Archived: Lymewood Court Nursing Home

We considered our inspection findings to answer questions we always ask;

Is the service safe?

Is the service effective?

Is the service caring?

Is the service responsive?

Is the service well-led?

This is a summary of what we found -

Is the service safe?

Systems were in place to assess any risks identified when planning people's care and support.

People who used the service, their relatives and carers felt the service was safe.

Is the service effective?

People who used the service told us that they were happy with the care and support they received. Their comments included, 'Food is good', 'Visitors are always welcome' and 'A very happy place.'

Is the service caring?

People told us they were supported by pleasant staff. People who used the service commented, 'The staff are good. They work really hard' and 'we have a good laugh.'

Is the service responsive?

A system of review was in place to enable care plans to be updated on a regular basis.

Systems were in place to regularly assess and monitor risks to individuals and the environment, catering and care planning. People who used the service told us that staff always responded to their needs and wishes. One person told us, 'If you need to see a doctor they get one straight away, if not sooner.'

Is the service well-led?

A quality assurance system was in place which included the regular monitoring of health and safety; infection control and the environment.

We undertook an inspection in December 2013 to determine progress towards meeting regulation and improvements within the service.

We found that significant improvements had not been made.

Care records reviewed did not detail the needs of people who lived in the home. This meant there was a risk people would not receive the care and treatment they needed. We saw that treatment and care was not monitored in order to make sure that people's needs were consistently met.

We looked at medicine administration and found medicines were not administered safely to people. People had run out of medication or had received medication incorrectly.

People spoke positively about the menus in the home and told us they enjoyed the food. We saw that the cook had made improvements to the information available to people, choices of meals and presentation of meals. We found that people's nutritional needs and fluid intake was not correctly assessed and risks to people had not been recognised.

The service did not have an effective system to assess and monitor the quality of care provided. Where a need for improvement had been recognise there were no formal plans in place as to what action was to be taken or any effective monitoring arrangements in place. .

Records within the service were inaccurate, out of date and did not reflect the needs of people living in the home.

We found people were treated with respect and dignity. We observed the staff providing care and support to people in accordance with individual need. Care records reviewed, for example, wound management, pain relief and nutrition did not detail the care needs of people who lived in the home. This meant there was a risk people would not receive the care and treatment they needed to ensure their health and well-being.

We looked at medicine administration and found medicines were not administered safely to people.

People spoke positively about the menus in the home and told us they enjoyed the food.

The number of staff available had been increased at the home. People we spoke with told us that for the majority of the times their calls for assistance were answered promptly by the staff.

The service did not have an effective system to assess and monitor the quality of care provided to people. This placed people at risk of receiving inappropriate care or treatment.

Our inspection was carried out late afternoon and early evening. We found there were insufficient staff on duty for long periods of time to provide care and support to people at the home. A number of people were unobserved by the staff in the lounges and dining room for long periods of time. This was because the staff were assisting people with personal care in their bedrooms and bathrooms. They were also serving supper to people. There was a risk therefore that a number of people did not receive care and support when they wished to receive it or when they needed it. There was little time for social interaction and inclusion by the staff with people, as they were undertaking a number of care duties to ensure people's comfort and wellbeing.

Information was available about visits by health care professionals, such as GPs and wound care nurses who visited people at the home. Records seen were clear, detailed and showed the support and treatment people received.

Areas of the home seen at the time of our visit were clean and odour free.

During the inspection we found people did not receive effective, safe and appropriate care, treatment and support to meet their individual needs. There was a lack of appropriate monitoring for changes in people's medical conditions and also a lack of information recorded about the level of care and support people needed and received. This included how the staff supported people with their nutrition.

Infection control procedures were in place, which meant people were cared for in a clean hygienic environment.

People told us they were satisfied with the standard of accommodation. During the inspection we found the home to be well lit, warm and ventilated. There was plenty of communal space for people to relax in comfort and sufficient bathing facilities.

At the time of the inspection was saw staff were available to meet people's needs. People we spoke with told they did not have to wait long for assistance when they needed help.

Systems in place to monitor and ensure further ongoing improvement of the service were not as robust as they should have been to ensure the ongoing protection of people who lived at the home.

We asked the provider to complete a provider compliance assessment (PCA) for this outcome. This document enables providers to tell us about the service and how they are maintaining compliance. The information provided meant the provider (owner) had a more robust system for managing records held at the home.