Archived: Laneside

This was an announced inspection which took place on 8 November 2016. We announced our inspection because we wanted to ensure people who lived at the home were available to meet.

The service was last inspected in April 2014 and at that time was found to be meeting standards.

The service had a registered manager in post. 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.

Because of communication difficulties of the people living at Laneside it was difficult to get any detailed verbal feedback. We did however meet three of the people living there and also met with a visiting relative who was able to give some detailed and informed feedback.

We made observations of the way staff interacted with people living at the home and the feedback from the relative we spoke with was very positive. We were told the care was personalised and the staff knew their relative well and understood their care needs.

We reviewed the way people’s medication was managed. We saw there were systems in place to monitor medication so that people received their medicines safely.

There was enough staff on duty to help ensure people’s care needs were consistently met.

We looked at how staff were recruited and the processes to ensure staff were suitable to work with vulnerable people. We found recruitment to be well managed and thorough.

The manager was able to evidence a series of quality assurance processes and audits carried out internally and externally by staff and from visiting senior managers for the provider. These were effective in managing the home and were based, were possible, on getting feedback from the people living there or their relatives/supporters.

Care was organised so any risks were assessed and plans put in place to maximise people’s independence whilst help ensure people’s safety.

The staff we spoke with described how they would recognise abuse and the action they would take to ensure actual or potential harm was reported. Training records confirmed staff had undertaken safeguarding training and this was on-going. All of the staff we spoke with were clear about the need to report any concerns they had.

Arrangements were in place for checking the environment to ensure it was safe. For example, health and safety audits were completed where obvious hazards were identified. We found the environment safe and well maintained. We had been informed by the provider that the people living at Laneside had been assessed for a move to a supported living environment and Laneside will be deregistered as a care home in the near future. Both manager we spoke with were aware of the issues surrounding the changes and have kept us (the Commission) informed. Meanwhile the home has been safely maintained.

The people living at Laneside were unable to consent to care and treatment. We found the principles of the Mental Capacity Act 2005 were followed, in that an assessment of the person’s mental capacity was made and decisions made in the person’s best interest. The decision to move to supported living in the future, for example, was well managed with input from social work teams and liaising with family members.

The managers had made appropriate referrals to the local authority applying for authorisations to support all four people deprived of their liberty under the Deprivation of Liberty Safeguards (DoLS). DoLS is part of the Mental Capacity Act (2005) and aims to ensure people in care homes and hospitals are looked after in a way that does not inappropriately restrict their freedom unless it is in their best interests. We found the applications were completed and were continuing to be monitored by the manager.

Daily living activities were organised in the home and these were appropriate and individualised to the people living at the home. All of the people we met were supported to engage in activity outside of the home on a daily basis.

We saw written care plans were formulated and reviewed on-going. We saw that people or their family members were involved in the care planning and regular reviews were held.

We observed staff interacting with the people they supported. We saw how staff communicated and supported people. Staff were able to explain each individual person’s care needs and how they communicated these needs. The family member we spoke with told us that staff had the skills and approach needed to ensure people were receiving the right care. People were observed to be comfortable and react positively with staff. The family member told us they had been consulted about their relatives care and we saw some examples in care planning documentation which showed evidence of this input.

Care records showed that people’s health care needs were addressed with appropriate referral and liaison with external health care professionals when needed. We saw an example during the inspection as the manager and staff had liaised well with community services to support one person to attend a dental appointment.

We saw people’s dietary requirements were managed with reference to individual needs. We saw one person enjoying their meal when they returned from being out for the day.

When we observed staff interacting with people living in the home they showed a caring nature with appropriate interventions to support people.

We saw a complaints procedure was in place and people’s family members were aware of how they could complain. We saw that a record was made of any complaints and these had been responded to. The last complaint was received in 2014.

Is the service safe?

Is the service effective?

Is the service caring?

Is the service responsive?

Is the service well led?

This is a summary of what we found-

Is the service safe?

People who lived at Laneside were treated with dignity and respect. Staff members asked before providing any support and knocked on doors before entering people`s rooms. This showed respect for the person`s privacy and dignity.

Regular meetings were held and any feedback or suggestions were acted on without delay. We also saw the results of a survey that had been recently conducted and again, suggestions from feedback had been acted on. This showed people who lived at the home and their families were having their views listened to.

We spent time inspecting the environment both inside and outside of the home. We observed it was safe, clean and hygienic. Equipment at the home was well maintained and serviced regularly and so kept people safe and avoided putting anyone at unnecessary risk.

Although no Deprivation of Liberty Safeguards applications had been made at Laneside, the provider was fully aware of the procedure for doing so. This maintained the safety of people at the home and also ensured people continued to have decisions made in their `best interests.`

Is the service effective?

People living at Laneside had a comprehensive assessment of their needs which helped ensure their needs were being met. We were told by a family member they were always invited to care plan reviews and were listened to and fully involved in the process. The layout of the home enabled people to move about safely and freely, including those people who were wheel-chair users.

Is the service caring?

We observed staff members who were very patient when attending to the needs of people at the home. Staff showed a good understanding of the support people required because of the knowledge they had about people in the home. One visitor told us, "I have no worries here - any problems at all and they get in touch."

Regular meetings and surveys were held which were aimed at ensuring the care being provided was of a high standard. Any concerns or issues that were raised within the surveys were addressed immediately. This ensured the level and quality of care continued to improve.

Is the service responsive?

People living at the home took part in a range of activities. We noted a time-table for all people which showed which activities they could take part in during the week. On the day of our inspection, three people were taking part in activities in day-centres and one person was taken out for her lunch because it was her day off. The provider had its own adapted minibus which helped people stay involved around the local community.

The provider had a thorough and comprehensive complaints process which ensured people`s comments and suggestions were listened to and, if necessary, acted on. People we spoke to knew how to make a complaint. The complaint we discussed had been carried out in an open and transparent manner. The final outcome was satisfactory to all who were involved.

Is the service well-led?

The provider told us, and we observed in care plans, that there was a multi-agency approach to providing care at Laneside. The home had a quality assurance system in place. Internal and external audits were conducted on a regular basis and any identified issues were addressed without delay. This was aimed at continually improving the quality of service being provided to people at the home. Staff members we spoke with were clear about their roles and responsibilities. This helped ensure people at the home were kept safe and were supported by staff who were competent and had the required skills to provide a high standard of care and support.

The home was clean and well adapted for people with learning disabilities and the rooms had been personalised to individual needs.

We found the provider had appropriate policies and procedures to ensure consent was taken correctly and adhered to. We found that people were cared for by a sufficient number of staff that had been through the appropriate recruitment checks.

There was an effective complaints system available, in case anyone wished to raise a complaint, and records were appropriately maintained.