferences. People told us they enjoyed the many and varied activities on offer.
There were enough staff to meet people’s needs. People felt supported by competent staff. Staff felt motivated and supported to improve the quality of care provided to people and benefitted from regular supervision and training in areas such as dementia awareness.
People were supported to have their nutritional needs met. However, people’s views on the quality of the food was mixed and the food at mealtimes was not always presented in an appetising way. People were supported with specialist diets.
The provider, registered manager and staff understood their responsibilities under the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS); these provide legal safeguards for people who may be unable to make their own decisions or who may be deprived of their liberty for their own safety.
The registered manager sought feedback from people and their relatives and was continually striving to improve the quality of the service. There was an open culture where people and staff were confident they could raise any concerns and these would be dealt with promptly.
We visited Larkrise Care Centre on 14 January 2015. The service is registered to provide accommodation for up to 60 people who are living with dementia or require nursing or personal care.
This was an unannounced inspection. We previously inspected the service in November 2013. The service was meeting the requirements of the regulations at that time.
There was a new registered manager who had been in post since October 2014. 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 and staff spoke highly of the new manager. They said she was open, approachable and visible throughout the home. There was a positive culture where people and staff felt confident to raise any concerns. Staff understood and upheld the values and ethos of the home.
People enjoyed living at the home. They told us they felt safe and staff were very friendly, kind and caring. People were cared for in a respectful and dignified way. People were involved in their care planning. They were provided with person-centred care which encouraged choice and independence. Staff knew people well, understood their individual preferences and supported people in their preferred routines at their own pace.
People were supported to stay healthy and to eat and drink enough. They were offered regular snacks and drinks throughout the day or could help themselves from the dining room kitchens or communal areas. Where people needed additional support or encouragement to eat and drink this was provided. If people lost weight they were referred to the dietician and GP for assessment and advice.
Visiting health professionals were complimentary about the service and commented on the warm and homely environment. Throughout the inspection the atmosphere was calm and pleasant. There were spontaneous sing-a-longs, laughter and chatting. Whenever staff passed a person in their room or the corridor they stopped to check they were okay.
People told us they enjoyed the many and varied activities. People who were living with dementia benefitted from an interesting and stimulating environment. People were able to walk freely around the service and access the garden.
Risk assessments had been carried out to ensure people's safety. However, one person had made a choice to eat food that was contrary to recommendations made by a speech and language therapist (SALT) and to their care plan. The risks of not having a soft diet had not been explained to the person and the speech and language therapist had not been contacted to ask what the risks were if the recommendations were not followed.
People's care records required improving. Prior to this inspection concerns had been raised regarding the care of people being fed by a tube into the stomach. During the inspection we found that the quality and content of the records did not enable the service to evidence that the right care was being been delivered. Improvements were also required to the recording of people's food and fluid intake and some support plans in relation to managing some people's behaviour where it could be described as challenging. Quality assurance systems had not identified any of these areas for improvement. We have made a recommendation about the monitoring and reviewing of quality assurance systems.
There were enough staff to meet people's needs however during the afternoon handover on the nursing unit all staff were in the office and not readily available to support people. During this time we identified people who required assistance and we alerted staff.
Staff understood their responsibilities under the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS); these provide legal safeguards for people who may be unable to make their own decisions. Where restrictions were in place for people we found these had been legally authorised.
The registered manager understood the changes and improvements that were required in the service. The registered manager was ensuring staff were more aware of their responsibilities and accountability through regular supervision and meetings with staff.
We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see the action we took and what action we told the provider to take at the back of the full version of the report.
We conducted a Short Observational Framework for Inspection (SOFI) and spoke with six people. Our observations showed us that people were involved in their care and their dignity was respected. People told us they enjoyed living at the home and they felt involved, safe and well cared for. One said "it really is lovely here, I cannot fault it". People were assessed and risks were well managed.
We spoke with five members of care staff and three kitchen workers. Every one we spoke with told us they liked working at the home and felt well trained and supported to carry out their jobs. All the staff we spoke with told us they had been trained in safeguarding vulnerable adults and the training records confirmed this. This meant people were safe from abuse.
Care workers and staff were recruited appropriately and we saw evidence that the provider had robust systems in place to select, recruit and train workers effectively. The provider checked that candidates were of good character and sought references before they started work.
The provider monitored the quality of service it provided and sought the comments and opinions of people who used the service. Complaints were dealt with in a timely and appropriate fashion and regular service user and staff meetings were held.
People were not always able or well enough to talk to us, but comments from the annual survey included “I like it here because I am allowed to do what I want when I want”. Someone else had written “My privacy and dignity is maintained”. Another person had written, in response to the question about what they most valued, “Privacy”.
One person said that the care they received was “Blooming lovely” and in a 6-monthly review a relative had said that they were “Happy with the quality of care being delivered. Staff are always available when I need to speak to them.”
People are also able to contribute to regular residents meeting which are minuted