The Lawns Care Home

Updated 6 October 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 Health and Social Care Act 2008.

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

The inspection was carried out by two inspectors, a pharmacist specialist and an Expert 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.

Service and service type

The Lawns Care Home 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. The Lawns Care Home is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the CQC to manage the service. 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.

At the time of our inspection, the service had a manager who was in the process of becoming registered with the CQC.

Notice of inspection

This inspection was unannounced.

Inspection activity started on 17 August 2022 and ended on 23 August 2022. We visited the location’s service on 17 August 2022.

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. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We reviewed the action plan completed by the provider following our previous inspection. We used all this information to plan our inspection.

During the inspection

We spoke with five people who used the service and six relatives about their experience of the care provided. We spoke with 14 members of staff including the manager, senior care workers, care workers, kitchen staff and domestic assistants. We also spoke with the regional manager and nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We spoke with two professionals who worked closely with the service.

We reviewed a range of records. This included six people’s care records, three staff recruitment files and multiple medication records. A variety of documents relating to the management of the service, including policies, training records, maintenance records and quality assurance documents were reviewed.

Updated 6 October 2022

About the service

The Lawns Care Home is a residential care home providing accommodation and personal care to up to 62 people. The service provides support to older people and people living with a dementia type illness. The Lawns Care Home accommodates people in one adapted building across two floors, with several communal areas and an outdoor garden space. At the time of our inspection there were 46 people using the service.

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

The management of people’s medicines had improved. However, further guidance was needed for medicines to be taken on a ‘when required’ basis and medicines with a variable dose. Records for the application of creams and lotions were not always complete. We have made a recommendation about the recording of medicines.

The provider’s oversight of the service had improved. More robust systems and processes had been implemented. However, systems and processes needed to become further embedded and maintained. We have made a recommendation about this.

Risks to people were assessed, monitored and managed. Some care plans provided staff with good information and guidance to keep people safe. Some care plans contained inconsistent information and lacked clarity, but staff confirmed they received all relevant up to date information in daily handovers and meetings.

People’s nutrition and hydration needs were appropriately assessed and people who required modified diets received these. Some staff did not have a clear understanding around high calorie drinks, and this was addressed by the manager immediately.

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.

There were enough staff to provide safe care to people. Safe recruitment procedures were in place. The service was clean, tidy and well maintained. Lessons were learnt when things went wrong, and good improvements had been made since our previous inspection. People told us they felt safe and were well supported.

The culture and atmosphere in the service was much more positive than our previous inspection and staff told us they were happy. Staff, relatives, professionals and people spoke extremely positively about the manager and the improvements made.

The manager had built good relationships with professionals and made timely and appropriate referrals. People were involved in the service and relatives were kept up to date. The provider and the manager were welcoming, open and honest throughout the inspection process.

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

Rating at last inspection and update

The last rating for this service was inadequate (published 14 April 2022) and there were four breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulation.

This service has been in Special Measures since 14 April 2022. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection. We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the key questions safe and well-led which contain those requirements. For those key questions not inspected, we used the ratings awarded at the last comprehensive inspection to calculate the overall rating.

The overall rating for the service has changed from inadequate to good based on the findings of this inspection.

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.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Lawns Care Home on our website at www.cqc.org.uk.

Recommendations

We have made a recommendation in the safe key question in relation to the management of medicines. We have made a recommendation in the well-led key question in relation to audits. Please see these sections for further details.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.