We carried out a review of the data available to us about Larchfield Manor 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 Larchfield Manor, you can give feedback on this service.
Larchfield Manor is a residential care home providing accommodation and personal care for up to 47 people, including people living with dementia. At the time of the inspection there were 42 people using the service.
The service has communal space and bedroom accommodation over two floors. There are two wings to the service each of which has separate adapted facilities. One of the wings is called the Coach House and specialises in providing care to people living with dementia.
People’s experience of using this service and what we found
People told us they felt safe and well supported by staff. The provider followed robust recruitment checks, to employ suitable staff, and there were sufficient staff employed to ensure care and support was carried out in a timely way. People's medicines were managed safely.
Staff received 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 received regular supervision to fulfil their roles effectively and had yearly appraisals to monitor their work performance.
People had choice and control of their lives and the staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
There was a planned programme of activities which met people's needs and was tailored to their interests and abilities.
Staff knew about people's individual care needs and care plans were person-centred and up to date. People and relatives gave us positive feedback about the staff and described them as "Excellent, caring and friendly." Staff treated people who used the service with compassion, dignity and respect.
The service was well managed and organised. The registered manager assessed and monitored the quality of care provided to people. People and staff were asked for their views and their suggestions were used to improve the service.
For more details, please see the full report which is on the Care Quality Commission (CQC) website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published April 2017).
Why we inspected
This was a planned inspection based on the previous rating. 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.
We last inspected the service in October 2014 and rated the service as ‘Good.’ At this inspection we found the service remained ‘Good’ and met all the fundamental standards we inspected against.
Accidents and incidents were appropriately recorded and risk assessments were in place. The registered manager understood their responsibilities with regard to safeguarding and staff had been trained in safeguarding vulnerable adults.
Appropriate arrangements were in place for the administration and storage of medicines.
The home was clean and suitable for the people who used the service. Appropriate health and safety checks had been carried out.
There were sufficient numbers of staff on duty in order to meet the needs of people who used the service. The registered provider had an effective recruitment and selection procedure in place and carried out relevant checks when they employed staff. Staff were suitably trained and received regular supervisions.
The registered provider was working within the principles of the Mental Capacity Act 2005 (MCA) and was following the requirements in the Deprivation of Liberty Safeguards (DoLS).
People were protected from the risk of poor nutrition and staff were aware of people’s nutritional needs. Care records contained evidence of visits to and from external health care specialists.
People who used the service and family members were complimentary about the standard of care at Larchfield Manor.
Staff treated people with dignity and respect and helped to maintain people’s independence by encouraging them to care for themselves where possible.
Care records showed that people’s needs were assessed before they started using the service and care plans were written in a person centred way.
Activities were arranged for people who used the service based on their likes and interests and to help meet their social needs.
The registered provider had an effective complaints procedure in place and people who used the service and family members were aware of how to make a complaint.
Staff felt supported by the management team and had opportunities to contribute their views. People who used the service, relatives and professionals were consulted about the quality of care at Larchfield Manor.
Further information is in the detailed findings below.
We visited this service on 9 October 2014; the inspection was unannounced. At the last full inspection of this service on 10 May 2013 the provider was asked to make improvements in two outcome areas; cleanliness and infection control and management of medicines. A follow up inspection on 19 September 2013 confirmed the necessary improvements had been made to these outcome areas and compliance had been achieved.
Larchfield Manor provides accommodation for up to 47 people. They can accommodate people who require personal care and support, those with mental health conditions, physical disabilities, sensory impairment or a dementia related condition. At the time of our inspection 36 people were using the service. The home consisted of the main house and a separate dementia unit called The Coach House.
People living at the home told us they were happy with the service they received. We observed that staff treated people kindly and with compassion. They were seen to be aware of people’s likes, interests, preferences and care needs. We spoke with a relative who told us that staff kept them informed of their loved ones progress and of any changes in their health care needs. Another relative we spoke with said “Staff really care and they know my relative very well.” Another said “I am aware that the new manager is looking at care plans, we have received a letter from the manager asking about our involvement and do not resuscitate forms.” This helped all parties feel informed. Ten people who used the service told us that they felt safe living at the home. Staff we spoke with were knowledgeable in recognising the signs of potential abuse and said any concerns would be reported to the management team and would be acted upon to help protect people. We found the provider to be meeting the requirements of the Deprivation of Liberty Safeguards.
