Lady Elsie Finney House Home for Older People

Updated 15 August 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 was planned to check 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.

This inspection took place on 19 July 2018 and was unannounced. A further inspection site visit took place 20 July 2018 which was announced. The inspection team comprised of two adult social care inspectors.

Before the inspection visit we contacted the commissioning department at Lancashire county council. In addition we contacted Healthwatch Lancashire. Healthwatch Lancashire is an independent consumer champion for health and social care. This helped us to gain a balanced overview of what people experienced accessing the service.

We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually 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.

We checked the provider’s website before the inspection visit to check if they were displaying their previous rating and found that they were.

During the time of inspection there were 44 people who used the service. We spoke with a range of people about Lady Elsie Finney House Home for Older People. They included three residents, four relatives, the registered manager, an area manager, the catering manager, a member of cleaning services, a visiting professional and six staff members.

We closely examined the care records of five people who used the service. This process is called pathway tracking and enables us to judge how well the service understands and plans to meet people's care needs and manage any risks to people's health and wellbeing.

We reviewed a variety of records, including policies and procedures, safety and quality audits, three staff personnel and training files, records of accidents, complaints records, various service certificates and medicine administration records.

We observed care and support in communal areas and had a walk around the home. This enabled us to determine if people received the care and support they needed in an appropriate environment.

Updated 15 August 2018

Lady Elsie Finney House Home for Older People is a residential care home offering accommodation and personal care for up to 46 older people who may be living with dementia. The home is divided into three separate areas known as Meadows. Each Meadow has an open plan lounge and dining area plus a smaller lounge. All bedrooms are single and have en-suite facilities. There are enclosed gardens with patio areas and both of the first floor Meadows have large outdoor balconies. At the time of our inspection there were 44 people living at the home.

Lady Elsie Finney House Home for Older People 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.

There is a registered manager 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.

At our last inspection we found that care plans did not always contain information around identifying and managing risks to people. This was a breach of Regulation 12 Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 (Safe care and treatment).

We looked at how risks to people were being managed during this inspection. We found people were protected from risks associated with their care because the registered provider had completed risk assessments. These provided updated guidance for staff in order to keep people safe.

During our last inspection we found that although feedback had been gained from people who used the service. There was not always evidence that the feedback had been acted upon. This was a breach of regulation 17 (Good governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

At this inspection we looked at the feedback gained and any improvements made in this area. The registered manager told us they encouraged and sought feedback on the service provided from people who lived at the home and relatives. We saw minutes of ‘resident’s meetings’ which had taken place since our last inspection. The provider also used questionnaires to gain people’s views about the service they received. This information was feedback to staff and management in meetings and any actions needed were taken.

At our last inspection we found issues with ‘as and when’ plans for people’s medicines. The MAR chart did not always have the same information as the 'as and when' documentation and variable doses were not always recorded. We made a recommendation about this.

During this inspection we looked at how the service was managing medicines. We found monthly audits were being completed and management had oversight of these. We found protocols for ‘as and when required’ medicines were in place as per the provider’s medicines policy. These protocols were in depth and contained person centred information to guide staff.

At our last inspection we found that some of the training documentation for the staff was inaccurate. We made a recommendation about this. During this inspection we found staff training was on going and evidence was seen of staff completing training. We checked the full training records of four staff and viewed the training matrix for the service. Training subjects included areas which affected the wellbeing of people, such as safeguarding. Staff told us they received adequate training in order to care for people effectively.

The home was clean and tidy however some areas required attention such as carpets and areas of high dust. Audits and daily walk rounds were being completed. However, upon further inspection we found that bath and shower chairs had ingrained dirt on these. Replacement equipment was sourced before the end of the inspection. The registered manager amended the audit paperwork to include these areas to be regularly checked.

The service had procedures to minimise the potential risk of abuse or unsafe care. Staff had received safeguarding training and were able to describe good practice about protecting people from potential abuse or poor practice.

Staff told us that they were provided with personal protective equipment. We found people were protected by suitable safe procedures for the recruitment of staff.

We looked at how accidents and incidents were being managed. There was a central record for accident and incidents to monitor for trends and patterns and the management had oversight of these.

We found people were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

We found in depth assessments were carried out by the registered manager before any person received a service. Assessments took place to ensure people’s needs could be met by the service.

Peoples needs for nutrition and fluids had been considered. Files contained likes and dislikes with regards to food and drink. People were supported by staff to live healthier lives. The service referred people in a timely manner, if required, to other services such as chiropodist and GPs.

People we spoke with and their relatives told us that the staff were kind and caring. Staff understood the needs of people they supported and it was apparent trusting relationships had been created. We saw people were offered a variety of choices, which promoted independence, such as what they wanted to do and where they would like to sit.

Staff had a good understanding of protecting and respecting people's human rights. Some staff had received training which included guidance in equality and diversity.

We saw care records were written in a person-centred way and we observed staff followed the guidance in care records. Staff took note of the records and provided care which was person centred.

People told us they were encouraged to raise any concerns or complaints. The home had a complaints procedure. We looked at what activities the home provided in order for people who lived there to receive stimulation and to maintain social health. One person told us, “There has been activities on today my relative likes getting involved.”

We found the registered manager was familiar with people who lived at the home and their needs. We found the management team carried out audits and reviews of the quality of care.

The provider and registered manager had clear visions around the registered activities and plans for improvement moving forward. The management team were receptive to feedback and keen to improve the service. The managers worked with us in a positive manner and provided all the information we requested.