This inspection took place on 8 September 2017 and was unannounced. This meant the provider and staff did not know we were coming. This was the first inspection of Lansbury Court Nursing Home since Indigo Care Services Limited became the registered providers in October 2016.
Lansbury Court provides accommodation for up to 56 persons who require nursing or personal care. Some people using the service were living with dementia. The service is set in its own grounds in a residential area.
The service had a registered manager in place. ‘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 provider had a robust recruitment process in place to ensure only appropriate staff were employed to work at the service to support people safely. Staffing levels were appropriate to the needs of the people using the service. The manager used a dependency tool to ascertain staffing levels.
Risks to people and the environment were assessed and control measures in place to mitigate against risks. We found these were reviewed regularly or when there was any change in circumstances. The provider ensured appropriate health and safety checks were completed. We found up to date certificates were in place which reflected that fire inspections, gas safety checks and portable appliance tests (PAT) had taken place.
The provider had a business continuity plan in place for staff guidance in case of an emergency. People had Personal Emergency Evacuation Plans (PEEPS) in place which were updated regularly. Accidents and incident were recorded and analysed regularly to identify any patterns or themes that may need to be addressed.
There were systems in place to keep people safe. We found staff were aware of safeguarding processes and now to raise concerns if they felt people were at risk of abuse or poor practice.
Medicines were managed safely by staff who were appropriately trained and had their competency to administer medicines checked regularly. This meant the provider had systems in place to ensure the people who lived at Lansbury Court were safe.
Staff received an induction on commencement of their employment, which included shadowing experienced staff. The manager kept an electronic matrix to monitor staff training. Staff training was either up to date. Staff received regular supervision and an annual appraisal to support with their development.
People had access to health care professionals to maintain their general health and wellbeing. People’s nutritional needs were assessed on admission and reviewed regularly. Staff supported people to eat a healthy varied diet. Records of nutritional intake were maintained where necessary.
Steff were caring in their approach with the people they supported. Staff knew people's abilities and preferences, and were knowledgeable about how to communicate with people. Staff supported people to maintain relationships with relatives as part of their caring role.
Information about advocacy services were accessible to people and visitors. At the time of inspection no one was using an advocate.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
The provider used an electronic care planning system. Care plans were personalised focussing on people's assessed needs. Plans were reviewed and evaluated regularly to ensure planned care was current and up to date. Where appropriate people had emergency health care plans in place. People were supported to attend appointments designed to promote their health and well-being.
The provider had an activity planner with a range of different activities and leisure opportunities available for people, for both inside the home and out in the community.
The provider had a policy and procedure in place to manage complaints. No formal complaints had been received by the service in the last 12 months.
The provider held regular meetings with staff, people and relatives. Minutes were readily available for those not able to attend meetings.
The provider had a quality assurance process in place to ensure the quality of the care provided was monitored. People and relatives views and opinions were sought and used in the monitoring of the service.
The manager submitted notifications to CQC in a timely manner.