We carried out a review of the data available to us about Lawton Manor Care Home on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Lawton Manor Care Home, you can give feedback on this service.
People’s experience of using this service and what we found
The management and administration of medicines was robust with clear procedures in place. The management of people’s ‘as required’ medicines was safe with clear and consistent records were in place.
People’s care plans and risk assessments were detailed and reviewed regularly. They reflected people’s individual needs and preferences. People who used the service told us they felt well cared for. They said staff were extremely kind and responsive to their needs.
The staff and management team worked closely with health and social care professionals to ensure the best outcomes for people.
People were protected from the risk of abuse. Safeguarding policies and procedures were in place. Staff had received training and understood how to keep people safe and who to report to if they had any concerns.
All areas of the service were clean and well maintained. Safety checks of the premises and equipment had been undertaken. People had personal emergency evacuation plans (PEEPs) in place.
There were a range of activities available for people and this included group and one to one interaction. People’s rights to privacy, dignity and independence were respected. People’s views about the service were listened to and acted upon.
There were effective systems in place to monitor the quality of the care provided. The management team identified and promptly addressed any areas identified for development and improvement.
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.
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 good (Published 17 December 2018).
Why we inspected
We undertook this inspection as part of a random selection of services rated Good and Outstanding.
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 Lawton Manor Care Home on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
We found the following examples of good practice.
¿ People spoke positively about the home. Comments from people included; "I've made lovely friends since I've lived here and we get together every day. I don't feel isolated anymore", "The staff are kind, caring and very conscientious" and "Everywhere is spotless, the domestic staff keep all areas very clean including my bedroom."
¿ Comments from relatives included; "The management team always answer any questions I have really promptly", "Communication has been really good. I've been kept up-to-date by email" and "Staff are kind and caring. [Name] looks really well cared for."
¿ All visitors were asked to complete a health screening form, have their temperature checked and were provided with face masks to wear throughout their visit. Full personal protective equipment (PPE) was available for all visitors along with access to handwashing facilities and hand sanitiser.
¿ The service had procedures and protocols in place which ensured people were admitted safely in accordance with national guidance.
¿ The service had increased the cleaning schedules and routines to reduce the risks of cross infection. The environment was very clean and hygienic.
¿ We observed staff to be wearing the correct personal protective equipment (PPE) throughout the inspection.
¿ People and staff were taking part in regular COVID19 testing. An area was allocated for this and the process was very clear.
¿ People had individual risk assessments in place that reflected their specific needs in relation to COVID19.
¿ Staff had all received training to meet the requirements of their role and for the management of COVID19.
Further information is in the detailed findings below.
Lawton Manor Care Home is a ‘care home’ operated by the Four Season Group. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The care home provides accommodation, personal and nursing care for up to 63 older people in one adapted building. Most of the rooms have en-suite facilities. Communal bathing and toilet facilities are also located throughout the care home. At the time of our inspection, the care home was accommodating 54 people.
At the last inspection in May 2016 we rated the service as good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.
At the time of the inspection there was 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.
The registered manager was present during the two days of our inspection and was supported by their regional manager and deputy manager. The management team were helpful and transparent throughout the inspection process and demonstrated a commitment to the ongoing development of the service.
Lawton Manor Care Home presented as a warm and comfortable environment in which to live. We observed that management and staff communicated and engaged with people in a caring and supportive manner and that people were encouraged to follow their preferred routines and lifestyle.
People’s needs had been assessed and care plans had been produced to help staff understand people’s needs and their support requirements. Risk assessments and other supporting documentation was also available for reference. Since our last inspection, an extensive review of care plan records had been undertaken to drive continuous improvement. Ongoing work was in progress to archive and update records at the time of our inspection.
Overall, people spoken with during the inspection told us that they were cared for appropriately by staff and confirmed they were treated with dignity and respect. We observed positive interactions between staff and people living in the care home and noted that staff were attentive and responsive to people’s needs.
People were supported to attend healthcare appointments and staffed worked in partnership with GPs and other healthcare professionals as necessary to maintain people’s health or support them at the end of life. People were also protected against the risk associated with unsafe medicines management.
A programme of individual and group activities was in place which included both on and off-site activities. People were seen to participate in a range of activities during the inspection and records of participation were maintained.
Staff had access to induction, mandatory and service specific training to help them understand their roles and responsibilities. Systems were in place to monitor the completion of training and to address the outstanding learning needs of staff.
Staff understood the systems in place to protect people who could not make decisions and followed the legal requirements outlined in the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS).
There were sufficient numbers of staff in post to meet the needs of people using the service. The registered provider had a staffing tool in place to help them determine the number of staff required to meet the dependency and needs of people using the service.
Systems had been established to ensure that staff working in the care home had been correctly recruited and to safeguard people from abuse or harm. A complaints policy and process was also in place to ensure concerns and complaints were listened to and acted upon.
The provider had a quality assurance framework in place that included seeking the views of people who used the service and their representatives. Action plans were in place which confirmed any feedback received was used to ensure the ongoing development of the service.
Kitchen staff were aware of people's dietary needs, which helped ensure that people were provided with appropriate options. Overall, people spoke highly regarding the standard of catering however some mixed feedback was received. We shared this feedback with the management team and have received confirmation that the views of people regarding the preparation of menus is regularly sought. Alternative options are also available upon request.
