We carried out a review of the data available to us about Littlebourne House Residential Care Home on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Littlebourne House Residential Care Home, you can give feedback on this service.
Littlebourne House is a residential care home providing personal and nursing care to 64 older people who may be living with dementia at the time of the inspection. The service can support up to 64 people, in two adapted buildings.
People’s experience of using this service and what we found
People told us they felt safe and happy living at the service. Potential risks to people’s health, welfare and safety had been assessed and there was guidance in place to mitigate risks.
Accidents and incidents had been recorded and analysed, action had been taken to reduce the risk of them happening again. The registered manager and staff understood their responsibilities to keep people safe from discrimination and abuse.
People’s medicines were managed safely. Staff monitored people’s health and referred people to relevant healthcare professionals and followed their guidance to keep people as healthy as possible.
People were supported by staff who had been recruited safely and received training appropriate to their role. Staff received supervision and appraisal to continue to develop their knowledge and skills.
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 met with the provider before moving to the service to check that staff were able to meet their needs. Each person had a care plan that contained details about their choices and preferences. These plans had been reviewed regularly and updated when needed.
People were supported to eat a balanced diet, people had a choice of meals. People’s preferences and dietary needs were catered for. People had access to activities that they enjoyed including minibus trips.
People were treated with dignity and respect. People were supported to be as independent as possible and express their views about their care and support. People’s end of life wishes were recorded. Staff worked with the GP and district nurse to support people at the end of their life.
The registered manager completed checks and audits on the quality of the service and acted when shortfalls were found. There was an open and transparent culture within the service, people were asked their views about the service and these were acted on.
Relatives told us they knew how to complain. The registered manager recorded all concerns raised and had investigated them according to the providers policy. People received information in formats they could understand.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was Requires Improvement (published 30 August 2018) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
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.
Littlebourne House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and care provided, and both were looked at during this inspection. Littlebourne House accommodates up to 64 people across two separate units, each of which have separate adapted facilities. People living at the service may be living with dementia and were able to spend time in either the main house or the King William unit. There were 60 people living at the service at the time of the inspection.
There was no registered manager in post. The previous registered manager had left in May 2018. There was a management team in place including a manager who was going to apply to be registered. 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.
The registered manager and other senior care staff had left the service in May 2018. The provider had not put a plan in place to check that their roles and responsibilities were being completed by other staff. This included the management of medicines, completing care plans and assessing potential risks for new people who moved into the service. There were no care plans, risk assessments and guidance for staff for people who had moved into the service since May 2018. This put people at risk of not receiving consistently safe, effective and person centred care.
People’s needs had not been consistently assessed before they moved into the service. When an assessment had been completed, this had not been put on the electronic care plan system for staff to access. People’s needs were not consistently assessed using recognised tools and following current guidelines.
Audits were completed on the quality of the service but these had not been effective in identifying the shortfalls found at the inspection. When shortfalls had been identified action had not been taken to rectify the shortfalls. Medicines audits had identified shortfalls, these same shortfalls were found at the inspection, people’s medicines were not being managed safely.
There were sufficient staff on duty to meet people’s needs, who had been recruited safely. Staff received one to one supervision to discuss their role and development. Staff received training appropriate to their role. We observed putting their training into practice including infection control, staff wore gloves and aprons when appropriate.
Staff knew how to recognise and report abuse to keep people safe. The manager had reported safeguarding concerns to the local authority when required. Accidents and incidents were analysed for patterns and trends, action was taken and lessons learnt to reduce the risk of them happening again.
People told us that staff were kind and caring while supporting them to be as independent as possible. We observed staff promote people’s dignity and respect their decisions. People had access to a variety of activities. People’s end of life wishes were recorded and staff supported people to be comfortable at the end of their lives.
People and relatives told us they knew how to complain. Any complaints received were investigated in line with the provider’s policy. The complaints policy was not available in formats such as pictorial, this was an area for improvement.
People were supported to remain healthy. Staff encouraged people to be as active as possible including dancing and exercise. People were supported to eat a balanced diet and people had a choice of meals. Staff monitored people’s health and when changes occurred people were referred to healthcare professionals such as the GP or dietician. Staff followed the guidance given to keep people as healthy as possible. People had access to the dentist, optician and chiropodist when required.
People were encouraged to plan their care and express their views. People were 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 supported this practice. People were supported to make decisions about their care and support.
People, relatives, stakeholders and staff were asked their opinions of the service. The results were analysed and the results were positive. People and staff attended regular meetings and any suggestions or concerns were addressed and resolved.
There was an open culture, we observed people going into the office and chatting with the manager and director. Staff told us they felt supported by the manager and provider and could speak to them about any concerns they may have.
The manager recognised the need to keep up to date with changes and improve their skills. The service worked with other agencies such as the local authority and clinical commissioning group.
The service was clean and odour free. People were accommodated in two units that had been adapted to meet people’s needs. Checks and audits had been completed on the environment and equipment to ensure it was safe for people to use.
Services that provide health and social care to people are required to inform the Care Quality Commission, (CQC), of important events that happen in the service. CQC check that appropriate action had been taken. The provider had submitted notifications to CQC in an appropriate and timely manner in line with guidance.
This was the first inspection of the service after the provider change their legal entity. At this inspection three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 were identified. You can see what action we have asked the provider to take at the end of the report.