Archived: Lavender Court Care Home

Lavender Court is a residential care home providing personal care for up to 36 people. The service provides support to people requiring care and assistance. Some people were living with dementia. At the time of our inspection there were 18 people using the service.

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

There were enough staff to meet people's needs and ensure their safety. Appropriate recruitment procedures ensured prospective staff were suitable to work in the service.

Staff told us that they had received the training they needed to meet people’s needs safely and effectively. The training matrix was overseen by an administrator and senior staff. This ensured all staff received the training and updates needed to provide safe consistent care.

Staff were supported in their roles through a plan of supervision. Staff told us they felt supported by senior staff and the manager.

There was equipment available to support staff in providing safe care and assistance. Health and safety checks of the environment and equipment were in place.

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.

Safeguarding processes were in place to help safeguard people from abuse. Risks associated with people's care had been assessed and guidance was in place for staff to follow. Medicines were safely managed.

There were processes in place to prevent and control infection at the service. Additional training and systems had been adopted through the COVID-19 pandemic. There were additional cleaning and safe visiting precautions.

Governance systems had been reviewed. Changes made to the management structure ensured effective oversight of the service. The service had clear and effective governance systems in place.

The management team maintained oversight of complaints, accidents and incidents and safeguarding concerns. The management team engaged well with health and social care professionals.

For more information, please read the detailed findings section of this report. If you are reading this as a separate summary, the full report can be found on the Care Quality Commission (CQC) website at www.cqc.org.uk

Rating at last inspection:

The last rating for this service was good published 07 July 2021.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

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.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Lavender Court Care Home is a residential care home that provides personal care for up to 36 predominantly older people, some of whom are living with dementia. Fifteen people currently lived at the service. The home had two floors. There was a range of sharing dining and lounge areas, although due to the low number of people living there the second floor was not being used at the time of this inspection.

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

At the previous inspection there had been some instability in the management team. At this inspection the service manager had applied, to register with the Care Quality Commission (CQC). This would meet the condition of registration for the location Lavender Court.

The manager provided effective leadership. Staff told us they had been well supported and reported the manager had made significant improvements within the service.

The service’s governance arrangements were effective, and action had been taken to address and resolve the breach of the regulations identified at our last inspection.

The service had developed how it assessed, reported and responded to risks. Staff had been provided with guidance on the management of risks within the service and understood how to meet people’s individual risks. There were sufficient staff deployed to meet people's needs and staff recruitment was on-going to ensure increases in resident numbers could be managed safely by suitable staffing levels.

Medicines were managed safely, and people received their medicines as prescribed. The systems in place to monitor the quality of care within the service were effective

Accidents had been investigated to identify areas of improvement or learning and to prevent similar incidents from reoccurring.

Everyone living at the service had a care plan which was regularly reviewed, and changes made where necessary.

Visiting arrangements for people’s families had been facilitated, in line with government guidance at any given time, throughout the pandemic. Nominated relatives were able to make visits to see their loved ones, and this had been welcomed.

The building was clean, and there were appropriate procedures to ensure any infection control risks were minimised. Management of the service had been vigilant in their approach to minimising the risk of COVID-19 infection, and procedures were in place to ensure people were protected.

Feedback from people and their relatives about the service’s performance was valued by the manger and any issues raised were investigated and action taken where necessary. The duty of candour was understood by the manager and relatives told us the service communicated with them effectively.

Rating at last inspection

The last rating for this service was Requires Improvement (published 7 October 2020).

Why we inspected

The inspection was carried out to follow up on the action we recommended the provider take at the last inspection. As a result, we carried out this focused inspection to review the key questions of Safe, Responsive and Well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions 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.

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.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Lavender Court Care Home on our website at www.cqc.org.uk.

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.

Lavender Court Care Home is a residential care home that provides personal care for up to 36 predominantly older people, some of whom are living with dementia. At the time of the inspection seven people lived at the service. The home was on two floors with a range of sharing dining and lounge areas, although due to the low number of people living there the second floor was not being used at the time of this inspection.

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

Since registering as a new provider in May 2019 there has been a lack of consistent leadership and management at the service. In that time there had been four different managers in charge of the day-to-day running of the service. The latest manager, who had been in post for 10 days at the time of our inspection, was a member of the provider’s operations team and was already familiar with the service.

Staff were positive about the new manager and this manager demonstrated a good knowledge of people’s needs. They had also addressed some of the concerns about communication with external professionals and management oversight that had prompted this inspection. However, because the service had such a new staff team and a history of inconsistent leadership not enough time has elapsed to evidence the sustainability of the management team.

