The Care Quality Commission
  • Care Home
  • Care home

Old Leigh House

Overall: Good read more about inspection ratings

3 Old Leigh Road, Leigh-on-Sea, Essex, SS9 1LB (01702) 711111

Provided and run by:
Cygnet (OE) Limited

Important: The provider of this service changed. See old profile

All Inspections

6 July 2023

During a monthly review of our data

We carried out a review of the data available to us about Old Leigh House 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 Old Leigh House, you can give feedback on this service.

9 February 2021

During an inspection looking at part of the service

About the service

Old leigh House is a care home with nursing providing support for up to six people. The service provides care and support to people with mental health or learning disability and complex needs. Care is provided in a large adapted building close to all amenities in the local community. At the time of our inspection five people were using the service.

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

People were positive about their experiences at the service. From surveys we saw relatives were happy with the care their loved ones were receiving.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the guidance CQC follows to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

The service was able to demonstrate how they were meeting underpinning principles of Right support, right care, right culture. Staff promoted people’s independence and care was personalised to each individual person’s needs and goals. Staff supported people to develop their skills and confidence to live full lives.

Care was person centred and delivered in a way that was intended to ensure people's safety and welfare. People were cared for safely by staff who had been recruited and employed after appropriate checks had been completed. Staff had received appropriate training. There were systems in place to minimize the risk of infection and to learn lessons from accidents and incidents. Medicines were dispensed by staff who had received training to do so.

The registered manager and provider had good oversight of the service, they had encouraged a culture of learning and development. There were systems in place to monitor and review care and people's experience at the service.

Rating at last inspection: The last rating for this service was requires improvement published 20 March 2020 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

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from Requires Improvement to Good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Old leigh House on our website at www.cqc.org.uk.

15 January 2020

During an inspection looking at part of the service

We rated Old Leigh House as requires improvement:

  • Staff did not always follow the provider’s policy and procedure for observing patients. We found gaps in the recording of observations and incidents of staff being on enhanced observations for more than two hours against the provider’s policy.
  • Managers did not always make notifications to the Care Quality Commission following incidents or after safeguarding concerns had been raised. We reviewed 13 records of incidents and safeguarding referrals and found staff had failed to notify the Care Quality Commission about four incidents.
  • The provider’s ligature risk assessment was not accurate.
  • Staff and patients did not always have access to a full range of rooms to support treatment. The clinic room did not have space for an examination couch to carry out physical health checks. There were no separate rooms for individual therapy sessions or one to one time with patients. The provider did not have a quiet area for patients to see visitors. Patients’ saw visitors in their bedroom or went out to spend time with them privately.

However:

  • The ward environments were safe and clean. The wards had enough nurses and doctors. Staff assessed and managed risk well, managed medicines safely. Staff had the skills required to develop and implement good positive behaviour support plans to enable them to work with patients who displayed behaviour that staff found challenging. Staff ensured that patients had good access to physical healthcare including access to specialists when needed. We saw evidence in care records that staff referred patients to dentists, opticians, and epilepsy specialists.
  • Staff developed holistic, recovery-oriented care plans informed by a comprehensive assessment. They provided a range of treatments suitable to the needs of the patients cared for in a ward for people with a learning disability (and/or autism) and in line with national guidance about best practice.
  • Staff communicated with patients so that they understood their care and treatment. Staff involved patients where appropriate, in discussions about the service. Staff held regular community meetings with patients. Staff made adjustments for patients with communication needs. All patients had communication passports that had been completed with the input of the speech and language therapist. The provider met the accessible information standards. The provider displayed information in easy read format and staff were able to provide patients with copies of their care plan in easy read formats.

16/05/2017

During a routine inspection

We rated Old Leigh House as good because:

  • The environment was clean and tidy and furnishings were in good condition. Cleaning records were up to date and demonstrated that staff regularly cleaned the environment.
  • The provider had safe staffing levels. We reviewed the duty rotas for the past six weeks. All shifts were covered with sufficient staffing levels.
  • Staff received and were up to date with mandatory training. Training records showed a 99% compliance.
  • Staff completed a thorough and comprehensive risk assessment for each patient. Staff reviewed these regularly during care reviews or when there was a change in risk or following an incident. 
  • There were safe medicines management procedures in place. Staff followed the National Institute for Health and Care Excellence guidelines and the Nursing and Midwifery Council guidance on medication management.
  • Patients' received an assessment of their needs following admission. Staff used the information gathered during these assessments to formulate care plans and risk assessments.
  • Patients' care plans were up to date and covered a range of needs. We checked four patients’ records and found that they reviewed these regularly during care reviews or when there was a change of need. Patients' were involved in the planning of their care and the care plans included the patient’s views.
  • Patients had access to physical health care. The provider registered patients with a local GP service. Staff also monitored physical health need regularly and evidenced this in the patients care records.
  • Patients told us that staff were kind and supported them to meet their needs.
  • Patients told us that the food was of good quality and that there was a choice. Staff would ask patients on a daily basis for their choice of food from the menu. 
  • Staff were aware of how to manage complaints. Staff we spoke with knew what action to take if a patient made a complaint to them. Staff told us they referred complaints to the manager who would then investigate them. 
  • The provider had systems in place to monitor mandatory training, supervision, and appraisals. The manager kept records of staff compliance with training, supervision, and appraisals. We checked these and found that they were up to date.
  • The provider had systems in place to share lessons learned from incidents and complaints. The provider discussed these during governance meetings and then shared with ward staff through team meetings. We reviewed the minutes of these meetings and found incidents and complaints were a standard agenda item.

