Lillington House

Updated 11 July 2019

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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team: The inspection was carried out by two inspectors, a specialist advisor and an expert by experience. A specialist advisor is a qualified health professional. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type: Lillington House is a care and nursing 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: The inspection visit took place on 20 June 2019 and was unannounced.

What we did: Before the inspection we reviewed information we held about the service. This included notifications the provider is required by law to send us about events that happen within the service such as serious injuries. The registered manager had completed a Provider Information Return (PIR). The PIR 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 sought feedback from the local authority. We used all this information in planning for the inspection.

To gain people's views and experiences of the service provided, we spoke with five people who used the service and nine people's relatives/friends.

We looked at the care records of four people who used the service, including risk assessments, care plans and records relating to medicines administration. We also observed the care and support provided and the interaction between people and staff throughout our inspection.

We spoke with the registered manager, deputy manager and 14 members of staff, including three nurses, five care staff, an occupational therapist, activities co-ordinator, rehabilitation assistant, lounge assistant, chef and member of the housekeeping staff. We also spoke with a healthcare professional who supported the home.

We reviewed information the service held about how they monitored the service they provided and assured themselves it was meeting the needs of the people they supported. This included audits, staff training and recruitment records.

Updated 11 July 2019

About the service:

Lillington House provides nursing and rehabilitative support to a maximum of 57 people suffering from a neurological disability. Most people also have highly complex medical conditions requiring continuous care and support or highly specialised nursing. The home is divided into three units over two floors. On the lower ground floor there is a therapy unit with a hydrotherapy pool, physiotherapy room and an occupational therapy assessment room. A range of on-site therapists provide rehabilitative input. There are large communal areas and extensive grounds which are accessible to the people living in the home.

People’s experience of using this service:

People had confidence in the service to keep them safe and were protected from avoidable harm by staff trained to recognise and report any concerns. Potential risks to people were assessed and minimised. Staff monitored signs and symptoms to keep people safe and well. Medicines were received, stored, administered and disposed of safely.

The registered manager ensured there were enough staff available with the appropriate knowledge and skills to meet people’s needs. People received effective care from staff who were well trained and well supported. There was a thorough approach to planning and co-ordinating people's care. Staff and therapy teams worked well together and with external care professionals to ensure people received the care and support they needed. People's nutrition and hydration needs were met. People were offered a choice of meals which promoted a healthy and balanced diet.

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. Information was presented to people in way that enabled them to be involved in their care.

People received compassionate care from staff who prioritised their needs and worked as a team to ensure people achieved good outcomes. Staff were responsive to people’s physical, emotional and mental health needs. People knew how to raise a concern or make a complaint and the provider had implemented effective systems to manage any complaints received.

There was a clear quality assurance system in place and the provider took learning from situations to improve outcomes for people.

The service met the characteristics for a rating of “good” in all the key questions we inspected. Therefore, our overall rating for the service after this inspection was “good”.

Rating at last inspection: At the last inspection the service was rated ‘Good’ overall, but some improvements were required in the leadership of the service. At this inspection the improvements had been made. (Last report published 20 December 2016).

Why we inspected: This was a planned inspection based on the previous rating.

Follow up: We will continue to monitor all information we receive about the service and schedule the next inspection accordingly.

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