Malmesbury Lawn Care Home

We found the following examples of good practice.

The registered manager ensured current government guidelines in relation to COVID-19 were being followed by staff and visitors to reduce the risk of infection to people living at the home. This included comprehensive checks for visitors on arrival.

Safe visiting arrangements were in place. Staff and visiting professionals were asked to provide evidence of their vaccination status against COVID-19 prior to entering the home. People were supported by staff to keep in touch with those important to them. Visitors were required to complete a COVID-19 test, had their temperature checked and wore PPE.

The home was coming to the end of an outbreak of COVID-19. One person had COVID-19 at the time of this inspection. Safe isolation procedures were in place to protect others from the risk of infection. A separate PPE station was placed outside this person's bedroom for staff to use. Appropriate procedures were also in place to dispose of used PPE safely.

Staff supported people's social and emotional wellbeing. Alternative forms of maintaining social contact were in place including video calls. The home had a visitors' 'pod' to allow partitioned visiting without having to enter the care home.

All staff had undertaken training in infection prevention and control (IPC) and Personal protective equipment. Policies and audits relating to infection prevention control, including coronavirus were up to date. We saw that regular IPC audits had been undertaken and the home had actioned the findings of the audits.

The provider had an up to date infection control policy in place and carried out appropriate environmental audits. The provider ensured staff were kept up to date with government guidance.

The home was clean, well maintained, air filtration unit had been placed in communal areas in the home.

Staff had worked effectively as a team through out the pandemic, managers and staff supported each other to ensure people received safe care.

Malmesbury Lawn care home is registered to provide accommodation and personal care services for up to 35 older people and people who may be living with dementia. At the time of our inspection there were 22 people living at the home.

The home was due to be refurbished so the number of people living at the home had been reduced in preparation for the refurbishment.

The home had allocated, short stay beds and reablement beds on the first floor whilst preparations were made for the refurbishment and reducing the disruption that may be caused during works to be carried out.

People’s experience of using this service:

People received safe and effective care from staff who understood how to recognise and report issues of concern and potential abuse.

The home was an integral part of the local community and actively looked for ways to include people in the outside community, with various events taking place both inside and outside of the home.

Staff supported with people with kindness and respect and involved them in decisions about their care.

The home has been rated outstanding in Responsive, consistently showing outstanding community links that benefited people’s well-being and promoted their inclusion within the community.

Complaints and concerns were always taken seriously, responded to in a timely way and listened to.

Systems were in place to monitor the quality of the service provision and to make any necessary improvements when shortfalls were identified.

People benefitted from staff who had completed training and had the skills and knowledge to care for them.

Peoples care plans were comprehensive and contained information on how to care for them.

People benefitted from a registered manager who led by example. There was a relaxed atmosphere in the home. Staff were spoken to and respected by managers and other staff, they felt confident in their job role and to challenge each other if it effected the wellbeing of other people.

Rating at last inspection:

At our last inspection, we rated the service good (report published 27th July 2016)

At this inspection, we found the evidence continued to support the rating of good overall with evidence that demonstrated outstanding in Responsive.

Why we inspected:

This was a planned unannounced inspection based on the rating at the last inspection. The service remains rated good overall.

Follow up:

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

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

Malmesbury Lawn Care Home is registered to provide accommodation and personal care services for up to 35 older people and people who may be living with dementia. At the time of our inspection there were 32 people living at the home. The main part of the home is a two-storey, rectangular building around a central, enclosed garden. There were a variety of shared areas, including lounges and dining areas.

There was a registered manager in place. 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.

The provider had arrangements in place to protect people from risks to their safety and welfare, including the risks of avoidable harm and abuse. Staffing levels were sufficient to support people safely and in a calm, professional manner. Recruitment processes were in place to make sure only workers who were suitable to work in a care setting were employed. Arrangements were in place to store medicines safely and to administer them according to people’s needs and preferences.