The service was previously inspected in January 2014 when it was found to be meeting all the regulatory requirements which were inspected at that time.
Lawton Manor is a care home with nursing for up to 63 older people with nursing, residential and respite needs, and also offers dementia, convalescence and palliative care.
Lawton Manor Care Home is a two storey Georgian detached house, which has been converted and extended into a 63-bedded care home. There are two passenger lifts and staircases. Wheelchair access is good within the building and grounds.
The home has a number of communal spaces, including two dining spaces, lounges, a conservatory, library, cinema room, and games room and a landscaped garden, tiered fountain, and large patio area outside for residents to relax and socialise in.
Sixty people were being accommodated at the time of the inspection.
At the time of the inspection there was a registered manager at Lawton Manor Care Home. 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.
The registered manager was present during our inspection and engaged positively in the inspection process. The manager was observed to be friendly and approachable and operated an open door policy to people using the service, staff and visitors. During the inspection we found Lawton Manor Care Home to have a warm and relaxed atmosphere and overall people living in the home appeared happy and content.
Feedback received from people using the service spoken with was generally complimentary about the standard of care provided. People living at Lawton Manor Care Home told us the registered manager was approachable and supportive.
Staff recruitment systems were in place and information about staff had been obtained to make sure staff did not pose a risk to people using the service. However, we noted the job application form did not allow room for the applicant to provide a full employment history.
We noted that a system had been developed by the provider to review the dependency of people using the service and to calculate staffing hours deployed. Staffing levels were structured to meet the needs of the people who used the service. There were sufficient numbers of staff on duty to meet people's needs.
Staff were supported through induction, regular on-going training, supervision and appraisal. A training plan was in place to support staff learning. Staff told us they were well supported in their roles and responsibilities.
Corporate policies were in place relating to the MCA (Mental Capacity Act (2005) and DoLS (Deprivation of Liberty Safeguards). We found staff were aware of the people using the service who were subject to a DoLS.
A process was in place for managing complaints and the home's complaints procedure was displayed so that people had access to this information. People and relatives told us they would raise any concerns with the manager.
There was a quality monitoring system in place which involved seeking feedback from stakeholders and people who used the service and their relatives about the service provided periodically. This consisted of surveys and a range of audits that were undertaken throughout the year.
The registered provider had policies and systems in place to manage risks and safeguard people from abuse. Staff were aware of the whistle blowing policy and they told us they would use it if required. Staff told us they were able to speak with the manager if they had a concern.
We observed the lunchtime meals and saw staff supported people appropriately and in an unhurried way.
Staff were very attentive, friendly and quick to respond whenever a person needed assistance. People had a choice of meals and drinks at lunchtime, breakfast and supper. The chef ensured special dietary needs were met, such as soft and pureed meals for people with swallowing difficulties.
Medicines were ordered, stored, administered and disposed of safely.
People using the service had access to a range of individualised and group activities and a choice of wholesome and nutritious meals. Records showed that people also had access to GPs, chiropodists and other health care professionals (subject to individual need).
People and staff were encouraged to attend meetings with the registered manager at which they could discuss aspects of the service and care delivery. People were asked for feedback about the service to enable improvements to be made.
We considered all the evidence we gathered under the outcomes we inspected. We used the information to answer one of the five questions we always ask;
. Is the service safe?
We found that the provider had recruited staff to ensure that the staffing levels and skill mix were suitable to provide care and support for the people who lived at Lawton Manor.
The provider had also updated the call bell system to ensure it was effective.
' Is the service responsive?
We found that the service did not have appropriate systems in place to assess the dependency needs of people using the service and for the effective deployment of staff. We found evidence that some people using the service were waiting for staff for prolonged periods of time when they had activated their call bells.
We have issued a compliance action to the provider to ensure appropriate action is taken to address this matter. This will ensure people using the service receive appropriate support in a timely manner and help to safeguard their health and welfare.
A second person told us that they had 'no strong feelings' about the home but that they enjoyed activities such as the newspaper reviews and 'going out from time to time'.
A relative told us they were assured that their spouse 'gets their breakfast properly' and that their spouse was 'kept clean' and 'kept comfortable'.
Asked about the food one person said that the food was 'very good really, can't find much to worry about'. Another said the food suited them and there were 'usually one or two things on offer' that they liked. A third person said the food was 'acceptable' and that it compared favourably to hospital food.
Several people mentioned that they felt that responses to call bells were not always quick enough.
We found that the building was properly maintained and that staff were recruited properly with the proper checks having been carried out.
A relative of a person living in the home told us that their relative had difficulty and lack of enthusiasm for eating. We were told that to encourage them the catering staff had been prepared to 'do anything for him' when it came to the preparation of meals. They said staff were 'very gentle' and were enthusiastic about the support provided by the home.
Another relative told us that the staff were 'very open about talking to you' when finding out about what you wanted.
We spoke to a person who was in receipt of nursing care and their spouse who approached us as they wished to let us know about the care received. Their experience was very positive and the care provided had resulted in a much better outcome than expected for the person.
Another relative told us that the care that their spouse had received was 'Excellent'.