Archived: Lorne House

Updated 20 August 2019

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was carried out by one inspector and an inspection manager.

Service and service type

Lorne House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with four people who used the service about their experience of the care provided. Many people who used the service, due to their complex needs could not make their views known verbally, therefore we observed people throughout the day, to see how they reacted to staff and their surroundings. We spoke with seven members of staff including the registered manager, deputy manager, senior support workers, support workers and the chef.

We reviewed a range of records. This included two people’s care records and multiple medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We reviewed documents sent by the registered manager to show what actions had been taken in response to initial feedback. We spoke with two relatives over the telephone to ask for their thoughts on the care provided to their family members.

Updated 20 August 2019

About the service

Lorne House is a residential care home providing personal and nursing care to 13 adults with a learning disability and/or physical disability at the time of the inspection.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

The service was a large home, bigger than most domestic style properties registered for the support of up to 14 people. This is larger than current best practice guidance. However, the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area and the other large domestic homes of a similar size. There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.

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

People’s medicines were ordered, stored and disposed of safely. Medicine records were completed correctly. People were encouraged to take positive risks and risk assessments were in place to minimise the risk of avoidable harm.

People were supported by well trained staff. Staff supported people to eat and drink enough to keep them healthy. When people required access to health care this was arranged to ensure the best outcome for the person’s wellbeing. The service was decorated in a homely way that met the needs of the people living there.

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.

Care was delivered with dignity and respect. People told us they liked the staff who supported them and were happy with the care and support they received.

People’s support plans contained detailed information to ensure their individual needs and preferences had been considered. They were reviewed regularly to reflect any changes. We have made a recommendation about end of life care planning.

People were involved in a variety of activities that reflected their own hobbies and interests. There was a procedure in place for addressing complaints and this was correctly followed.

An effective system of checks and audits was in place. People and staff were regularly consulted about the quality of the service.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

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 (published 12 July 2018) and there was one breach 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 and had improved to good in all the key questions.

Why we inspected

This was a planned inspection based on the previous rating.

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.