Archived: Loran House

Updated 1 February 2017

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 registered provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, 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 29 December 2016 and was unannounced. The inspection was completed by an adult social care inspector.

Before the inspection, the provider completed a Provider Information Return (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 spoke with the local authority commissioning and safeguarding teams to gain their views on the service. We also looked at the notifications we received from the service and reviewed all the intelligence held by the CQC.

During the inspection we spoke with five people who used the service and seven visiting relatives. We also spoke with the registered provider, two senior care staff, four care staff, the cook, the maintenance person, a member of domestic staff and a visiting healthcare professional.

We looked at five people’s care plans along with the associated risk assessments and their Medication Administration Records (MARs). We also looked at how the service used the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS) to ensure that when people were assessed as lacking capacity to make informed decisions themselves or when they were deprived of their liberty, actions were taken in their best interest.

We completed a tour of the premises to check general maintenance as well as cleanliness and infection control practices. We looked at a selection of documentation pertaining to the management and running of the service. This included quality assurance information, dependency levels and staff rotas, staff training records, complaints, recruitment information, policies and procedures and records of maintenance and checks carried out on equipment.

We used the Short Observational Framework Tool for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We observed staff interacting with people who used the service and the level of support provided to people throughout the day, including meal times.

Updated 1 February 2017

Loran House is registered to provide care and accommodation for up to 46 older people who may be living with dementia. It is close to the centre of Hull and has good access to local amenities and public transport routes.

This unannounced inspection took place on 29 December 2016. At the last inspection of the service on 25 and 26 June 2015 the registered provider was non-compliant with regulations pertaining to deploying suitable numbers of staff [regulation 18 (1) staffing], providing effective levels of support to staff [regulation 18 (2)(a) staffing], and quality monitoring systems [regulation 17 good governance].

During this inspection we saw that the registered provider had taken action to ensure compliance had been achieved with the aforementioned regulations. People who used the service were supported by suitable numbers of staff who had received effective levels of one to one supervision and support. The registered provider had reviewed and developed their quality monitoring systems to ensure shortfalls in care and support were highlighted and rectified in a timely way.

The registered provider is required to have a registered manager in post at Loran House. We found the manager had been registered with the Care Quality Commission since 1 October 2010. 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.

Assessments of people’s care and support needs were undertaken regularly to ensure staff were deployed in suitable numbers to meet their needs. People who used the service were supported by staff who had been recruited safely following the completion of appropriate checks. Staff had completed training to ensure they knew how to protect people from abuse and avoidable harm. The registered provider had developed plans to deal with foreseeable emergencies which included guidance to enable staff to evacuate people safely in an emergency. Medicines were ordered, stored and administered safely and people received their medicines as prescribed.

Staff received effective levels of support and one to one supervision. Staff told us they felt supported by the service’s management team. People were supported by staff who had completed relevant training to enable them to meet the assessed needs of the people who used the service. Staff were encouraged to develop their knowledge and skills by undertaking nationally recognised qualifications. Staff understood how to gain consent from the people who used the service and the principles of the Mental Capacity Act 2005 were followed when people could not make specific decisions themselves. A range of healthcare professionals were involved in the care and treatment of the people who used the service. People were supported to eat a healthy balanced diet and appropriate action was taken when concerns with people’s dietary intake were identified.

People who used the service were supported by caring staff. People were treated with dignity and respect by staff who knew their needs and understood their preferences. Staff showed a genuine interest and affection for the people they cared for. We heard people laughing and sharing stories during their interactions with staff. People’s private information was stored securely and treated confidentially as required.

Staff recognised changes in people’s presentation or condition and responded appropriately. Reviews of people’s care took place on regularly and people or their appointed representative were involved in the initial and on-going planning of their care. Care plans had been created to ensure staff understood and could deliver the care and support people required consistently and safely. People took part in a range of activities and were encouraged to follow their interests. The registered provider had a complaints policy which was displayed within the service. We saw that when complaints were received they were responded to appropriately.

The registered provider’s quality assurance system included audits, checks, observations and service user feedback. The manager understood their responsibilities to report accidents, incidents and other notifiable incidents to the CQC as required. Meetings were held with staff and people who used the service to ensure their views were known and could be acted upon. Staff told us the management team were approachable, supportive and listened to their views regarding developing the service. People and visiting relatives knew the registered provider and were observed to comfortably engage with them during the inspection.