We carried out a review of the data available to us about Lisburne Court 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 Lisburne Court, you can give feedback on this service.
Lisburne Court is a residential care home providing personal and nursing care to 47 people aged 65 and over at the time of the inspection. The service can support up to 48 people.
Accommodation is provided across two floors which can be accessed via a stair-well and passenger lift. There are communal bathrooms, toilets and kitchen facilities as well as social, dining and garden areas that people can access.
People’s experience of using this service and what we found
People felt safe at Lisburne Court. People and relatives told us staff were kind and attentive. Risk assessments were carried out and incidents and accidents were investigated. Medicines were managed safely. We have made a recommendation about the provider’s ‘medication’ policy.
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’s needs were assessed, and care was delivered in line with their preferences and choices. Staff had completed additional training to support people’s nutritional needs. We have made a recommendation about the provider’s ‘nutritional and hydration needs’ policy.
The provider had developed a robust policy to strengthen the infection prevention and control (IPC) practices in the home. Staff complied with the requirements to wear protective personal equipment (PPE) and regularly washed their hands. The home was clean and tidy.
The management team completed effective audits and systems to monitor the quality of care at Lisburne Court. People, relatives and staff said the management team engaged with them positively.
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 11 February 2020).
Why we inspected
The inspection was prompted by concerns raised by Her Majesty's Coroner. A Regulation 28 Report was issued to the CQC on 26 April 2021 relating to processes to identify risk and escalate care, pre-assessment processes and how effectively Lisburne Court worked with other agencies. The Coroners and Justice Act 2009 allows a Coroner to issue a Regulation 28 Report to an individual, organisations, local authorities or government departments and their agencies where the Coroner believes that action should be taken to prevent further deaths. A decision was made for us to inspect Lisburne Court and examine those risks.
We found no evidence during this inspection that people were at risk of harm from this concern.
Please see the safe, effective and well-led sections of this full report.
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.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Lisburne Court on our website at www.cqc.org.uk.
Follow up
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.
Lisburne Court is a residential care home providing personal and nursing care for up to 48 people aged 65 and over. Accommodation is provided across two floors which can be accessed via a stair-well and passenger lift. There are communal bathrooms, toilets and kitchen facilities as well as social, dining and garden areas that people can access. At the time of this inspection 48 people were living at the home.
People’s experience of using this service and what we found
People received effective care that was tailored around their support needs and areas of risk. People’s needs were effectively assessed, areas of risk were safely monitored, and regular care reviews took place. People received support by trained and competent members of staff who were appropriately recruited into their roles. Staffing levels were routinely monitored, we received positive feedback about the levels of staff and support they provided.
Medication processes and procedures were safely in place. The provider ensured medication administration policies were complied with. Safeguarding policies were effectively in place; people were protected from harm and staff were familiar with safeguarding and whistleblowing procedures.
The provider complied with the principles of the Mental Capacity Act 2005 (MCA). 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 received timely and effective care and support from Lisburne Court staff as well as external health and social care professionals. Positive working relationships meant that people received a holistic level of support in relation to many aspects of their health and well-being. People were supported to maintain a healthy, balanced diet; preferences and dietary support needs were established from the outset.
Regular and consistent staff meant that people received person-centred care that was tailored around their individual preferences, wishes and likes. Staff provided kind, caring and compassionate support in a sensitive and dignified manner. Positive feedback we received included, “I wouldn’t like to leave here I love it here” and “They [staff] are very kind to me here. I have been to other places and it wasn’t like this. This is like my second home.”
People were encouraged to remain as independent as possible and to share their views and suggestions on the provision of care being delivered. There was an up to date complaints policy in place, any complaints were responded to and managed in line with company policy. Activities were regularly scheduled, people were encouraged to participate and engage in activities that were stimulating.
Effective quality assurance systems were in place. The quality and safety of care was routinely monitored, analysed and where necessary, improved upon. Lessons were learnt, measures were in place to effectively manage risk and the manager was aware of their regulatory responsibilities. Newly implemented electronic systems enabled the manager and senior managers to maintain a good level of oversight in relation to the provision of care provided. Positive comments we received about Lisburne Court included, “I would recommend the place to anyone” and “There is a good atmosphere here and when I go home I am not worrying about [relative] which gives me peace of mind.”
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 17 February 2017). There was also an inspection on 24 September 2018. However, the report following that inspection was withdrawn as there was an issue with some of the information that we gathered.
At this inspection we found the provider was not in breach of any regulations.
Why we inspected
This is a planned re-inspection because of the issue highlighted above.
Follow up
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 2013. At that inspection we found the service was meeting all the regulations that we reviewed.
Lisburne Court is registered with the Care Quality Commission (CQC) to provide care and accommodation for up to 42 older people living with dementia. It is one of 11 residential care homes operated by Borough Care Limited which is a not for profit company providing residential accommodation. The home is located in Offerton Stockport and is situated on a bus route into Stockport town centre. Accommodation was provided over two floors which could be accessed via a passenger lift. All bedrooms were single without en-suite facilities. At the time of this inspection 42 people were living at the home. Day care was provided for up to four people each day.
