Larchmere House Nursing Home

Updated 25 August 2017

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.

This inspection took place on 13 and 14 July 2017 and was unannounced. The inspection was carried out by two inspectors 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. The service was last inspected 23 June 2015 and was rated Good in all domains.

Prior to the inspection, we gathered and reviewed information we held about the service. This included notifications from the service and information shared with us by the local authority. Before the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

We focused the inspection on speaking with people who lived at Larchmere House Nursing Home, staff and relatives. We spoke to 10 people living at the service, three relatives, six care assistants, two nurses, activities coordinator, the chef, office administrator and the registered manager. We made observations of staff interactions and the general cleanliness and safety of the home. We looked at eight care plans, four medicines records, three staff files, training records and quality assurance documentation.

Updated 25 August 2017

We inspected Larchmere House Nursing Home on 13 and 14 July 2017. The inspection was unannounced. Larchmere House Nursing Home provides support and accommodation for up to 33 older people with nursing needs. At the time of our inspection there were 29 people living at the service.

At the last inspection on 23 June 2015, the service was rated as Good. At this inspection, we found the service remained Good.

There was a registered manager in post who was registered with the CQC. 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 provider had systems in place to protect people against abuse and harm. The registered provider had effective policies and procedures that gave staff guidance on how to report abuse. Staff demonstrated good knowledge of the safeguarding policy and procedures.

Risks to people's safety had been assessed and actions taken to protect people from the risk of harm. Risk assessments were personalised to people's needs and reviewed on a regular basis and when required.

Staff recruitment practices ensured that staff were safe to work with vulnerable adults. There were enough staff on duty to provide safe personalised care.

Trained competent staff managed medicines safely. There were regular audits carried out by trained staff to identify any areas for improvement and to ensure there were sufficient levels of stock.

Staff were well trained with the right skills and knowledge to provide people with the care and assistance they needed. Staff received regular supervisions and yearly appraisals.

The principles of the Mental Capacity Act 2005 (MCA) were adhered to for more complex decisions. People's mental capacity was being assessed appropriately and meetings took place to make decisions on people's behalf and in their best interests, when they were unable to do so. People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

The CQC is required by law to monitor the operation of Deprivation of Liberty Safeguards (DoLS) which applies to care homes. Appropriate applications to restrict people's freedom had been submitted and the least restrictive options were considered as per the MCA.

People were assisted with their nutrition and hydration needs. Staff were completing fluid and eating charts for those that need it. People were involved with improving the food service and menu through weekly surveys carried out by the chef.

People who were at risk of pressure sores had appropriate assessments in place that identified methods to mitigate risk. These were being followed by staff. People were being referred to health professionals when required.

People told us they were very satisfied with the care staff and the support they provided. Relatives told us they were happy with the service their loved ones received.

People and their relatives told us they were involved in the planning of their care. Care plans were being reviewed on a monthly basis by staff. There was a yearly meeting with people and relatives to discuss the care plan and any other concerns they may have.

People at the service had access to a wide range of activities that were designed for their individual needs. People told us they were very happy with the amount of activities on offer at the service.

Staff respected people's privacy and dignity at all the times. The provider had ensured that people's personal information was stored securely and access only given to those that needed it.

The provider had ensured that there were effective processes in place to fully investigate any complaints. Outcomes of the investigations were communicated to relevant people.

The registered manager was approachable and took an active role in the day to day running of the service. Staff felt confident to approach the registered manager with any concerns they may have. The registered manager encouraged people, relatives and staff to voice their opinions of the service through regular meetings and surveys. The registered manager used effective auditing systems to identify any areas of improvement within the service.