Since the last inspection improvements had been made to how risks were identified, assessed, monitored and reviewed. However, we had concerns about how some records were kept about decisions taken in relation to the risk management of people's care.

Improvements had been made to the systems for staff recruitment, staff training and inductions. There were enough staff on duty to meet people’s needs and staff knew how to keep people safe from harm. Staff had received appropriate induction, training and support to enable them to carry out their role safely.

There were clear records to show, when assessed as needed, staff were monitoring specific health needs such as people’s weight, nutrition and hydration and skin care.

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.

The premises were clean and well maintained. Cleaning and infection control procedures had been updated in line with Covid-19 guidance to help protect people, visitors of staff from the risk of infection.

People had access to equipment where needed. The gardens were accessible and there was garden furniture for people to use in the summer.

People were involved in meal planning and staff encouraged them to eat a well-balanced diet and make healthy eating choices.

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. (Report published on 2 January 2020). The provider completed an action plan after the last inspection to show what they would do and by when to improve.

Why we inspected

We received concerns in relation to management of the service and the quality of care and support that was being provided. There had been some safeguarding concerns raised by other professionals. As a result, we carried out a focused inspection to review the key questions of safe, effective and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has remained requires improvement. This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvements. Please see the well led section of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Lavender Court Care Home on our website at www.cqc.org.uk.

Enforcement

At this inspection we have identified a continued breach in relation to the governance and oversight of the service.

Follow up

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

Lavender Court Care Home is a residential care home providing personal care to 36 people, some of whom are living with dementia. People are primarily aged over 65 years. At the time of the inspection five people lived at the service. The home was on two floors with a range of communal areas. These included dining spaces and lounges.

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

Whilst people seemed happy with the care they received, they were not always protected from the risk of harm. Appropriate risk assessment procedures were not in place so any risks to people were not always minimised. The registered provider had not consistently taken suitable action in a timely manner.

Staff were not always recruited appropriately. For example suitable references were not always obtained when new staff had previously worked in a caring capacity.

Staffing levels were not satisfactory. Staffing levels, during the day on the days of the inspection were stretched, and depended on managerial staff assisting care staff to deliver adequate support to people. However we observed people receiving prompt support from care staff when required.

Care planning systems were not satisfactory. Care plans did not always accurately outline people’s needs, and were not being accurately reviewed when people’s needs changed.

Staff induction procedures were not satisfactory. For example there was not suitable information to show staff had received a comprehensive induction, or supervisory staff had provided comprehensive information to assist new staff to carry out their roles. There were gaps in the delivery of training staff had received. This meant staff employed had not received all training which was legally required and to assist them to carry out their roles. There was no record staff had received any one to one supervision with a senior member of staff.

The service had not been managed effectively which had led to the identified failings. The manager did not have sufficient time to carry out their managerial duties. However the current manager had only been in post for a short period. The manager and the nominated individual were aware of some of the shortcomings highlighted and said they were working to make suitable changes. Staff and the majority of people had confidence in the management of the service.

It is too early to conclude if management were able to demonstrate the service learned from mistakes to minimise them happening again.

The provider had inadequate systems to monitor service delivery and bring about improvement when necessary.

Some external professionals currently did not have confidence the registered provider was working well with them to provide good quality care.

The service had suitable safeguarding systems in place, and staff had received training about recognising abuse.

The medicines system was well organised and staff received suitable training. People received their medicines on time.

The building was clean, and there were appropriate procedures to ensure any infection control risks were minimised.

The service had suitable assessment systems to assist the registered provider to check they could meet people’s wishes and needs before admission was arranged.

People received enough to eat and drink. Some people said the quality of meals was variable. People received some choice about the meals they received.

People received care and support in the least restrictive way possible and in their best interests. Policies and systems in the service supported this practice.

People received support from external health professionals and were encouraged to live healthier lives.

People said they received support from staff which was caring and respectful. Care promoted people’s dignity and independence. People were involved in decisions about their care.

People had the opportunity to participate in some activities and to spend time with the wider community.

People felt confident raising any concerns or complaints. There had not been any complaints about the service since it was registered.

The team worked well together and had the shared goal of providing a good service to people who lived at the home.

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 inadequate (published 24 May 2018). Since this rating was awarded the registered provider has altered its legal entity .

Why we inspected

The inspection was prompted due to concerns received about standards of care, staffing levels and management of the service. A decision was made for us to inspect and examine those risks.

We have found evidence that the provider needs to make improvements. Please see the Safe, Effective, Responsive and Well Led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

Enforcement

We have identified breaches in relation to staffing, staff recruitment, induction, training and supervision, risk assessment and care planning, and quality assurance and governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from 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.