Lavender Court Residential Home

Lavender Court Residential Home is a residential care home providing personal care to up to 18 people. The service provides support to older people, some of whom may live with dementia. At the time of our inspection there were 18 people using the service. The care home accommodates people in one adapted building.

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

Systems, processes and practices safeguarded people from abuse. Risks to people were assessed and their safety monitored and managed. People were supported to maintain their independence. Sufficient numbers of staff were employed. Staffing rotas were arranged to meet people's needs. Medicines were administered safely by appropriately trained staff. People were protected from infection by effective IPC processes and practices. Lessons were learned and shared with staff.

People's needs and choices were assessed and care was planned to meet people's needs. Staff had the appropriate skills, experience and training to support people effectively. Staff teams worked well together and had access to a good level of detail in handovers. Staff were confident they received updates and an appropriate level of information. People were supported to eat and drink, where needed. People had good and timely access to healthcare, when needed, and were supported to access health appointments. People's needs were met by the home’s decoration and environment. Consent to care was sought and documented appropriately, including where people needed best interest decisions making on their behalf. 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.

People were treated with kindness, respect, and compassion. Warm, friendly, and positive interactions took place between staff and people. People were supported to express their views. People's privacy and dignity were respected.

People received care responsive to their needs. People's concerns were listened and responded to. People were supported at the end of their life to have a dignified death. People had been involved in producing their EoL care plans.

The provider had a clear vision to deliver exceptional high-quality care and support, which was shared with and understood by staff. Staff were highly motivated to deliver excellent quality care. There was a thoroughly embedded culture of openness and positivity throughout the home. The robust governance framework supported the delivery of high quality care and support. Assurance audits contained appropriate information to support this. Feedback from a variety of partners had been sought. This was used to support continuous improvement at the service. The service was very creative in exploring and using technology to support people's individual needs. The service worked in close partnership with other organisations to facilitate good outcomes for people, and was constantly exploring and developing connections to support the high quality care and deliver exceptional social interactions for people living at the home. The home was thoroughly embedded in the local community.

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 outstanding (published 12 July 2017).

Why we inspected

This comprehensive inspection was part of CQC’s scheduled inspection approach.

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.

• Staff supervised all visits to ensure social distancing and infection control guidelines were followed. All visitors were asked a set of screening questions to ascertain any risks posed and for track and trace. People chose to use applications such as facetime to maintain contact with their families. The provider was working with the local authority to source pods, which can be attached to the main building to facilitate safer visits.

• The provider had organised socially distanced entertainment. People were able to sit in the courtyard area, whilst singers performed in the garden. Walks in the community were supervised by staff. Reminiscence activities were encouraged. Staff supported people to wash their hands correctly using music and songs to encourage best practice.

• Staff had reviewed their existing skills to support people during challenging times. For example, the hairdresser was unable to visit the service. One member of staff was a qualified hairdresser and they were encouraged to use their skills to support people to maintain their appearances. People had given positive feedback and it was agreed for the current hairdresser to continue permanently.

• The service had thought about how they could support people, their families and staff to access vital supplies. The provider had created a shop within the home to reduce the time spent shopping outside of the service, which ensured everyone had access to items they may require at all times. The provider also facilitated the collection of prescriptions.

• The provider was fully aware of all current best practice guidance. This had been communicated to people, their families and staff as and when updates occurred. Regular virtual meetings were arranged for staff to ask any questions and ensure they understood changes in guidance. Personal Protective Equipment was safely stored in designated stations throughout the service. This reduced staff time putting on and taking off PPE and reduced the risk of transmission. Some of these stations were portable to accommodate visitors that remained outside the building.

• Cleaning schedules were thorough. An additional cleaner had been employed to complete COVID-19 specific cleaning of highly used areas and deep cleans. The schedules through the day were continued at night to ensure all areas were regularly cleaned to reduce the risk of transmission.

Further information is in the findings below.

At the last inspection in March 2015, the service was rated as Good, with Well-led being rated as Outstanding. At this inspection we found that the service was also Outstanding in Effective, making the overall rating Outstanding.

The service was involved in a number of initiatives which promoted people’s wellbeing and enhanced their quality of life. They worked in partnership with other professionals to ensure that care was based on best practice.

The registered manager continued to lead the team with a positive and pro-active style of management, and they went ‘over and above’ their duties and responsibilities.

People were supported to have maximum choice and control over their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People had been supported by staff to take part in a research project and one person had felt empowered to take control of their general health following the outcome.

There was a strong emphasis on the importance of eating and drinking well. There were excellent links with dietetic professionals and some people's general well-being had improved as a result of staff following advice from these professionals. The home had continued to improve in this area and had been awarded the silver Nutrition Mission award.

There continued to be sufficient numbers of staff employed to make sure people received the support they needed, and those staff had been safely recruited. People told us they felt safe living at the home.

Staff had continued to receive appropriate training to give them the knowledge and skills they required to carry out their roles. This included training on the administration of medicines and on how to protect people from the risk of harm. Staff were offered a variety of training opportunities to reflect their differing learning styles. They had a number of champions whose role was to drive improvements in care.

Staff were kind, caring, compassionate and patient. They respected people’s privacy and dignity and encouraged them to be as independent as possible.

Care planning described the person and the level of support they required. Care plans were reviewed regularly to ensure they remained an accurate record of the person and their day to day needs.

People were very involved in the local community to the extent they were raising money for a local dance school.

People understood how to express any concerns or complaints but told us they had not needed to make a complaint. People were also given the opportunity to feedback their views of the service provided.

The registered manager carried out audits to ensure people were receiving the care and support that they required, and to monitor that staff were following the policies, procedures and systems in place.

We looked at four peoples' case files and observed interactions between people and staff. We found that people and their relatives were involved in the planning and giving of care and that people received the care that met their needs well.

People were satisfied with the care they received. They said, "It's alright living here", "We have to be here to be looked after", "The staff do the very best they can for us, they are alright", "I am quite satisfied sitting here with my music", "I am looked after very well, the staff are courteous and helpful", "I am very happy here, the food is excellent" and "It is quite nice here, the food is very good".

We found that people were well protected from the risk of harm or abuse because the provider had taken steps to prevent abuse from happening and because staff were safely recruited.

We found that while there were minor issues with some environmental comforts, the premises were safe, well maintained and appropriate for the purpose of providing care to older people.

We found that the quality monitoring and assuring system was still in its infancy, but because there was evidence of further future growth within the monitoring system, because the service was only six months old and because there was other evidence that people were satisfied with the service provision, we judged that the provider was compliant with this regulation.