Archived: Loudoun House Care Home

Updated 7 December 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check 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.

This inspection took place on 1 and 2 November 2016. The first day of our visit was unannounced. We returned announced the next day.

The inspection team consisted of two inspectors and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Before the inspection visit the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We reviewed the information within the PIR along with information we held about the service. This included notifications. Notifications tell us about important events which the service is required to tell us by law.

We contacted the commissioners of the service to obtain their views about the care provided. The commissioners had funding responsibility for some of the people using the service. We also contacted Healthwatch Leicestershire who are the local consumer champion for people using adult social care services to see if they had any feedback about the service.

At the time of our inspection there were 34 people using the service. We were able to speak with 10 people living there and four relatives of people living there. We also spoke with a senior manager, the registered manager, the quality manager, nine members of the staff team and a visiting professional.

We observed care and support being provided in the communal areas of the service. This was so that we could understand people’s experiences. By observing the care received, we could determine whether or not they were comfortable with the support they were provided with. We also used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We reviewed a range of records about people’s care and how the service was managed. This included four people’s plans of care. We also looked at associated documents including risk assessments and medicine records. We looked at records of meetings, four staff recruitment and training files and the quality assurance audits that the senior manager and registered manager had completed.

Updated 7 December 2016

This inspection took place on the 1 and 2 November 2016. The first day of our visit was unannounced. We returned announced to complete our inspection on the second day.

Loudoun House provides accommodation for up to 35 people who require personal care and support. There were 34 people using the service at the time of our inspection including people living with dementia.

The service had a 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.

Concerns had been raised with us prior to our visit regarding staffing numbers at the service. During our visit it was evident that there were insufficient numbers of staff on duty to meet the care and support needs of the people using the service and to keep them safe from avoidable harm.

There were systems in place to audit the medicines held at the service and appropriate records were being kept. However, people did not always receive their medicines as prescribed.

There were monitoring processes in place to monitor the quality and safety of the service. However these had not identified the shortfalls that we identified during our visit.

The provider’s recruitment process had not been consistently followed, this was because up to date references had not always been collected.

People told us they were treated with respect by the staff team and they were kind and caring. Whilst this was observed, the actions of some staff members meant that people were not always treated in a caring or dignified manner.

People told us they felt safe living at Loudoun House Care Home. Relatives we spoke with agreed what they told us. The staff team were aware of their responsibilities for keeping people safe from harm and knew what to do if they felt someone was being abused. We did however observe practices that didn’t always keep people safe from harm. This included two people being transferred in a wheelchair without the use of footplates.

Risks associated with people’s care and support had been assessed. Where risks had been identified these had, where ever possible, been minimised to better protect people’s health and welfare. We did note however that the staff team did not always follow the information contained in people’s risk assessments or plans of care to keep people safe.

People were supported to maintain good health. They had access to relevant healthcare services such as doctors, community nurses and opticians and they received ongoing healthcare support.

People had been involved in making day to day decisions about their care and support. Where people lacked the capacity to make their own decisions, these had been made for them in their best interest and in consultation with others.

People’s nutritional and dietary requirements had been assessed and a varied and balanced diet was being provided. For people assessed to be at risk of not getting the food and fluids they needed to keep them well, records were kept. We noted that these were not always completed accurately.

People’s needs had been assessed before they moved into the service and plans of care had been developed from this. People’s plans of care did not always include the actions the staff members should take to meet people’s needs.

Observation records were not always completed accurately. This meant that staff could not demonstrate that they had observed people, as required within their plan of care or risk assessment, to keep them safe.

The staff members we spoke with felt supported by the management team. Though concerns were raised with regard to staff deployment. They were provided with opportunities to meet regularly with them to discuss how they were progressing within the staff team.

Staff meetings and meetings for the people using the service had been held. These meetings provided people with the opportunity to be involved in how the service was run.

We found the service was in breach of one of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have told the provider to take at the back of the full version of the report.