We carried out this unannounced inspection on the 7th and 9th January 2015. We last inspected this service in January 2014.
Loxley Chase is a three-storey converted building providing single en-suite accommodation for up to 30 older people including people who were living with dementia. There is a lift giving access to all floors. The home has a large lounge as well as a smaller snug area, a dining room and a separate room, which is used for activities and social events. It is situated close to shops and amenities and it is on a bus route providing access to Middlesbrough town centre.
The home had a registered manager in place and they have been in post as manager since 2005. 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.
People living at the service received good, kind care and support that was tailored to meet their individual needs. Staff ensured they were kept safe from abuse and avoidable harm. People we spoke with were positive about the care they received and said that they felt safe.
Staff were trained and understood the principles and processes of safeguarding, as well as how to raise a safeguarding alert with the local authority. Staff said they would be confident to whistle blow (raise concerns about the home, staff practices or provider) if the need ever arose.
Accidents and incidents were monitored each month to identify trends. We found that when trends were found action was taken. For example certain times of the day were highlighted as being high risk, so the provider ensured extra staff were rostered on to cover these times.
We found people were cared for by sufficient numbers of suitably qualified, skilled and experienced staff. Robust recruitment and selection procedures were in place and appropriate checks had been undertaken before staff began work. This included obtaining references from previous employers and a we saw evidence that a Disclosure and Barring Service (DBS) check had been completed before they started work in the home. The Disclosure and Barring Service carry out a criminal record and barring check on individuals who intend to work with children and vulnerable adults, to help employers make safer recruiting decisions and also to prevent unsuitable people from working with children and vulnerable adults.
We observed a morning medicines round and observed medicines were administered and stored correctly.
We observed two meal times. On the first observation we saw staff supporting people to eat, one of whom tried to feed two people at once, which meant neither person received the support they needed. On the second observation two members of staff were feeding two people in the lounge. Both members of staff were sat chatting to each other and did not seem to be including the people they were feeding, and one of the staff members was feeding the person whilst sitting at the side of them, not directly in front of them. We discussed this with the registered manager and the owner who said they would act on this immediately with staff.
The service was clean and tidy. We observed the cleaning rota that highlighted what needed cleaning when. We saw there was plenty of personal protection equipment (PPE) such as gloves and aprons. Staff we spoke to confirmed they always had enough PPE. The infection control policy was in need of updating to include contaminated bedding and clothing being placed in red bags.
The registered manager had been trained and had a good knowledge of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). The registered manager understood when an application should be made, and how to submit one. Staff did have a limited understanding but were booked in for MCA and DoLS training on the 25th February 2015.
People’s needs were assessed and care and support was planned and delivered in line with their individual care needs. The care plans contained a good level of information setting out exactly how each person should be supported to ensure their needs were met. The care plans included risk assessments which were sufficiently detailed for each individual.
People were supported to maintain good health and had access to healthcare professionals and services. People were supported and encouraged to have regular health checks and were accompanied by staff or relatives to hospital appointments.
Staff received training to enable them to perform their roles and the service looked at ways to increase knowledge to ensure people’s individual needs were met. Staff had regular supervisions and appraisals to monitor their performance and told us they felt supported by the registered manager.
We saw people were provided with a choice of healthy food and drinks which helped to ensure their nutritional needs were met. People were also supported to use equipment they may need to maintain their independence whilst staying at the service such as adapted plates and cutlery. People also had a choice of which dining room they ate in.
We saw people had access to advocacy services. Advocacy seeks to ensure that people, particularly those who are most vulnerable in society, are able to have their voice heard on issues that are important to them). One person used such a service from Avalon, this had been set up where they had previously lived and was kept going once the person moved to Loxley Chase.
People who used the service were encouraged to be as independent as they wanted to be. They often went for cream tea at Nunthorpe Hall. We saw evidence of some excellent activities taking place at the time of our inspection.
The service had a system in place for the management of complaints, although not all complaints were documented. One relative we spoke with related a concern, the registered manager rectified this at the time of our inspection and the relative was satisfied with the outcome.
There were effective systems in place to monitor and improve the quality of the service provided.
We saw safety checks and certificates that were all within the last twelve months for items that had been serviced such as fire equipment and water temperature checks.