Background to this inspection
Updated
6 April 2018
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
The inspection took place on the 05 February 2018, and was completed by one adult social care inspector, and a Specialist Advisor. A Specialist Advisor (SpA) offer particular professional knowledge and expertise to inspections when this is needed. They are health and social care professionals and clinicians drawn from a range of disciplines. In this instance, the SpA was a nurse with expertise in working with adults with learning disabilities.
Prior to the inspection we gathered the available information from Care Quality Commission (CQC) systems to help plan the inspection. This included the detail of any notifications received, any safeguarding alerts made to the Local Authority, any complaints or whistle-blowing information received and the detail of the Provider Information Return (PIR) received from the provider. The PIR is submitted to the CQC by the provider and includes details of the provider’s perspective on meeting the requirements of the regulations.
As many of the people who lived at the home did not use words to communicate due to their cognitive impairment, we observed the way they engaged with staff at home and their environment. We also observed how the staff interacted with people. We spoke with three relatives, and two visiting professionals. We spoke with 6 members of staff and the registered manager. During the inspection we reviewed four people’s care plans, four staff files, quality audits, team meeting notes, medication records and other documents and records associated with the running the of service.
Updated
6 April 2018
Lisieux Hall Residential Nursing Home is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. This inspection took place on 05 February 2018, and was unannounced.
Lisieux Hall is run by Brothers of Charity and is part of a wider service, which also provides day care, supported employment, and domiciliary services to people with learning disabilities in the Chorley and South Ribble areas. Lisieux Hall is registered to provide nursing and personal care for up to 16 people with a learning disability.
The service provides accommodation in two single storey bungalows (Meadows and Woodlands). There is a third property on the site (St Edwin’s), however, as this property has been determined as not fit for purpose by the service provider, it is no longer in use. At the time of our inspection there were 10 people living at Lisieux Hall.
At the last inspection on 27 September and 4 October 2016 we found that the service was in breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 Safe care and treatment, as the management and administration of people’s medicines did not demonstrate that people received their prescribed medicines safely by staff who were competent.
In 2016, we also found a breach in Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 Good Governance, as without clear and accurate records, people’s current and changing needs could not be easily monitored and acted upon in order to ensure their health and well-being was maintained. As a result, the service was given the rating: Requires Improvement.
At this inspection, we found that the service was no longer in breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, and that no further breaches were found. The service has been given the rating: Good.
A registered manager was now in post at the service. 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 registered manager and staff team were passionate about ensuring people at the service had a good quality of life and were supported safely. They worked well with outside professionals and took on board advice and guidance to make a positive difference to the care and support people received. They used information from complaints, mistakes and incidents to learn lessons and improve safety.
Relatives and visiting professionals told us the registered manager and staff were approachable and visible. There was an open culture at the service which meant staff felt able to raise concerns freely and know that something would be done as a result.
Staff were trained in infection control. Accidents and incidents were monitored and we noted that these had lessened in this service. Good risk assessments and emergency planning were in place.
Staff had received training on ensuring people were kept free from harm and abuse. They were confident in management dealing with any issues appropriately.
Staff recruitment was thorough with all checks completed before new staff worked with vulnerable people. Staffing levels were suitable to meet the assessed needs of people in the service. The organisation had robust disciplinary procedures in place.
People had their medicines reviewed by their GP and specialist health care providers. Medicines were well managed.
Staff we spoke with to displayed a caring attitude. They understood how to support people and help them maintain their dignity and privacy.
There were regular internal and external audits of all aspects of the service. Changes were put into place after evaluation of the service. Good recording systems were in place and these covered all the support needs of the people in the service.