However:

  • Staff had not complied with the provider’s policy on supervision. All staff had received supervision within the past 3 months. The provider’s policy stated that staff should receive management supervision at least four times per year. The supervision matrix showed that 13 out of the 21 staff listed had not had this in the past 12 months. 
  • Two carers felt they could be more involved in their loved one's care. They told us that they had not been consulted about care plans and had not been given a copy of their loved one's care plans.
  • There was not a private room for patients to use to see visitors.

30 March 2016

During a routine inspection

We rated Old Leigh House as good because:

  • Clinical areas were visibly clean and cleaning records were up to date. Staff prescribed and administered medication appropriately. Staff adhered to infection control principles. Resuscitation equipment was checked and accessible and staff carried personal alarms.
  • Staff completed health and safety risk assessments of the environment, assessed the risks to patients thoroughly and reviewed plans to keep them safe regularly. They produced positive behaviour support plans that were holistic and based on the needs of each patient. Staff were aware of incident reporting and safeguarding processes, how to report and follow procedures.
  • Patients had annual and ongoing physical health monitoring. Patients could see a General Practitioner (GP) at the hospital or at the local GP surgery. Patients could access other services such as dental, dietician or podiatry services when required. Nutrition, exercise and weight management were care planned if required.
  • The hospital was appropriately staffed, regular bank staff were used who were familiar with the service, leave and activities were rarely cancelled due to staff shortages and there was adequate medical cover at day and night.
  • All staff were trained in the Mental Health Act 1983 (MHA) and the Mental Capacity Act 2005 (MCA). Staff read patients their legal rights regularly and advocacy services were available. Staff assessed patients’ capacity to make individual decisions. Where patients were unable to make decisions for themselves, staff worked with local authorities to assess patients’ best interests and invited relatives to meetings to represent patients’ interests. The Responsible Clinician (RC) assessed detained patients’ capacity to consent to treatment on renewal of their detention.
  • Patients had keys to their bedrooms, they had access to drinks and snacks when they wanted them and could personalise their bedrooms. Patients were involved in their Care Programme Approach (CPA) meetings, said they felt safe and listened to by staff, and knew how to complain. Relatives spoke positively about the manager, staff and the progress their relatives had made. Patients were happy with the access to and range of activities provided. They said they went out most days.
  • All patients had Care Treatment Reviews to discuss discharge planning every three months. The hospital worked with case managers and care co-ordinators to find appropriate placements for patients.
  • All staff involved in caring for patients, including nurses, doctors and therapy staff, worked well together and with external agencies.
  • The provider reported, investigated, and learnt lessons from incidents and complaints. These were shared with staff and patients.
  • Staff training, supervision and appraisals were up to date and staff had opportunities for professional development. Staff enjoyed their jobs, had good morale and job satisfaction.
  • Senior managers visited the unit regularly and staff and patients knew who they were.

However:

  • The provider had rated as low risk potentially harmful ligature points (anything that can be used to self-harm with) and the assessment was incomplete. Some staff were not aware of ligature points and the hospital’s ligature risk assessment. However, Staff did mitigate this risk by maintaining constant observations of high-risk patients.
  • The provider escorted all patients on leave, including patients not detained under the Mental Health Act. Staff confirmed this was due to patient risks and vulnerabilities but they would be reviewing their leave policy to consider unescorted leave for appropriate patients.
  • One patient consent to treatment capacity assessment did not include a record of the discussion between the consultant and the patient.
  • Although patients signed care plans, evidence of patient and relative involvement were minimal.
  • Room space was limited. Patients could not access the kitchen to cook and there was no separate clinic room for staff to treat patients. The provider told us they were commencing renovation work to create separate rooms for these purposes.
  • Patients could not make a private telephone call or use the computer, as these were broken. The provider told us these were due to be repaired.
  • Results of a staff survey conducted by the Danshell Group that owns the hospital were not broken down for individual services. Staff at Old Leigh House were not aware of the results for their service.
  • There were no nurse call alarms for patients in their bedrooms, bathrooms or corridors. Staff mitigated this by regularly observing patients.
  • The provider did not have patient discharge care plans or easy read versions for patients to work towards discharge.

9 December 2013

During a routine inspection

We met with all six people that were using the service when we visited. People communicated with us verbally and non-verbally using gestures, pictures or assistive technology. People mostly gave positive feedback. People communicated to us that they felt able to approach staff if they had any issues and that staff gave them support. They indicated that their room was, 'fine' and that they had activities to do in the day.

We found that the provider had systems in place for gaining people's consent for the care and treatment and keeping people safe. Additionally there were arrangements to give staff support, for ensuring the premises were safe and suitable and for assessing and monitoring the quality of service provision.