Risk assessments and care plans were in place. This helped staff to deliver the care and support people needed to receive. There were effective systems in place in relation to medication administration and storage. We saw that people at the home were offered appropriate food and fluids to maintain their nutrition. People said they had good meals and we saw people were offered second helpings of food at mealtimes.
A range of activities were provided throughout the home, which people could take part in if they wished. One person who lived at the home who we spoke with said “We do lots of activities and we are asked what we would like to do. We have knitting groups, quizzes and special event nights.” People told us they were entertained and felt looked after.
At the time of our inspection the manager had been in post for four weeks and had submitted their application to the Care Quality Commission to become the registered manager. This application was being processed. 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 responsibilities for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
Staff we spoke with told us that the manager was approachable, supportive and organised which helped to reassure the staff and gave them confidence.
Staffing levels appeared to be provided at a level to ensure people’s needs could be met, although some staff said they would always like to have more staff available. A person that lived at the home said “I think there are enough staff around when I need help” Staff received regular supervisions and appraisals and training which meant that staff were supported to develop and maintain their skills. People who used the service and their relatives told us they were satisfied with the service they received. A person who lived at the home said “It’s lovely here, the staff are very kind.” Another said “I feel safe. I have nothing to complain about the staff are super.” One person talked with us was adamant that we placed their views in the report. They said “Larchfield Manor is home from home, you could not get a better place to live.”
We received information from Healthwatch. They are an independent body who hold key information about the local views and experiences of people receiving care. CQC has a statutory duty to work with Healthwatch to take account of their views and to consider any concerns that may have been raised with them about this service. We also consulted the Local Authority to see if they had any concerns about the service, and none were raised.
We revisited the service to see whether improvements in these two areas had been made.
We spoke with three people who lived at Larchfield Manor who all told us the service was kept fresh and clean all the time. One person told us they sometimes needed painkillers. They said they always got their tablets quickly when they asked staff for them and added they thought the medicines process worked well. Another person said they were able to look after all their own medicines but were worried that they were unable to lock them away safely.
People now lived in an environment that was kept clean and fresh at all times. This minimised the risk of an infection spreading around the home.
People now received their medicines in a safe way and at the times they needed them. We found the service now had better systems to account for the medicines kept there. Good medicines management meant people's health and well-being was being promoted.
People were protected from the risks of inadequate nutrition and dehydration. We saw a range of tools that were used to identify and monitor those people at a greater risk of poor nutrition and dehydration.
People were not always cared for in a clean, hygienic environment. We have asked the provider to address this.
During our inspection we spoke with a number of people living at the home and they told us they thought they received their medication as required. Despite this we found evidence that the provider did not have suitable arrangements in place to protect people against the risks associated with the safe management of medicines. We have asked the provider to address this.
People who used the service, their representatives and staff were asked for their views about their care and treatment and they were acted on. We saw that the manager frequently asked people living at the home and their representatives about the quality of the service they received, covering areas such as quality of care, cleaning and quality of food.
The inspection team was led by a CQC inspector, and joined by an 'expert by experience' and a healthcare professional. These are people who have experience of using services and can provide that perspective and professional advice.
People told us that they liked living at the home one person said 'Staff are good and caring and nothing is too much trouble for them. They always consult, always support they are just always there for us'.
People we spoke with also made positive comments about the quality of the food at the home and the choices available. For example, one person told us "The food is very good" whilst another said "We always have a very good balanced diet and always have plenty of choice at each mealtime" People said they would either speak to the manager or assistant manager if they did have a concern or a complaint.
We also talked with relatives who were visiting the home. They all spoke highly about Larchfield Manor. One relative said "The staff at Larchfield Manor are all absolutely lovely. They are all helpful and caring. I can't fault the home. I would recommend it to anyone"
We also spoke with a health care professional who spoke highly about the home. They told us 'It has always had the feeling of being a good place. They make the most of social activities. They give people privacy and manage peoples care well. They make sure they have the right balance and they always know the person that they are talking about. I would be quite happy to recommend the home'
We spoke with the Local Authority Contracts Officer who informed us that they did not have any concerns about this service.