Lydia Eva Court

Updated 22 March 2018

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 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.

At our last inspection on 1 and 2 December 2016 the service was rated as requires improvement. We asked the provider to complete an action plan to show what they would do and by when to improve the key questions for safe, effective, responsive and well-led. These areas were rated as requires improvement because the systems in place to assess, monitor and improve the quality and safety of the service were ineffective.

The first day of our inspection on 17 January 2018 was unannounced and carried out by two inspectors, a medicines inspector and two Experts by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service. The second day of our inspection on 30 January 2018 was announced and completed by one inspector. At this inspection we found that the provider and management team had made significant improvements to all aspects of how the service was being run. This meant that people living in the home were experiencing a much higher quality of care.

Before the inspection we looked at all the information we held about the service. This included information about incidents happening within the service and which the provider or registered manager must tell us about by law.

Because some of the people who used the service were not able to tell us in detail about their care, we used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk directly with us.

During our inspection visit, we observed how people were being supported and how staff interacted with them. We met and spoke with 10 people living in the home, 12 relatives and two visitors from the local church. We also spoke with an operational manager of the organisation, the registered manager, the deputy manager, an activities coordinator and five members of support staff. In addition, we spoke with a senior member of the organisation’s staff, who came to the home on a weekly basis to complete audits, in order to help monitor and improve the quality and safety of the service.

We looked at assessments and plans of care for nine people and checked how they were supported. We reviewed records associated with the employment of three staff, staff meeting minutes and staff training records. We also looked at the arrangements for storing, administering and auditing medicines and a sample of other records associated with the quality and safety of the service.

Updated 22 March 2018

This inspection was undertaken on 17 and 30 January 2018. The first day of this inspection was unannounced and carried out by two inspectors, a medicines inspector and two Experts by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service. The second day of our inspection was announced and completed by one inspector.

Lydia Eva Court is a care home that is registered to accommodate up to 89 older people, some of whom may be living with dementia, in one adapted building. At the time of our inspection there were 84 people living within the home. People in care homes receive accommodation and 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 accommodation is over two floors with three separate, smaller units, on each floor. There are a number of communal areas throughout the home and all bedrooms have en-suite facilities. The home also has a number of enclosed

outdoor spaces.

At our last inspection on 1 and 2 December 2016 the service was rated as requires improvement in safe, effective, responsive and well-led. The overall rating was requires improvement. We asked the provider to take action and make improvements to ensure that effective systems were in place to assess, monitor and improve the quality and safety of the service. The findings from our inspection on 17 and 30 January 2018 confirmed that appropriate action had been taken and significant improvements had been made.

There was a registered manager in post. 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 management team used a number of methods to ensure the quality of the service provided was regularly monitored. All aspects of the service were checked regularly by the provider’s senior management team, the registered manager and care staff, in order to identify any areas that needed improvement. Action was taken promptly to address any identified issues.

Risks to people's safety were identified, recorded and reviewed on a regular basis. There was also written guidance for staff to know how to support people to manage these risks. Staff worked closely with healthcare professionals to promote people's welfare and safety. Staff also took prompt action to seek professional advice, and acted upon it, where there were concerns about people's mental or physical health and wellbeing.

There were enough staff working in the home to help ensure people's safety. Staff worked well together to ensure people's needs were met safely and appropriately. Proper checks were carried out when new staff were recruited, which helped ensure only staff who were suitable to work in care services were employed. Staff knew how to recognise different kinds of possible abuse and understood the importance of reporting any concerns or suspicions that people were at risk of harm appropriately.

People's medicines were stored and managed safely and administered as the prescriber intended. Staff were appropriately trained and competent to support people with their medicines.

People enjoyed their meals and were provided with sufficient quantities of food and drink. People were also able to choose what they had. If people were identified as possibly being at risk of not eating or drinking enough, staff would follow guidance to help promote people's welfare and input would be sought from relevant healthcare professionals.

Staff were trained well and were competent in meeting people's needs. Staff understood people's backgrounds and preferences and supported people effectively. New staff completed an induction and all staff had frequent one-to-one time with their line manager, during which supervisions and appraisals of their work were undertaken.

Staff understood the importance of helping people to make their own choices regarding their care and support and consistently obtained people’s consent before providing support. Some people did not have the capacity to make all their own decisions but staff understood how to act in people’s best interests, to protect their human rights. 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.

Staff had developed respectful, trusting and caring relationships with the people they supported and consistently promoted people’s dignity and privacy. People were able to choose what they wanted to do and when. People were also supported to maintain relationships with their friends and families.

People were supported to engage in meaningful activities of their choosing and were supported to maintain and enhance their independence as much as possible. Staff interactions with people living in the home were frequent, engaging and positive.

The service was well run and communication between the management team, staff, people living in the home and visitors was frequent and effective. People and their families and friends were able to voice their concerns or make a complaint if needed and were listened to with appropriate responses and action taken where possible.