Borough Care Limited specialise in dementia care. The company's head office is located at Heaton Lane, Stockport, Greater Manchester.
During the inspection we identified three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations. You can see what action we asked the provider to take at the back of this report.
A registered manager was not 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. At the time of the inspection an interim manager was in place. This manager was also the registered manager at another Borough Care Ltd location but was not the registered to manager Lisburne Court. The interim manager was assisted in managing the home by a deputy manager.
Written information for a person identified as being at medium risk of weight loss, had not been transferred to their risk management plan and was not shared in a timely way with the management team. Whilst the person had not come to any harm it was apparent their identified risks were not continually monitored to prevent the risk from increasing.
A care record we looked at lacked robust information to enable staff to continually identify and assess some of the risks to their health, safety and welfare. For example, although the district nurse was managing the person’s skin integrity their care record did not contain enough information about the wound treatment or care to be provided by staff members.
Another person’s daily record sheet was not detailed enough to demonstrate their care had been delivered in a person centred way. We also saw a care plan did not clearly instruct staff how to support a person with mental health needs should they display paranoid behaviour. This meant these people were at risk of receiving unsafe and inappropriate care.
Daily record sheets relating to the care and treatment of people who used the service, such as changes to care plans following medical advice, had been archived prematurely. This meant information about decisions taken was not immediately accessible for staff to help them deliver people’s care and treatment in a way that met their needs and kept them safe.
A medicine’s emergency policy aims and guidance, and a policy to support service users consent to examination of treatment, both referred to obsolete care standards and regulations. Both policies had not been updated or reviewed since May 2014 which meant they were not managed in line with current legislation and guidance.
Records showed staff received infrequent supervision and they also told us they had not received an annual appraisal during 2016. The interim manager confirmed there have been no staff appraisals since April 2016. This meant the provider could not show that staff were supported in their role to make sure their competence was maintained and risks to people’s health and wellbeing was minimised.
An up to date annual service user satisfaction survey had not been carried out since 2015. The interim manager was unable to provide us with the survey results. However a service user and relative meetings were in place to ascertain people’s views and opinions about their satisfaction of the service provided. These systems enable the registered provider to identify where quality and safety are being compromised and to respond appropriately.
People who used the service and their relatives were complimentary and positive about the support provided and attitude of the care workers. They told us they were happy with the service provided and felt their needs were being met. They also told us care workers treated them caringly, sensitively and with respect and they tried to make sure that their independence was maintained wherever possible.
People were supported by sufficient numbers of suitably trained staff. We saw that recruitment procedures helped to make sure staff had the appropriate qualities to protect the safety of people who used the service.
Care workers we spoke with told us they had undergone a thorough recruitment process. They told us training appropriate to the work they carried out was always available to them and following their employee induction. This training helped to make sure the care provided was responsive to meet peoples identified needs.
When we looked at six individual staff training records we saw training certificates to show the care workers had received appropriate training to carry out their roles effectively. Care workers we spoke with confirmed they had received training in topics such as safeguarding and whistle blowing and knew who to report to if they suspected or witnessed abuse or poor practice.
The registered provider was working towards implementing The Care Certificate which is a professional qualification that aims to equip health and social care workers with the knowledge and skills they need to provide safe care and support to people using the service.
Medicines were stored safely. Information regarding people’s dietary needs was included in their care records and clear guidance for care workers helped make sure these dietary requirements were met.
Information about how people wanted to be supported, their likes and dislikes, when support was required and how this was to be delivered was also included in the care records we examined.
We saw written evidence of people and their relatives involvement in the decision making process at initial assessment stage and during their care needs review.
Complaints, comments and compliments were encouraged by the provider and any feedback from people using the service or their relatives was addressed by the registered manager. People spoken with knew how to make a complaint and felt confident to approach any member of the staff team if they needed to.
We were told by the people who used the service; 'I didn't choose to come here, but I accepted my nephew's choice. It is really good and the staff are extremely helpful'; 'My relative is smiling, and I haven't seen them look so happy, even though I think they don't know us sometimes'. 'We think this place is absolutely fabulous'.
We looked at a selection of care records. These contained information regarding the needs and wishes of individuals and the care that they had agreed with the service.
We found that systems were in place to monitor the quality of the service provided.
The members of staff we spoke with said that they had received training and that training was on-going.
We found no evidence to suggest that there were insufficient staff on duty to meet the health care needs of the people who use the service.
We spoke with the manager, two members of staff, a family member and two of the people who lived at the home. We also spoke with a GP who was visiting one of his patients. We also contacted four other family members and a member of staff by telephone.
The family members we spoke with said; 'I am happy with the care'; 'I am kept informed and I am involved in the annual review of care'; 'The girls (care workers) are lovely'; 'The bedroom is spotlessly clean'; 'There are regular entertainers and there is always something going on'. We were also told by all the family members we spoke with that people's privacy and dignity was respected.
There had been two safeguarding investigations. One of the investigations resulted in recommendations being made for improvements to record keeping. The second investigation recorded an outcome of unsubstantiated.
After our visit we were informed of a new safeguarding referral which had been made to Stockport Social Services Adult Safeguarding team due to a complaint. This referral was still under investigation at the time of writing this report.