Archived: Leen Valley Care Home

We found the following examples of good practice.

The provider had a good stock of all Personal protective equipment [PPE]. PPE was accessible to staff and areas for putting on and taking off PPE had been carefully considered.

Staff were observed wearing the appropriate PPE during the inspection.

Staff and people were observed socially distancing in the lounges. Seating at mealtimes was prepared so people could all eat together with support from staff but still remain socially distanced.

People had been supported to keep in touch with families through phone and video calls. Visiting arrangements were in place and had changed throughout the pandemic in line with government guidance.

Leen Valley Care Home is a residential care home for up to 36 people which provides accommodation for people who require personal care. At the time of the inspection, nine people were living at the home.

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

All staff understood their responsibility to keep people safe from harm. People were supported to take risks and make informed choices, promoting their independence. Risks were assessed, and plans put in place to keep people safe. There was enough staff to safely provide care and support. Checks were carried out on staff before they started work to assess their suitability to support people in a care setting. Medicines were well managed, and people received their medicines as prescribed. People were kept safe from the risk of cross infection. We made a recommendation to the provider to ensure carpets were regularly deep cleaned to minimise odour.

Staff had received training to meet the needs of people using the service. They felt supported by the management team. Staff promoted choice and people were supported in the least restrictive way. People were supported with maintaining a balanced diet including having a choice of meals. People were encouraged to attend appointments with other health care professionals to maintain their health and well-being.

People received care from staff who knew them very well. Staff were caring, and people were treated with kindness and respect. Staff had a good understanding of people's needs, choices and preferences and they were provided with detailed information about people’s needs. People were encouraged to make decisions about how their care was provided and their privacy and dignity was protected and promoted. Staff gained people's consent before providing personal care.

The service was responsive to people's health and social needs. People's care records were reflective of people's individual care needs and preferences and were reviewed on a regular basis. People knew about the service's complaints procedures and knew how to make a complaint. People were encouraged and supported to remain in contact with people important to them.

People benefitted from a service that was well led. The management team promoted a positive culture that was open and transparent. The registered manager demonstrated good visible leadership and understood their responsibilities. Quality assurance practices were robust and used to make improvements. Staff were motivated and talked about people and working at Leen Valley in a way which demonstrated they wanted to support them as much as possible and provide the best standards of care.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection The last rating for this service was Good (published 4 April 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our reinspection programme. If we receive any concerning information we may inspect sooner.

There was a registered manager in post when we inspected 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.’

People who used the service were safe; staff had a good understanding of how to protect people from potential abuse. The risks to people’s safety were assessed and staff used the measures in place to reduce risks to their safety.

People were cared for by sufficient numbers of staff who had received training for their roles. People received their medicines when they required them.

People’s right to make choices was respected and staff understood the need to obtain consent from people when providing care. Where people lacked the mental capacity to make their own decisions staff were aware of the legislation in place to protect people and had followed the principles of the Mental Capacity Act 2005 (MCA) to ensure people were not unlawfully deprived of their liberty.

People were supported to maintain a nutritionally appropriate diet according to their needs and their health needs were managed by the staff who cared for them.

People received care from staff who were kind and respectful, their views on their care were listened to and incorporated into their individual plans to ensure person centred care was provided.

People, who used the service, or their representatives, were encouraged to be involved in decisions about their care and their environment, and systems were in place to monitor the quality of service provision. People also felt they could report any concerns to the management team and felt they would be taken seriously.

We inspected the service on 9 August 2016. The inspection was unannounced. Leen Valley Care Home is registered to accommodate up to 36 people. The home has two floors with a passenger lift for people to access the upper floor. On the day of our inspection seventeen people were using the service.

The service did not have a registered manager in place at the time of our inspection. 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.

People were not always supported by enough staff to ensure they received care and support when they needed it. People did not always receive their medicines as prescribed.

People were supported by staff who knew how to recognise abuse and how to respond to concerns. Risks in relation to people’s daily life were assessed and planned for to protect them from harm.

