The Leylands - Residential Care Home

Updated 31 March 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection team consisted of 1 inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

The Leylands – Residential Care Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. The Leylands – Residential Care Home is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 3 people that use the service. We also spoke with 10 members of staff including the nominated individual, the registered manager, senior care assistants, care assistants, and kitchen staff. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We observed staff providing support to people in the communal areas of the service. We reviewed a range of records. This included 4 people's care records and 5 people’s medicines administration records. Quality monitoring systems and a variety of records relating to the management of the service, including policies and procedures were reviewed.

Updated 31 March 2023

About the service

The Leylands – Residential Care Home is a care home providing personal care to 19 people at the time of the inspection. The service can support up to 21 people. The service provides support to older people, people living with dementia, people with learning disabilities and people with physical disabilities.

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

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Quality checks in place did not always identify where there were gaps in recruitment files. Checks did not always identify where documentation had been completed inconsistently or where records had not been completed accurately.

People told us they felt safe and staff understood how to keep them safe. Improvements had been made to medicines systems since the last inspection and people’s medicines were stored and administered safely. Risk assessments were in place that guided staff on how to meet people’s needs safely and staff followed them. People were supported by a sufficient number of staff to meet their needs safely. The home environment was clean and systems were in place to reduce the risk of infection.

Medicines audits were comprehensive and effectively checked whether medicines were being stored and administered safely. The registered manager and staff were clear about their roles and a positive and supportive culture was evident in the home.

People and relatives told us the registered manager and senior staff were approachable. Staff were able to engage with the service through supervision and team meetings. The provider worked proactively to improve care at the service and shared learning with other care home managers through local engagement groups.

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.

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 3 March 2022) and there was a breach of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve.

The service remains rated requires improvement. This service has been rated requires improvement for the last five consecutive inspections. At this inspection we found improvements had been made but the provider remained in breach of regulations.

Why we inspected

We received concerns in relation to falls not being reported, staff using unsafe moving and handling techniques and bullying at the home. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service remains requires improvement based on the findings of this inspection.

We found no evidence during this inspection that people were at risk of harm from these concerns. However, we have found evidence that the provider needs to make improvements. Please see the well led section of this full report. You can see what action we have asked the provider to take at the end 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.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Leylands – Residential Care Home on our website at www.cqc.org.uk.

Enforcement

We have identified a breach in relation to governance at this inspection. Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.