Background to this inspection
Updated
6 January 2017
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
We carried out our inspection visit on 2 November 2016. The inspection was unannounced. The inspection team consisted of two inspectors, a nurse specialist advisor and an expert by experience (ExE). An ExE is a person who has personal experience of using this type of service or caring for someone who uses this type of service.
Before our inspection visit we reviewed information we held about the service. This included previous inspection reports, and notifications sent to us by the provider. Notifications tell us about important events which the service is required to tell us by law. We also reviewed the Provider Information Return (PIR). This is a form completed by the provider, where the provider gives key information about the service, what the service does well and improvements they plan to make. We also contacted the local authority we were responsible for the funding of some people that used the service.
We spoke with eight people who used the service, a relative of one person who used the service, five care workers, the team leader, the manager and area manager. We looked at the care records of five people who used the service, people’s medication records and fluid monitoring records, staff training records, three staff recruitment and supervision records and the provider’s quality assurance documentation and policies. We observed staff and people’s interactions. We spent time observing the care and support that people received. We also used the Short Observational Framework for Inspectors (SOFI) to observe the support staff provided to people over lunch time. SOFI a specific way of observing care to help us understand the experiences of people who were unable to talk to us.
Updated
6 January 2017
This was an unannounced comprehensive inspection that took place on 2 November 2016. At the last inspection completed on 2 July 2015, we found the provider had not met the regulations for three areas; safe care and treatment, staffing and good governance. At this inspection we found the provider had made some of the required improvements and the regulations were being met.
Lutterworth Country House Care Home provided accommodation and personal care for up to 66 older people living with dementia and similar health conditions. At the time of our inspection there were 48 people using the service.
Accommodation is provided over two floors. The ground and first floors provide a dining area, and two lounges. The ground floor in addition has a conservatory. There is a garden which is accessible and provides areas of interest. People who are living with advanced levels of dementia were accommodated on the ground floor.
Staff had not received supervision and appraisal at the frequency specified within the provider’s own policy and procedure. We also saw that not all staff had accessed training required to equip them with the necessary knowledge and skills to provide effective care to people. Staff demonstrated a very limited understanding of the Mental Capacity Act (MCA) 2005 and the Deprivation of Liberty Safeguards (DoLS) and were not supported to ensure that they supported people in accordance with relevant legislation and guidance.
The provider had safe recruitment practices. They completed relevant pre-employment checks which ensured new staff were safe and as far as possible were suited to supporting the people who use the service. People we spoke with told us there were sufficient numbers of staff on duty to meet their needs. We received mixed responses from staff about staffing levels. We found that the provider was taking measure to address the recruitment and availability of sufficient numbers of staff to support people.
People received their medicines as prescribed by their doctor. They told us staff supported them to take their medicines in a timely manner. Records showed that people received their medicines as prescribed. We found some issues regarding the storage of medicines. The provider rectified these immediately.
People felt safe when they used the service at Lutterworth Country Care Home. Staff were aware of their responsibilities to keep people safe from abuse and avoidable harm. They put into practice the provider’s policies to safeguard people. The provider assessed risks associated with people’s care. This identified where people could be at risk and the additional support they required to remain safe.
People received the support that they required to meet their nutritional needs. People received the support that they required to meet their health needs. They had prompt access to healthcare services when needed.
Staff were kind and compassionate to people. We saw that people were supported in a positive and caring manner. Staff that we spoke with demonstrated an interest in the people who used the service, that people mattered to them and treated them with dignity and respect. They provided the support that people needed to be involved in decisions about their care by giving them choices. People told us that staff respected their choices.
Staff supported people to be as independent as possible. People’s care plans described the level of assistance people required to complete various tasks whilst enabling them to remain independent.
The care that people received was focused on their individual needs. Their care plans were comprehensive and included information that guided staff to tailor support to the individual. People’s relatives were involved in developing their support. Staff regularly reviewed people’s care plan to ensure that it reflected their current needs. The provider ensured that the environment within the home met people’s needs.
People were supported to access a variety of activities which reduced their risk of becoming socially isolated. They were support to engage in meaningful activities and to follow their interest. They were also supported to maintain links with their relatives and friends.
People had opportunities to provide feedback about the service they received. We saw that the provider responded to their feedback and made improvements were this was required.
People and their relatives felt that the home was well-managed. The provider had systems and procedures for assessing and monitoring that they provided a good quality service. We saw that the manager completed regular audits and dealt with any issues these identified. They consulted with people, staff and other professionals to make the required improvements in the service.
Staff felt supported by the manager and team leader to meet the standard expected of them. They told us that they were approachable and within easy access to staff and people. The manager was in the process of registering with the Care Quality Commission to become the registered manager. 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.