Archived: Thomas Leigh Care Home

We considered our inspection findings to answer questions we always ask;

Is the service safe?

Is the service effective?

Is the service caring?

Is the service responsive?

Is the service well-led?

This is a summary of what we found '

Is the service safe?

There were enough staff on duty to meet the needs of the people living at the home. Staff were available in communal areas and regularly checked on people who remained in their bedrooms to ensure their needs were being met.

Systems had been put into place to ensure potential safeguarding adults concerns were identified and reported to the local authority for investigation.

People had been cared for in an environment that was safe, clean and hygienic. Equipment at the home had been maintained and serviced regularly.

Care records were up-to-date and contained current information. This helped to ensure sufficient information was available to meet people's needs. The complaints procedure and statement of purpose for the home had been updated. This meant that people living at the home and their visitors had information available to them regarding the running of the home and how to raise any concerns they may have.

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. These safeguards help to protect the interests of vulnerable people and ensure they are not subject to unnecessary restrictions. We found that DoLS applications had been made appropriately to the local authority. Where a DoLS had been agreed information on this had been recorded in the persons care plan. This meant staff had the information needed to ensure people were not unduly deprived of their liberty.

Is the service effective?

Care plans formats had been reviewed and updated. This meant that staff had the information available to support people safely.

People living at the home had access to call bells. This meant they could summon help if needed.

Staff were monitoring people's health and liaising with other healthcare professionals. This meant that people were getting the support they needed to meet their health care needs.

Training records for staff were up to date. This meant that training could be easily audited and future training needs identified.

Is the service caring?

Staff were available in communal areas of the home and regularly checked on people who were in their bedrooms. This meant that people had the reassurance of knowing support was readily available if needed.

Activities did take place for people. However these did not interest many of the people currently living at the home. Exploring different ways to occupy people would be of benefit to them.

Is the service responsive?

Checks on people who remained in their bedrooms had increased according to their needs. A system for ensuring these were recorded had also been put into place. This meant that people's individual needs were being taken into consideration and responded to.

Referrals for support from other professionals had been followed up and acted upon.

Is the service well-led?

Health and safety checks had been carried out to ensure the environment and equipment were in working order. Any issues identified had been acted upon.

Systems were in place to check the quality of the service provided. This included audits care plans, the environment and medication. Any areas were improvements or actions were required had been noted and acted upon.

During the inspection we spoke with four of the people living at Thomas Leigh and with three of their relatives. We also spoke with seven members of staff who held different roles within the home.

Below is a summary of what we found. The summary describes what people using the service, their relatives and staff told us, what we observed and the records we looked at. If you want to see the evidence that supports our summary please read the full report.

Is the service safe?

People were not getting the support they needed to meet their care and welfare needs. Staff did not always identify when they could not meet people's needs and take appropriate action. Advice was not always obtained or followed from other healthcare professionals.

People were left for periods of up to twenty minutes without staff present and with no means to summon help when they needed it.

People told us that they did not always feel the home was a safe place to live. One person told us, 'I go to bed at 7 o'clock to get out of the way.' They told us and records confirmed, that there had been a number of incidents between people living at the home.

We found that people had not been cared for in an environment that was safe. Access to the main cooking kitchen was unrestricted and access to some staircases was also unrestricted. No risk assessments had been carried out to ensure these practices were safe for the people living at the home.

A Deprivation of Liberty Safeguard (DoLS) had been agreed for one of the people living at the home. No information regarding the DoLS had been recorded in the persons care plan to guide staff on how this affected the support the person may need.

A number of records relating to the running of the home could not be found on the day of the inspection. Some of the records relating to peoples care had not been reviewed or updated; other care records did not contain all of the required information.

Is the service effective?

Care plans had not been reviewed and updated regularly. This meant that changes to the person's care and welfare needs had not been noted and acted upon as quickly as they should be.

People living at the home did not always have access to a call bell to summon support from staff if needed. As a result support was not provided in a timely manner for people who were unwell or required assistance.

Staff did not always identify people whose care and welfare needs they were not meeting. They did not always monitor people's health care effectively. This meant people were not always getting the input from other professionals that they needed.

Is the service caring?

People were left sitting in a lounge for long periods of time without staff present. One of the people living there told us, 'It gets awful lonely.' There were no social activities taking place and staff told us these had not taken place very often.

Staff did not always respond to requests for help from people living at the home. One person called for help for several minutes with no response. When they used their call bell staff failed to respond.

No surveys had been carried out to establish the views of people living at the home or their relatives. Relatives told us that they did not think concerns they had raised had been listened to and acted upon.

Records were judgemental and lacked factual information. One record stated, continued to scream for a lot more attention.' No consideration had been given to other reasons for the person's behaviour.

Is the service responsive?

Referrals for support from other healthcare professionals had not always been made or followed up.

Hourly checks on people living at the home were carried out by staff. There was no evidence that this instruction had been based on an assessment of individual's needs.

Staff did not respond to a person who was calling for their help. Nor did they respond to the call bell when used. Other people were left with no means to summon help when they felt unwell or needed support to walk.

Is the service well-led?

The home did not have a robust system in place for checking the quality of the service they provided.

Care records had not been monitored and reviewed regularly. This meant that the information they contained was inaccurate or insufficient to provide a clear overview of the person's health.

Health and safety checks had been carried out on the environment. The majority of these showed that equipment was safe to use. However an audit of call bells identified some did not have leads attached for people to use. Six days after this audit some of the missing leads had still not been replaced.

We spoke with people who used the service, relatives and carers, and staff. Their comments included:

'The staff have been very busy but they are very caring.'

"The staff are very kind they'd do anything for you.'

We observed during our inspection that the people who used the service appeared happy and content living there. People were treated with care and consideration. We observed that staff focussed on completing tasks for people, but always acknowledged and engaged them.

Staff told us that staffing levels had improved and they had the skills to carry out their job roles.

Staff were aware of the processes to protect vulnerable adults and knew how to report any concerns. We noted that not all referrals had been made to the relevant bodies.

We found that appropriate arrangements were in place for the storage of medicines.

In this report the name of a registered manager appears who was not in post and not managing the regulatory activities at this location at the time of the inspection. Their name appears because they were still a Registered Manager on our register at the time.