We carried out an inspection of Lawwood on 27 and 28 April 2015. The first day of the inspection was unannounced.
We last inspected this home 7 February 2014 and found the service was meeting the regulations in force at that time.
Lawwood is registered to provide accommodation and personal care for up to 11 people. It specialises in the care and support of people with mental ill health and does not provide nursing care. At the time of the inspection there were 11 people accommodated at the service. All people were provided with a single room with an ensuite shower facility.
During the inspection we found the provider was required to make improvements to the management of medication. This was because medication was not managed in a safe and appropriate way and people’s well being was placed at risk. We have also made recommendations in respect to the development of staff training, the care planning processes and the quality monitoring systems.
At the time of the visit the registered manager was not working in the 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 home was being operated by a temporary manager and one of the owners of Lawwood Ltd.
People told us they felt safe and were well cared for in the home. However, they raised a number of concerns which related to the last few months. We raised the issues with the local authority under safeguarding procedures. The local authority is the lead organisation for the investigation of safeguarding alerts. Although staff had completed training on safeguarding procedures we found two staff were unsure where to report safeguarding concerns and the role of the local authority.
We noted from looking at training records that staff had completed a level three diploma in health and social care. However, the staff spoken with were unsure about the principles associated with the Mental Capacity Act 2005 and had not received specialist training on nutrition in order to support people with a healthy diet. The staff also told us they had not had an individual supervision for some time. Supervision is important to enable staff to discuss the operation of the home and future training needs. There were enough staff at the service to provide people with support and changes to staffing levels could be made if needed.
People told us they liked the food provided and confirmed they were offered choices at every mealtime.
People made complimentary comments about the current staff team and told us their rights to privacy and dignity were recognised and upheld. We observed staff were kind and sensitive in all their interactions with people living in the home.
Each person had an individual care plan which was supported by series of risk assessments. However, people told us they were unfamiliar with their plan and staff said the plans were difficult to follow and access information.
People were provided with opportunity to participate in a variety of activities both inside and outside the home. People were also supported to build their independence skills.
Whilst feedback was sought from people and staff about the quality of the service, we found the quality monitoring systems had not been fully implemented.
Our findings demonstrated a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.