Larwood House

Updated 26 February 2022

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.

As part of CQC’s response to the COVID-19 pandemic we are looking at how services manage infection control and visiting arrangements. This was a targeted inspection looking at the infection prevention and control measures the provider had in place. We also asked the provider about any staffing pressures the service was experiencing and whether this was having an impact on the service.

This inspection took place on 8 February 2022 and was announced. We gave the service 24 hours’ notice of the inspection.

Updated 26 February 2022

The inspection took place on the 22 August 2018. The service was last inspected in December 2016, when it was rated ‘Good’. At this inspection we found the majority of the evidence continued to support the overall rating of good and there was no significant evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns. However, we have made a recommendation for improvement in ‘effective’ and this key question has been rated ‘requires improvement’. This does not affect the overall rating which remains ‘good’. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The service is a small service registered to provide care and support to people with a learning disability. It is registered to care for nine people. At the time of the inspection eight people lived there. Larwood House is a purpose built property all on one level with level access to a large outdoor space.

Larwood House 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 care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

There was a registered manager in post. 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.

Care plans were developed in line with current legislation and guidelines. They were person-centred and included the views and preferences of people. However, we found they were not always reviewed and up-dated in a timely manner when people’s needs changed. People had a varied and nutritious diet based on their preferences and staff knew if people needed further support or monitoring if they were at nutritional risk. However, we found the records were not always consistent with what was actually taking place and guidance was not always followed. We made a recommendation regarding nutrition and hydration.

The provider took responsibility to ensure that they were operating under the principles of the Mental Capacity Act 2005 (MCA) and were not placing unlawful restrictions on people. Where required, Deprivation of Liberty Safeguards (DoLS) were in placed or had been requested, and any conditions had been met. 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.

Staff understood how to keep people safe at Larwood House and there were policies in place to support this. Risk assessments were used to identify risks to people and plans put in place to reduce the likelihood or impact of such risks. Medicines were managed safely and people received their medicines as prescribed.

Staff were kind and compassionate and developed positive and friendly relationships with people. They respected people’s choices and personal space and promoted their independence and dignity.

Staff knew people’s preferences and encouraged people to access activities of their choosing, either within the home or in the local community. People were supported to become active citizens in their local community. People received information in a format that they understood and they were supported to participate in meetings and decisions about their care. Discussions had taken place regarding people’s preferences regarding the end of their life, these were documented and easily accessible to staff, when required.

The quality assurance systems in place were effective and identified areas for improvement. The development plan was reviewed and updated each month, which ensured continuous improvements were made to the service. The provider actively sought feedback from people, staff and stakeholders, and this was used to improve the care offered to people. Staff felt included and supported by the management team.