Archived: Lehmann House Residential and Nursing Home

Updated 12 March 2020

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 and a specialist advisor in nursing care.

Service and service type

Lehmann House Nursing and Residential 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.

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. 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.

During the inspection

We spoke with three people who used the service and three relatives about their experience of the care provided. We spoke with five members of care staff including the cook. We also spoke with the service’s nominated individual and a director of the provider. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We reviewed a range of records. This included seven people’s care records and multiple 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 liaised with the local authority regarding action they had taken.

Updated 12 March 2020

About the service

Lehmann House Residential and Nursing Home is a residential care home providing personal and nursing care. The service can support up to 34 people. It is divided into four units over two floors. Two units were being used one upstairs and one downstairs. There were 16 people living in the service at the time of this inspection.

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

There was a lack of clear governance in the service and the provider did not have effective systems in place to consistently assess, monitor and improve the quality of care. This meant poor care was not identified and rectified by the provider. The provider had not effectively and consistently worked with professionals to ensure people's needs were met.

Risks to people's health and wellbeing were not consistently identified, managed or followed to keep people safe. Where advice had been received from health care professionals this was not always followed.

Improvements were needed to ensure incidents of suspected abuse were investigated and reported to the local authority when required. Improvements were needed to ensure people were consistently protected from the risk of infection and cross contamination.

The provider did not use a staffing tool to assess the number of staff required. There were not enough staff deployed effectively to provide care and support. Due to pressures on staff time, interactions with people were often task focussed. Staff told us the training was not of a high quality. We observed poor moving and handling practice during our inspection visit.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice. The service had obtained consent to people’s care and support arrangements from relatives who did not have the required legal authority.

The activities co-ordinator had left the service and no alternative arrangements had been put in place for people’s social engagement. We were told staff should be providing activities, but no extra staff had been employed to meet this requirement.

The service placed people at risk of physical harm and at the risk of significant emotional harm due to isolation, lack of engagement and the impact of poor care

Rating at last inspection

The last rating for this service was Requires Improvement (published 5 February 2019). At this inspection the service has deteriorated to Inadequate. Previous to the Requires Improvement rating the service was rated Inadequate at the inspection in July 2018.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Lehmann House Residential and Nursing Home on our website at www.cqc.org.uk.

Why we inspected

The inspection was prompted in part due to concerns received about staffing and care provided. A decision was made for us to inspect and examine those risks.

Enforcement

At this inspection, we identified breaches of regulation in relation to the management of risks, staffing levels and recruitment practices, people’s emotional and physical needs not being met and the overall governance of the service. We placed an urgent condition on the providers registration and issued a Notice of Decision to close the service

Follow up

This service has now closed.