Staff received appropriate training and supervision to make sure they had the skills and knowledge to support people according to their needs. Staff were aware of the need to gain people’s consent to their care and support. Where people lacked capacity to make certain decisions the home was guided by the principles of the Mental Capacity Act 2005 to ensure any decisions were made in the person’s best interests. The Care Quality Commission monitors the operation of the Deprivation of Liberty Safeguards which apply to care homes. We found the home to be meeting the requirements of the Safeguards.

People were supported to eat and drink enough to maintain their health and welfare. They were able to make choices about their food and drink, and meals were prepared appropriately where people had particular dietary needs. People were supported to access healthcare services, such as GPs and community nursing teams.

Shared areas of the home had been decorated and adapted with exceptional imagination and creativity to support people living with dementia.

People found staff to be kind and caring. They were encouraged to take part in decisions about their care and support and their views were listened to. Staff respected people’s individuality, privacy, dignity and independence.

The provider involved people in the care assessment and planning processes. Care and support were based on plans which took into account people’s needs and conditions, but also their abilities and preferences. Care plans were adapted as people’s needs changed, and were reviewed regularly. People were able to take part in leisure activities and hobbies which reflected their interests. Group activities and entertainments were available if people wished to take part.

The home had an open, friendly atmosphere in which people were encouraged to make their views and opinions known. Systems were in place to make sure the service was managed efficiently and to monitor and assess the quality of service provided.

This is a summary of what people told us and what we found.

Is the service safe?

People told us they felt safe and comfortable in the home. They said they had good relationships with staff. They said, 'I couldn't wish for better' and 'It is very nice and comfortable'.

We found there were sufficient staff employed to support people safely. The provider had taken appropriate steps to protect people from the risk of abuse.

We saw staff were mindful of people's welfare and safety. Appropriate risk assessments were in place. People were assisted to move around the home safely. If equipment used required two members of staff, two care workers were available.

Is the service effective?

People told us that they were satisfied with the care and support they received. One person said, 'I have no complaints.' Another said, 'No problems'.

We found people's care and support were based on assessments of their needs. Care plans were detailed and personalised. Systems were in place to ensure care was delivered according to people's plans.

We found day to day care was delivered with people's consent. The provider followed suitable procedures where people did not have capacity to consent.

People were cared for and supported in an environment that was maintained and adapted to the needs of people living with dementia. The service made arrangements for people to maintain their involvement with the wider community.

Is the service caring?

Staff we spoke with were motivated to provide good care. They knew about people's needs and how they preferred to have their care delivered. One member of staff said they were 'One big, happy family'.

We observed positive, friendly interactions between staff and people who used the service. Staff took time to make sure people understood what they were saying, spoke clearly and made eye contact with the person they were talking to.

Staff were seen to make sure people were comfortable and that their dignity and privacy were respected. When people sat outside, staff made sure they were protected from the sun.

Is the service responsive?

People told us staff listened to them. People's care plans were individualised and person-centred.

We found the service had systems in place to ensure the care provided was appropriate to people's changing needs. People were supported by other healthcare providers as appropriate.

Is the service well-led?

Staff told us they were supported to deliver quality care in an open culture. People who used the service were satisfied with the care and support they received.

We found risks were assessed and appropriate action plans were in place in people's individual care plans. Effective systems were in place to regularly assess and monitor the quality of service provided. The provider sought the views of people using the service and others. Incidents, accidents and complaints were handled appropriately and lessons were learned.

People were supported to make choices. These included decisions about what they wanted to do and when they wanted to get up and go to bed. Staff interacted with people who used the service in a respectful and very sensitive manner. Comments from people who used the service included "I can choose what to do," "I couldn't be better looked after," "I have help when I need it," "the staff are always very busy," and "I am happy living here."

Each person who used the service had a plan of care that included up to date information about the individual support and care they needed. People's health, safety and welfare were protected as they received the advice and treatment that they needed from a range of health and social care professionals. Staff had the skills to meet people's needs and they received appropriate support and advice from the manager.