Lawrence Mews

Updated 18 April 2020

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 Care Act 2014.

Inspection team

The inspection was carried out by one inspector.

Service and service type

Lawrence Mews is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

The inspection visit on 13 February 2020 was announced. We gave the service 24 hours’ notice of the inspection. This was because it is a small service and we wanted to give the registered manager time to ensure the people living there knew in advance who would be visiting their home.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We used all of this information to plan our inspection.

The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

During the inspection

We spoke with one person, who used the service, and observed interactions between the other people and the staff who were supporting them. We spoke with six members of staff including the registered manager, team leaders, care worker, maintenance worker and the provider’s head of care; who was also the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We reviewed two people’s care records and people’s medicines records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data, policies, procedures and risk assessments. The registered manager sent us updates about work carried out immediately following the inspection. We contacted the local Borough Council environmental health team and shared our observations with them; in respect of potential food safety issues at Lawrence Mews. We obtained feedback from a healthcare professional, and a person's relative, about their experience of the service.

Updated 18 April 2020

About the service

Lawrence Mews is a residential care home which can provide personal care for up to five people. The service specialises in supporting people who have a learning disability, are on the autistic spectrum, or have mental health support needs.

The care home comprises of two adjacent buildings with separate facilities. One building accommodates two people and the other building accommodates three people. The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures people, who use the service, can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

There were deliberately no identifying signs, intercom, cameras or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.

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

People were not always protected from the risk of potential health infections, and there were lapses in good food hygiene practices by staff. Some parts of the care home could not be effectively cleaned because of deteriorated paintwork and surface damage. Maintenance issues were not always well managed. However, staff understood how to protect people from potential abuse and people’s prescribed medicines were well managed.

The provider’s quality monitoring and governance processes were not always effective. The impact of this was seen in the way some maintenance and environmental safety issues had not been identified by the provider until we inspected. The registered manager supported people to achieve good care outcomes and understood their responsibility to notify relevant authorities when incidents occurred. The service had a positive relationship with specialist health care agencies who were involved in supporting people at the care home.

Although people lived in a care home that needed internal redecoration in some areas, they liked where they lived and had personalised their bedrooms. Staff understood and met people’s care needs; and received the necessary training to work effectively. Staff felt well supported by the registered manager and provider. People enjoyed the food provided and were supported to manage their diet. Staff worked in partnership with other agencies to meet people’s needs and ensured people’s rights and choices were respected.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure people, who use the service, can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

People were supported by staff who were kind and compassionate. People were involved in deciding how their care was provided; and staff supported people, who were nonverbal, to express their views by observing their body language. People’s privacy and dignity was respected.

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 care plans were comprehensive and guided staff on how to support them. People’s communication needs were understood. People were supported to establish, and maintain, relationships with family and friends. When concerns were received, the registered manager responded positively and acted to resolve issues.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

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 Outstanding (published 2 July 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified breaches in relation to the assessment and prevention of the potential spread of health infections, and the cleanliness of some parts of the care home, 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 for 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.