Lavender Fields - Care Home with Nursing

Updated 26 March 2022

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

One Inspector carried out the inspection.

Service and service type

Lavender Field is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Lavender Field is a care home with nursing care. 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 inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We communicated with three people who used the service and five relatives about their experience of the care provided. We spoke with six members of staff including the registered manager, deputy managers, nurses and support workers.

We used the Short Observational Framework for Inspection (SOFI) and spent time observing people. SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We also reviewed a range of records. This included two people’s care records and three medication records. We looked at three staff files in relation to recruitment and staff supervision, and a variety of records relating to the management of the service.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We spoke with one professional who had recently been involved in the service.

Updated 26 March 2022

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

About the service

Lavender Field is a residential care home providing personal and nursing care to nine people with physical and learning disabilities at the time of the inspection. The service can support up to 10.

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

The provider and manager had a governance system in place, which included various audits and

monitoring, however, actions were not always documented, and it was unclear if actions were completed to improve the service.

The service was not able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture. Staff said there was not always sufficient time to be able to encourage people’s independence by getting them involved in day to day tasks. People’s activity records showed that they were doing limited things in the day. The manager did not have knowledge of the Right support, right care, right culture guidance which meant staff were not knowledgeable about the guidance.

People had risk assessments in place. People received their medicines when they needed them. Staff received training that covered aspects of their role, however staff felt they needed additional training such as learning disability and autism.

People and relatives felt staff provided care that was safe, and systems were in place to report concerns. The staff team had been safely recruited. Systems were in place to report and respond to accidents and incidents.

People were supported by staff who offered them choices and supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

The manager had built positive relationships with professionals that were involved with the service. Relatives felt that they could contact the management if they needed to and that they were responsive.

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 16 November 2018).

Why we inspected

We initially undertook a targeted inspection to specifically look at infection prevention control. A decision was made for us to inspect and examine those risks. We inspected and found there was a concern with the service applying the principles of Right support, right care, right culture, so we widened the scope of the inspection to become a focused inspection which included the key questions of safe, effective and well-led.

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. This included checking the provider was meeting COVID-19 vaccination requirements.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to person centred care and good governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.