Loring Hall

Updated 28 September 2019

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 service was inspected by an inspector and an Expert by Experience on the first day. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service. An inspector returned to complete the inspection on the second day.

Service and service type

Loring Hall 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.

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

This inspection was unannounced.

Inspection activity started on 29 August 2019 and ended on 30 August 2019.

What we did

We reviewed information we had received about the service since our last inspection and requested feedback from the local authority who commissioned from the service. We also reviewed the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used this information to plan our inspection.

The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement.

As part of the thematic review, we carried out a survey with the registered manager at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people.

During the inspection

We spoke with five people lived at the home to gain their views on service they received. We also spoke with eight members of staff, including the nominated individual, registered manager, the maintenance person and three care staff. The nominated individual is responsible for supervising the management of the service on behalf of the provider. Our discussions helped us understand how the service was being run and what it was like to work there.

We reviewed a range of records. These included three people's care records and staff records relating to their recruitment, training and supervision. We also looked at records relating to the management of the service, including the provider's policies and procedures, people's medicine administration records (MARs) and quality assurance information.

After the inspection

We spoke with a healthcare professional who was involved in the care of people living at the home.

Updated 28 September 2019

About the service

Loring Hall is a residential care home providing personal and nursing care to 12 people with learning disabilities. The service can support up to 16 people in one building across three floors.

The service is a large home, bigger than most domestic style properties and larger than current best practice guidance. However, the size of the service having a negative impact on people has been reduced by the provider's focus on ensuring that people receive person-centred support which promotes choice, inclusion, control and independence. The service has been developed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that 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.

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

People were protected from the risk of abuse. Risks to people had been assessed and were managed safely. There were sufficient staff to safely meet people’s needs. Staff knew to report any incidents or accidents and the registered manager reviewed incident records to look for trends and reduce the risk of repeat occurrence. People’s medicines were securely stored and safely administered. The provider followed safe recruitment practices. Staff were aware of the action to take to reduce the risk of infection.

Staff were supported in their roles through regular training, supervision and an annual appraisal of their performance. People had access to a range of healthcare services and staff worked with other agencies to ensure people received consistent and effective support. Staff sought people’s consent when offering them support. 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 were supported to maintain a balanced diet and told us they enjoyed the food on offer at the service. Staff treated people with dignity and respected their privacy. People were involved in making decisions about the support they received. Staff were caring and compassionate in their approach.

People’s needs were assessed before they moved into the home. They were involved in the planning of their care. People’s care plans reflected their individual needs and preferences. Staff were aware of the details of people’s care plans and supported them accordingly. People took part in a range of activities which they enjoyed and were supported to maintain the relationships that were important to them. The provider had a complaints procedure in place and people confirmed they knew how to make a complaint.

Staff spoke positively about the registered manager and the working culture at the service. The provider had systems in place for monitor the quality and safety of the service and sought to make improvements where any issues were identified. The registered manager understood the responsibilities of their role. Staff told us they worked well as a team and received a high level of support from the registered manager. The provider sought people’s views on the service through regular residents and key worker meetings.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that 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.

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 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 and update

The last rating for this service was requires improvement (published 10 September 2018). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This was a planned inspection based on the previous rating.

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.