Archived: Ladysmith Care Home

Updated 8 March 2017

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 registered 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 unannounced inspection took place on 6 January 2017 and was undertaken by two adult social care inspectors.

We asked the registered provider to complete a Provider Information Return (PIR). This is a form that asks the registered provider to give some key information about the service, what the service does well and improvements they plan to make. We looked at the notifications we had received and reviewed all the intelligence CQC held to help inform us about the level of risk for this service. We reviewed all of this information to help us to make a judgement.

During our inspection we undertook a tour of the building. We used observation to see how people were cared for whilst they were in the communal areas of the service. We watched lunch being served in two dining rooms upstairs. We observed a member of staff giving out medicine. We looked at a variety of records; this included six people’s care records, risk assessments and medicine administration records, (MARs). We looked at records relating to the management of the service, which included policies and procedures, maintenance, quality assurance and complaints. We also looked at staff rotas, training, supervision, appraisal and recruitment records.

We spoke with the registered manager, deputy manager, three staff and the cook. We gained the views of seven people living at the service and six visitors. We also interviewed two health care professionals to gain their views.

We used a number of different methods to help us understand the experiences of people living at the service, especially for those living with dementia. This including using the Short Observational Framework for Inspection (SOFI). We observed the care and support provided over a period of time to help us understand people experiences especially for those who could not talk with us. This confirmed that people were supported by staff and provided us with evidence that staff understood people’s individual needs and preferences.

Updated 8 March 2017

This unannounced inspection was undertaken on 6 January 2017 by two adult social care inspectors. The service was last inspected on 1 June 2015 and it was found to be compliant with the regulations that we looked at and an overall quality rating of ‘requires improvement’ was awarded.

Ladysmith Care Home is registered with the Care Quality Commission (CQC) to provide accommodation for up to ninety people who require nursing or personal care. The service can provide support to people who are living with dementia, older people and younger adults. There are four separate units, two units on the ground and two on the first floor. The units on the ground floor, (Heather and Lavender) provide residential and dementia care. Those on the first floor (Iris and Orchid) provide care to people living with dementia. There is a car park for visitors to use. Staff are available 24 hours a day to support people.

This service had a registered manager in place. 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 the legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

We found there were shortfalls, mainly on the first floor. We found issues with recording of topical creams and one person’s eye drops were in use after they should have been discarded. Care plans needed to have clearer information for staff about the care to be given in people’s best interests. One person’s care records needed reviewing regarding their pressure area care and a care plan was required for a condition they were receiving treatment for. Supplementary charts about people’s food and fluid intake needed to be filled in when food and drink was offered to people. One person’s slippers were ill fitting and may have posed a trip hazard. All these issues were discussed with the registered manager who addressed them during our inspection. Auditing in these areas needed to be improved and this was implemented following our inspection.

We have made a recommendation about a shortfall that we found regarding medicines.

Staff received training about protecting people from harm and abuse. Safeguarding issues were reported to the local authority and CQC.

We observed the staffing levels provided on the day of our inspection were adequate to meet people’s needs. Staff received training, supervision and appraisals which helped to support them and develop their skills.

Visiting health care professionals told us staff contacted them to discuss any changes in people’s conditions or concerns they may have and that staff followed their guidance, which helped to maintain people’s wellbeing.

People’s nutritional needs were assessed and monitored and their preferences and special dietary needs were catered for. Staff encouraged and assisted people to eat and drink, where necessary. Advice was gained from health care professionals to ensure people’s nutritional needs were met.

Staff supported people to make decisions for themselves. People chose how and where to spend their time. Staff reworded questions to help people living with dementia understand what was being said.

Activities were provided and visiting was encouraged at any time. People visiting the service were made welcome.

A programme of redecoration and refurbishment was in progress and the gardens had been improved. This enhanced the facilities that were provided for people. Pictorial signage was in place to help people living with dementia find bathrooms, toilets and their own room. General maintenance occurred and service contracts were in place to maintain the environment and equipment in use.

A complaints procedure was in place. This was explained to people living with dementia or to their relatives so that they were informed. People living at the service, their relatives and staff were asked for their views. Feedback received was acted upon. This helped the management team to maintain or improve the service provided.

The registered manager undertook a variety of audits to help them monitor the quality of the service. However, the issues we found regarding people’s care records, prescribed topical creams and eye drops and best interest information at the time of our inspection had not been identified by the auditing process in place. The registered manager took action to address the shortfalls we found during our inspection. They supplied us with an action plan which they put in place to make sure the issues we found would not occur again.