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Inspection Summary

Overall summary & rating


Updated 17 October 2018

We inspected this service on the 20 and 21 September 2018 and it was unannounced.

Leonora 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. Leonora Home accommodates 20 people in one adapted building. At the time of our inspection there were 12 people living at the service.

There was a registered manager in post. 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.

At our last inspection in May 2017, we found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because medicines that were prescribed ‘as required’ (PRN) were not managed safely. We asked the provider to complete an action plan to show what they would do and by when to meet the Regulations. At this inspection, we found the service had made the required improvements.

Medicines were managed safely. We observed staff administering medicines and saw their practice was safe. The medicines administration records were completed in full with no unexplained gaps. Protocols for ‘as required’(PRN) medicines were in place with good detail for staff to know when to administer particular medicines.

Risks had been identified, assessed and there were detailed risk assessments in place to keep people safe. There were environmental risk assessments, which identified generic risks, safety measures were detailed and reviewed regularly.

There were sufficient staff available to meet people’s needs. Staff understood their role in keeping people safe and had received training on safeguarding people from harm. The registered manager had carried out the required pre-employment checks before staff started work.

Staff were trained and had opportunity for regular supervision. New members of staff had an induction period where they could learn about the job role. There was a clear staff structure and everyone was aware of their responsibilities.

People had sufficient food and drinks. Feedback from people about the food was very positive, they appreciated the choice and quality on offer.

The premises were kept clean and well maintained. At our last inspection we observed staff wearing gloves in corridors. At this inspection staff did not apply gloves until they were in people’s rooms or bathrooms. The service was a small home that felt very homely.

People were supported by a staff team that knew their needs well. We observed kind and positive interactions. People are 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 support this practice.

Care plans were comprehensive and regularly reviewed. There was a ‘key-worker’ system in place, which meant people were allocated a member of staff to work more closely with.

People had been given the opportunity to record their end of life wishes. The service had supported people at the end of their lives with assistance from healthcare professionals.

Activities were varied and provided daily. People had the option to be involved but could also choose to spend time doing their own activity. Visitors were welcomed without restriction.

There were regular meetings for people, relatives and staff and minutes were kept. Surveys were completed so that feedback about the service could be sought. Complaints were managed, recorded and investigated in full.

Inspection areas



Updated 17 October 2018

The service was safe.

Medicines were managed safely.

Staff were recruited safely with the required pre-employment checks in place. There were sufficient staff to meet people’s needs.

Risks had been identified and measures were in place to make sure people were safe. The environment was risk assessed and well maintained.

The service was clean with no odours noted. We observed the staff followed effective infection prevention and control good practice.



Updated 17 October 2018

The service was effective.

People’s needs were continually assessed and referrals were made to healthcare professionals where needed.

People told us they were very happy with the food. Food was of good quality, people had choice and the support they needed to eat and drink sufficiently.

Staff were trained and supported by the provider and registered manager. They had opportunity for formal supervision and an annual appraisal.

The home had 20 rooms, two had en-suite facilities and some were quite small. Plans were in place to build a new home nearby.



Updated 17 October 2018

The service was caring.

People were supported by staff that were kind and caring.

Family members and friends were able to visit without restrictions. People were supported to maintain important relationships.

People were involved in their care and support. There were regular ‘resident’s meetings’.



Updated 17 October 2018

The service was responsive.

People’s care needs were being met. Care and support plans were detailed and reviewed monthly.

Activities were available and varied. People were encouraged to participate and given support from staff if needed.

Complaints were recorded and investigated by the registered manager. All complaints received were closed.

End of life care had been provided and people were supported to make decisions about what they wanted at the end of their lives.



Updated 17 October 2018

The service was well-led.

The registered manager gathered people’s views and feedback. People, relatives and staff told us they found the registered manager to be approachable.

Community links were established. The service had a number of regular volunteers who visited to provide support to people.

Team meetings were held regularly and minutes kept. Staff told us they felt supported by the registered manager.

Quality assurance was comprehensive and made sure all areas in the service was monitored. All senior staff were involved in quality assurance systems.