Laburnum Lodge

Updated 11 June 2021

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.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

This inspection was carried out by one inspector.

Service and service type

Laburnum Lodge 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

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought and received feedback from the local authority and safeguarding team who work with the service. 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. We used all of this information to plan our inspection.

During the inspection

The start of the inspection was the unannounced site visit on 30 April 2021, and we finished gathering our inspection evidence and gave feedback on 12 May 2021. We spoke with five relatives about their experience of the care provided to their family member. We spoke with seven members of staff including the provider/nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We also spoke with the registered manager, the business development and IT manager, the administrator manager, and three senior care workers.

We reviewed a range of records. This included three people’s care plans and risk assessments. We also looked at medication records and variety of records relating to the management of the service, including audits, policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at actions taken as a result of learning from incidents and accidents.

Updated 11 June 2021

About the service

Laburnum Lodge is a residential care home providing personal care to 18 which increased to 20 older and younger adults by the end of the inspection. The service can support up to 22 people. The service provides support mainly to people over 65 years of age some of whom are living with dementia. The care home accommodates people in one adapted building, over two floors accessed by stairs or a stair lift.

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

The registered manager and staff had made improvements to people’s care records. Care plans contained individualised information to guide staff on how to monitor people’s known risks and to support people’s wellbeing. People and their relatives were involved in decisions around their or their family members care. Staffs communication with people’s relatives was good. Relatives told us they knew how to raise concerns and were confident they would be listened to.

The provider and registered manager had introduced a new system of policies and procedures and audit forms to help improve the monitoring of the service provided. The registered manager notified the CQC of incidents they were required to. People and staff were able to formally feedback on the service by completing a survey.

The registered manager and staff promoted satisfactory infection control and cross contamination processes. Where improvements were noted to be needed during the site visit the registered manager was signposted to current guidance. The provider and registered manager were working with the local authority care home support team and they also worked with health and social care professionals. This was when people’s wellbeing required this joined up working.

Staff were trained in safeguarding and told us they would raise any concerns around poor care and harm. Staff administered people’s prescribed medicines safely. Some improvements in medication recording were found and staff confirmed that this would be dealt with during supervision by the registered manager. This staff learning would help reduce the risk of recurrence.

Potential new staff had checks completed on them to try to make sure they were of good character. There were enough staff available to meet people's needs. Staff promoted people’s wellbeing by offering different activities for people to join in should they wish to.

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 11 March 2020) and there were two breaches of regulation. The provider had not 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

We carried out an unannounced comprehensive inspection of this service on 12 March 2020 and breaches of legal requirements were found. The breaches were Regulation 9 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 (Person-centred care), and Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 (Good governance).

We undertook this focused inspection to check they had made the necessary improvements and to confirm they now met legal requirements. The inspection was also prompted in part due to whistle-blowing concerns received about poor infection control procedures, and poor maintenance. This report only covers our findings in relation to the Key Questions Safe, Responsive and Well-led which contain those requirements.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Please see the safe, responsive and well-led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Laburnum Lodge on our website at www.cqc.org.uk.

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.