Archived: Lawrence Home Nursing Team

Updated 29 October 2016

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 and 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 28 September 2016 and was announced. We told the provider the day before our visit that we would be coming. We did this because the registered manager is sometimes out of the office supporting staff or visiting people who use the service. We needed to be sure that they would be in. The inspection was undertaken by two inspectors.

Before the inspection, we asked the provider to complete a Provider Information Return (PIR). The provider had completed and submitted their PIR. This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We also looked at previous inspection reports and notifications we had received. Services tell us about important events relating to the care they provide using a notification. This enabled us to ensure we were addressing potential areas of concern.

On the day of our inspection we spoke with three registered nurses, the registered manager and one health care professional. We looked at five people’s care records, compliments records, a sample of policies and procedures and at a range of records about how the service was managed. We also reviewed staff files for three individuals, including their recruitment, supervision and training records.

After the inspection we spoke with four people’s relatives and contacted eight external professionals involved with people who received support from the service to obtain their views.

Updated 29 October 2016

We inspected Lawrence Home Nursing Team (LHNT) on 28 September 2016. LHNT is a small charity, which was established to provide palliative, mostly overnight, nursing care to people in the last stage of their lives.

The service is registered to provide personal and nursing care to people in their own homes and they offer a free of charge, specialist support enabling people to die in their own homes. LHNT provides care around Chipping Norton and surrounding areas and works closely with the local GP surgeries. The registered manager told us the team was like ”an extension of community service provided by District Nurses’ team to ensure people received 24 hours care at home”. At the time of our visit the service cared for three people.

There was a registered manager in post 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.

Due to the nature of the care provided we were unable to directly contact the people who used the service to obtain their views. The feedback received from people’s relatives was positive. People’s relatives were complimentary about the caring approach and professional attitude of the team. They told us Lawrence Home Nursing Team enabled them to fulfil their loved ones’ wishes of remaining at home at the final stages of their illness. They also told us the team helped them to ensure people experienced a comfortable and dignified death.

People’s relatives told us people were always supported in a safe way and their wishes were respected and their dignity promoted. They also commented on positive caring relationships the service built with the people they cared for and with their families.

The service communicated well with families and other professionals to ensure people received tailored, person centred and compassionate care at the end of their lives. People’s nutritional needs were considered, assessed and recorded.

People were supported by a team of registered nurses who all had many years of experience either working as a District Nurse or at hospices. The nurses were aware what action to take to ensure that people were protected if they suspected people were at risk of abuse. The registered manager and the nurses were aware about the Mental Capacity Act and their responsibilities regarding involving people. The nurses were well supported by the registered manager and had access to further training and professional development opportunities. People’s relatives also told us the nurses displayed exceptional empathy towards the whole families and to all who mattered to people who received the service from Lawrence Home Nursing Team.

There were sufficient numbers of nurses employed to provide care to the people using the service. Records confirmed relevant checks had been carried out to ensure the safe recruitment practices were followed.

The provider had signed a partnership agreement with the Oxford Health NHS Foundation Trust which detailed cooperation between the service and the local health professionals and the provider's use of district nursing notes to ensure continuity of care for people. The registered manager ensured risks to people’s individual needs had been identified and actions had been taken to manage these.

People were mostly referred to LHNT by the local health professionals and the referral notes reflected people’s needs were known to the service before they supported people. The registered manager ensured detailed records of any support provided were kept. Each overnight shift was followed up by a robust handover to the nurse co-ordinator and to the District Nurses team to ensure people’s changing needs were met. People’s relatives commented positively on the flexibility of the service that changed according to people’s needs. The service received a number of compliments from relatives grateful for the support and care provided to their family members.

The registered manager had quality assurance processes in place to monitor the service provided. The audits included people’s documentation, competencies of the nurses and feedback received. People’s relatives had opportunities to make suggestions in relation to the support and service provided by LHNT. The registered manager and their team demonstrated a positive culture and a strong commitment to delivering high quality support to people at the end of their lives.