This inspection took place on 19 and 20 December 2017 and was unannounced. Leah Lodge Care Home 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.
Leah Lodge Care Home is registered to provide care to up to 48 older people, some of whom were living with dementia. 18 people were using the service at the time of our inspection and two were in hospital.
The service has recently been refurbished. Bedrooms are located over three floors and are single occupancy with en-suite facilities. The ground floor is occupied by people who are elderly and the second floor with those living with dementia. The bedrooms on the first floor were not occupied at the time of our inspection. The provider was in the process of making new admissions to the home. There are several communal areas, a café, and hair salon and spa baths for people to use. There is a dining area and sitting room located on each floor and quiet areas where people can sit with their families or alone if they wish to do so. The building and accommodation are wheelchair accessible and there is a passenger lift. The service has three small gardens and the environment appeared well maintained, bright and welcoming.
The service had a registered manager who was also a general manager of the home. 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 who had complex needs were at risk of receiving care and treatment that was not responsive to their needs. Staff did not have sufficient knowledge and skills required to provide care to people at the end of their lives and those enduring a decline in their health because of dementia.
People were supported in line with the requirements of the Mental Capacity Act 2005 (MCA) and the restrictions placed on them by a supervisory body under the Deprivation of Liberty Safeguards (DoLS). Staff understood their responsibility to obtain people’s consent before providing care. However, records did not always show when consent had been given and where best interests decisions had been made. People who were unable to make decisions about their care were supported by their relatives where appropriate and health and social care professionals.
Staff maintained records of the care they provided to people. However, information about people’s daily lives did not always provide sufficient detail of the impact of the care and support being provided.
Appropriate quality assurance checks and audit systems were in place. However, had not been effective in identifying and resolving the shortfalls we identified about care provision at the service.
People were supported by staff who underwent regular supervision and a review of their practice. Staff had attended the provider’s mandatory training to enable them to undertake their roles.
People’s needs were met in a safe and timely manner because risks to their health and well-being were identified and managed. People received the support they required to take their medicines.
A sufficient number of suitably skilled staff were deployed at the service. New staff underwent appropriate recruitment checks before they started to provide care and support.
People were protected from the risk of harm because staff knew how to identify and report potential abuse. Staff minimised the spread of infection by following good hygiene practices. Incidents and accidents were monitored at the service to help staff in learning from mistakes.
People’s nutrition and hydration needs were met. People had meal choices that took into account their preferences, cultural and dietary needs. People had access to healthcare services when needed.
Staff delivered people’s care in a dignified and compassionate manner. People were treated with respect and had their privacy, dignity and confidentiality maintained.
People were involved in planning their care and support. Care plans reflected the support each person required and their wishes and preferences about service provision. People enjoyed taking part in a wide range of activities provided at the service.
People had opportunities to share their views about the service and felt that the registered manager listened to them. People using the service and their relatives knew how make a complaint. Complaints were investigated and resolved in line with the provider’s procedures.
People using the service, their relatives and staff commended the registered manager and about the manner in which they managed the service. Staff understood their responsibilities and were clear about the reporting structures at the service to help provide effective care to people using the service.
People benefitted from the close working partnership between the registered manager and external agencies.
We found one breach of regulation in relation to person centred care and meeting complex needs. You can see what action we have told the provider to take at the back of the full version of this report.