People were supported by staff who had the knowledge and skills to provide safe and appropriate care and support. People were supported to make decisions and staff knew how to act if people did not have the capacity to make decisions.

People were supported to maintain their nutrition and staff were monitoring and responding to people’s health conditions.

People lived in a service where staff treated them with kindness and listened to them. People’s emotional needs were recognised and responded to by a staff team who cared about the individual they were supporting.

People were not always given enough opportunity to follow their hobbies and interests and could not be assured that if they raised concerns these would be resolved.

People were involved in giving their views on how the service was run and there were systems in place to monitor and improve the quality of the service provided.

We last inspected this service on 5 December 2013. At this inspection we found people were not protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were not always maintained. At this inspection we found improvements had been made to record keeping. Senior care staff recorded information daily about people's needs and how they were being met. We saw care plans were also reviewed monthly by the manager. A summary of what we found is set out below. We used the evidence we collected during our inspection to answer five questions.

Is the service safe?

We spoke with six people the service supported. One person told us, "I think the care is excellent here. Staff listen and help me when I have lost something or I am not feeling too good.' One person we spoke with told us their relative had moved to the service. They said, 'We can see [they] are happier and more relaxed.'

Another relative we spoke with told us, 'When the phone rang I used to worry. But things have improved since the home came under new management."

A visiting healthcare professional told us the service was, 'Good at contacting us for advice.' The service acted to protect people who were unable to make decisions, for example, about their finances. The service had arrangements in place to make decisions in people's best interest if the person's mental capacity meant they were unable to make some decisions. The process followed by the service met the requirements of the Mental Capacity Act 2005.

Is the service effective?

Peoples needs were assessed and care plans were reviewed monthly by the manager. Care staff we spoke with understood people's needs. Senior care staff explained how they led a shift and ensured the care described in care plans was delivered. Care staff told us senior care staff allocated their work based on people's needs as described in the person's care plan. We saw senior care staff update people's care plans to monitor the care delivered. Risk assessments had been carried out and were reviewed.

We found examples of gaps in the co-ordination of some people's care. It was not clear what action care staff had taken to respond to diagnostic test results in one instance and action had not been taken in response to a communication recorded in another person's care plan.

We found care staff had the appropriate training and experience to enable them to carry out their role effectively. Care staff told us they received regular supervision and appraisal. Care staff training was up to date.

Is the service responsive?

We spoke with a relative who told us that the service had improved considerably since the new owner provided the service. They said, 'Looking after people with dementia is such a difficult task. Care staff now all seem very nice. I would know how to raise concerns if I had any.'

We spoke with people who were having their lunch and asked them about the food. One person said, 'They know what we like. I don't want spicy food or pasta or garlic. I like traditional food. The puddings here are really nice.'

Is the service caring?

One person we spoke with told us, 'Staff are always polite and kind and if I had any complaints I would say something.' We observed care staff supporting people at lunchtime. Care staff sat at the dining table and engaged in conversation with people as well as supporting them to eat. We saw care staff were patient when they supported people.

Is the service well led?

People who used the service and relatives told us the service had improved over the last year. One relative told us, 'The manager makes sure things get done.'

The provider had developed a quality assurance process which consisted of audits and checks designed to identify and manage the risks to people 's health and welfare. The service had also obtained feedback from people who used the service and staff. The manager met with relatives and people who used the service to discuss improvements to the service.

There were effective systems in place to reduce the risk and spread of infection. We looked at nine bedrooms, all communal areas, the laundry and the sluice room to assess the cleanliness and how the risk of the spread of infection was being managed. Improvements had been made to the environment such as new carpets and curtains and there were plans for further improvements.

There were systems in place to make sure people received their medication as prescribed by their doctor. The provider also had systems in place to gain the views of people using the service and to monitor the quality of care provided.

Records did not always reflect the care people were receiving. For example, one person had a history of falls and had been assessed as being at risk of further falls. The care plan was basic in relation to how staff should support this person to reduce the risk of further falls. We saw staff were taking appropriate measures to reduce the risk and that equipment was in place and being used. This meant the care was being delivered but the records were not fit for purpose.