Background to this inspection
Updated
26 November 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. 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.
Inspection team
The inspection was carried out by one inspector.
Service and service type
Lowfield House Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as 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
This inspection was unannounced.
What we did before the 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, including Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.
During the inspection
We spoke with one person who used the service. We spoke with four relatives over the telephone on 8 and 11 November 2019 about their experience of the care provided. We spoke with eight members of staff in total including the Associate Regional Director, the registered manager, nurse, care workers and the cook. We spoke with four of the care workers over the telephone on 8 and 11 November 2019.
We reviewed a range of records. This included three people’s care records and five people’s medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data, supervision and appraisal trackers and various other documents to support this report.
Updated
26 November 2019
About the service
Lowfield House Nursing Home is a residential care home providing personal and nursing care to 18 people, with complex needs relating to a learning disability, at the time of the inspection. The service can support up to 21 people. The home accommodates people in one adapted building. The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
People’s experience of using this service and what we found
People were safeguarded from abuse by appropriate systems and processes. Risks to people were assessed and people’s independence was promoted. Staff numbers were assessed according to people’s needs. Medicines were administered safely by trained and competent staff. Infection control procedures were evident. Processes were in place to analyse and learn when things go wrong.
People’s needs and choices were assessed to support good outcomes for people. Staff appeared knowledgeable and were provided with training. People were supported to eat and drink and maintain a balanced diet. Staff shared information with colleagues and professionals to facilitate the best support for people. People had regular and appropriate access to health professionals. The service had considered people’s needs when adapting and decorating the home. Consent to care was sought. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
People’s views were sought wherever possible and considered within their care plans. People’s privacy and dignity were respected.
Care plans were individual and personalised to the needs and preferences of people. Comments, complaints and compliments were used to improve the quality of care. People’s end of life wishes were sought and people were supported in their end of life, where applicable.
There was a clear vision for the home and an open culture. There was a governance framework in place which covers all aspects of the service and the care delivered. People, relatives and staff were engaged in the running of the home. There was evidence of continuous improvement by analysing trends, themes and by sharing best practice. The home worked in partnership with the community.
The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence. The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.
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 27 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 re-inspection programme. If we receive any concerning information we may inspect sooner.