Archived: Lutterworth Country House Care Home

This inspection took place on the 2 July 2015 and was unannounced.

Lutterworth Country House Care Home provides residential care for up to 66 people of which some are living with dementia. At the time of our inspection there were 51 people in residence.

Accommodation is provided over two floors with access via a stairwell or passenger lift. The ground and first floors provide a dining area, and two lounges. The ground floor in addition has a conservatory. There is a garden which is accessible and provides areas of interest.

Lutterworth Country House Care Home had a registered manager in post at the service at the time of our inspection. 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.

We found a breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

The system for recording the administration of medicine to people was not robust and the quantity of medicines on site were not always consistent with records held. The provider could therefore not be confident that people were receiving their medicine as prescribed.

We found a breach of Regulation 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

We found staff were not adequately supervised or had their work appraised, which impacted on the consistency and quality of care people received. Our observations showed that the support people received was not always supported by good practice as not all staff had received training relevant to people using the service, which included dementia awareness training.

We found a breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Audits were not carried out as regularly as required by the provider and did not always include sufficient information as to the improvements needed or a timescale for implementation to bring about improvements.

People told us they felt safe and staff were trained in safeguarding (protecting people who use care services from abuse) and knew what to do if they were concerned about the welfare of any of the people who used the service. Where people were at risk, staff had the information they needed to help keep them safe.

Staff were able to tell us what action they would take should they believe somebody was being abused and were aware of the provider’s policies and procedures, which included whistleblowing. Records showed staff had received training to support them in recognising potential abuse and this provided them with guidance as to their role in promoting people’s welfare.

People using the service, visiting relatives and staff had mixed views as to whether there were sufficient staff to meet people’s needs. Our observations showed that people’s personal care needs and request for assistance were provided in a timely manner to maintain their safety and meet their personal care needs. We found that the deployment of staff was not always effective in that staff did maximise their opportunities to converse or interact with people, leaving people socially isolated.

Visiting professionals were complimentary about the service provided to people and said that the service and staff worked well to provide good quality care and support.

Staff gave mixed views as to the effectiveness of communication, with staff giving differing views as to the frequency of meetings and the sharing of information.

People were protected under the Mental Capacity Act 2005 Deprivation of Liberty Safeguards (MCA 2005 DoLS). We found that appropriate referrals had been made to supervisory bodies where people were thought to not have capacity to make decisions themselves about receiving personal care and leaving the service without support.

People we spoke with gave differing views about the meals provided at the service and our observations showed that the dining experience for people could be improved to promote people’s independence and choice. We noted that staff did not converse with people using the service at lunchtime so dining experience was not used to promote social interaction.

A majority of people ate their meal and assistance was provided to those who needed support. Our observations of the dining experience showed that people were given sufficient to eat and that a majority of people ate their meal.

Where people were at risk of poor nutrition, advice from health care professionals was sought and their recommendations followed. This meant people were supported to eat and drink enough and maintain a balanced diet.

People we spoke with and their visitors told us they had good access to healthcare. Records showed people were referred to the appropriate health care professionals when necessary and that their advice was acted upon. This meant people were supported to maintain good health.

People we spoke with including visiting professionals and relatives of people gave mixed views as the service they received. People were in the main complimentary about the attitude and approach of staff.

People who used the service and their relatives told us that some of them had been involved in the development and review of their plans of care and we noted a member of staff approach people during our inspection to speak with them about their needs. We found plans of care were regularly reviewed, however when changes had been identified this was not always reflected in changes to the main plan of care. Visiting relatives told us that they were kept up to date about any changes to people’s health and welfare by staff at the service.

The service provided a programme of activities, to which some people took part. External providers visited to provide themed events. The registered manager told us relatives and friends of people using the service were encouraged to visit and take part in 'fun days' and events organised at the service. The garden was accessible to people using the service and provided areas of interest which included an aviary.

Some people told us that they were bored and that staff did not have time to spend with them. In the afternoon we saw a group of people taking part in a knitting group whilst some spent time in the garden. A majority of people throughout the inspection sat in comfortable chairs in communal areas, some watching television. There was minimal interaction between people and staff and staff did not maximise their opportunities to interact with people.

The provider had a system for auditing the quality of the service and in some instances these were used to improve the quality of care people received and promote their safety. We received information following the inspection with regards to falls. An audit of the falls people experienced identified preventative measures to reduce future falls.

The registered manager following the inspection sent us information that systems within the service were maintained, which included gas, electrical and fire.

You can see what action we told the provider to take at the back of the full version of the report.