Archived: Leighton House Private Nursing Home

Leighton House Private Nursing Home is a care home which provides personal and nursing care for up to 27 people. At the time of the inspection there were 24 people living at the service. They had a range of support needs, such as dementia, older age, frailty, and some required more complex nursing care.

People’s experience of using this service and what we found

People told us that they felt safe living at the service. Staff knew people well and demonstrated a good understanding of their needs. Recruitment procedures were robust and adequate checks were made on their conduct and suitability before they started work. The service was clean and well maintained, and staff adhered to the latest infection control guidance. Medicines were appropriately administered and recorded.

There was visible leadership and a clear person centred culture within the service. Staff were able to raise concerns with the manager and these were addressed in a timely manner. Relatives told us that communication was good and they felt involved in decisions and were made to feel welcome when visiting. The Registered Manager had good oversight of the service with systems in place to identify shortfalls and rectified these without delay.

People were supported to have maximum choice and control of their lives and staff them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

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 (published 16 March 2020).

Why we inspected

This was a planned inspection based on the previous rating.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

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.

We found the following examples of good practice.

Clearly communicated measures were in place to reduce the risk of visitors spreading infection. All visitors were screened for symptoms of COVID-19 before being allowed to enter the home.

Staff had received regular training about infection prevention and control including specific training about personal protective equipment (PPE) and how to use it correctly. The frequency of infection prevention and control training had increased in response to the COVID-19 pandemic.

People living at the service had individual COVID-19 risk assessments which were regularly reviewed. This was to help identify factors which might make them particularly vulnerable and how these could be addressed.

The layout of communal areas had been adapted to help with social distancing. For instance, tables and chairs in the dining area and lounge had been spaced out where possible.

Cleaning had increased during the COVID-19 pandemic and frequently touched surfaces such as light switches and lift buttons were cleaned regularly throughout the day to reduce the risk of infection. There were hand sanitizer dispensers readily available around the service.

Leighton House Private Nursing Home is a care home which provides personal and nursing care for up to 27 people. At the time of the inspection they were supporting 24 people. The care home accommodates people over three floors in one adapted building with a lift.

People’s experience of using this service and what we found

The provider did not always follow suitable recruitment procedures to ensure people’s needs were met safely. We have made a recommendation.

People were supported by kind and caring staff who treated people as individuals and with dignity and respect. Staff spoke knowledgably about the systems in place to safeguard people from abuse. People were supported by staff who were inducted, trained and supervised.

People told us they felt safe and systems were in place to safeguard people. Risks to them were identified and managed. Where required people were safely supported with their medicines. Infection control measures were in place to prevent cross infection. The support required by people with health and nutritional needs was identified and provided.

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’s privacy and independence were promoted. Systems were in place to deal with concerns and complaints. This enabled people to raise concerns about their care if they needed to.

People had person centred support plans in place. People and their relatives were actively involved in their care and contributed to the development of care plans and reviews. People had staff support to access activities in the home and the community. People’s communication needs were identified, and their end of life wishes were explored and recorded.

People, relatives and staff told us the registered manager was approachable and supportive. Staff told us they felt well supported by the service. Whilst the provider had established quality assurance systems, they had failed to identify recruitment procedures had not been followed appropriately. The service worked well with other organisations to improve people’s experiences.

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 Good (Published 12 July 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

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.

At the last inspection on 21 October 2014, the service was rated Good. At this inspection we found the service remained Good.

Why the service is rated Good.

People were safe living at Leighton House. Staff understood any risks involved in their care and took action to minimise them. Accidents and incidents were recorded and reviewed to ensure any measures that could prevent a recurrence had been implemented. There were sufficient numbers of staff who were appropriately trained to meet the needs of the people who live here. Staff understood their roles in keeping people safe and protecting them from abuse. Staff recruitment procedures were safe to ensure staff were suitable to support people in the home.

Staff managed the medicines in a safe way and were trained in the safe administration of medicines. People received their medicines when they needed them.

Staff received a comprehensive induction and ongoing training, tailored to the needs of the people they supported. Staff received regular support in the form of annual appraisals and formal supervision to ensure they gave a good standard of safe care and support.

People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

People had enough to eat and drink, and received support from staff where a need had been identified. People’s individual dietary requirements where met. People’s healthcare needs were monitored and they were supported to obtain treatment if they needed it. People who had ongoing conditions were supported to see specialist healthcare professionals regularly.

People enjoyed living at the home and had developed positive relationships with staff and the other people who lived here. Staff treated people with respect and maintained their privacy and dignity. People were supported to maintain relationships with their friends and families. People were encouraged to be independent.

People were encouraged to give their views about the service they received and the provider responded positively to feedback. People had access to activities. The registered manager was in the process of employing a new activities coordinator to increase the choice and frequency of activities for people.

The registered manager provided good leadership for the service. They were experienced in their role and communicated well with people, relatives and staff. Staff felt valued and had access to support and advice from the registered manager if they needed it. Staff shared important information about people’s needs effectively. Team meetings were used to ensure staff were providing consistent care that reflected best practice.

The provider had effective systems in place to monitor the quality of care and support that people received. Quality assurance records were kept up to date to show that the provider had checked on important aspects of the management of the home. The registered manager had ensured that accurate records relating to the care and treatment of people and the overall management of the service were maintained.

The provider and staff have continued to improve the service since our previous inspection. This included a completed redesign of the communal area to better meet the mental health needs of the people who live here.

Further information is in the detailed findings below.