6 July 2019
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
An inspector and inspection manager were present at the service on the first day. An inspector, assistant inspector and Expert by Experience were present on the second day. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
Lent Rise 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 service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We read the report of a recent visit by Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used all of this information to plan our inspection.
During the inspection
We spoke with ten people who used the service and five relatives. We had discussions with the registered manager, clinical lead, three nurses, four care workers and two housekeeping staff. We spoke with an activity organiser, the leisure and lifestyle manager, the chef and regional operations lead for older people’s services.
We observed mealtimes in different parts of the home, part of a medicines round and a daily meeting for managers and leaders to report any concerns or areas for follow up.
We looked at a range of records. These included seven care plans, seven staff recruitment files, seven staff development files, the staff training matrix and staff meeting minutes. Medicines administration records were looked at for two of the houses. We checked a sample of internal audits, audits by the provider, records of complaints, accident and incident forms. Other records included maintenance and upkeep of the premises, health and safety records and a sample of policies and procedures.
After the inspection
We sought clarification about some of the evidence we found about fire safety precautions at the service.
6 July 2019
About the service
Lent Rise House is a nursing home which can provide care for up to 60 people. Thirty six people used the service at the time of our inspection. The building was purpose-designed and divided into four units, known as ‘houses’. Each house contained en-suite bedrooms, shared bathrooms, shared dining and lounge areas and small quiet areas. Ground floor houses provided care to people with dementia; first floor houses provided care to people with general nursing needs. There was a shared lounge on the ground floor used for activities and other events. There were well-maintained enclosed gardens with seating areas for people to enjoy
People’s experience of using this service and what we found
People were protected from the risk of injury or harm at the service. Staff understood about safeguarding people from abuse and undertook training to ensure they followed safe working practices. People were assisted by staff who had been suitably recruited and received good support to be able to meet their needs. Medicines were managed safely and people received support to access healthcare services as and when they needed them. End of life care was managed sensitively.
People’s nutritional needs were met and any weight loss concerns were managed appropriately. People were protected from the risk of infection and the premises were kept clean and odour-free. There was appropriate maintenance of the building to ensure people were kept safe. The landlord had carried out a survey of all fire doors at the home. The survey report identified actions were needed but it was not known whether all of these had been completed. We have made a recommendation about this.
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 could take part in a range of activities and there were good links established with the local community.
Managers monitored the service to make sure it met people’s needs in a safe and effective way. Staff worked well together. They treated people with compassion and kindness, respected their privacy and dignity and took account of their individual needs. People were supported to be as independent as they could be. Staff understood about people’s communication needs and provided appropriate support to them where required. People’s equality and diversity needs were well met at the service.
The provider kept us informed of any significant events and worked well with us and other external agencies to monitor and improve people’s care. Action was taken when things went wrong or people made complaints.
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 22 June 2018). There were no breaches of regulations at that time but the provider needed to show they could sustain improved practice in the Safe, Effective, Responsive and Well-Led domains. At this inspection we found improvements had been made.
Why we inspected
This was a planned inspection based on the previous rating.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Lent Rise House on our website at www.cqc.org.uk.