Lavender Fields - Care Home with Nursing

About the service

Lavender Field is a residential care home providing personal and nursing care to nine people with physical and learning disabilities at the time of the inspection. The service can support up to 10.

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

The provider and manager had a governance system in place, which included various audits and

monitoring, however, actions were not always documented, and it was unclear if actions were completed to improve the service.

The service was not able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture. Staff said there was not always sufficient time to be able to encourage people’s independence by getting them involved in day to day tasks. People’s activity records showed that they were doing limited things in the day. The manager did not have knowledge of the Right support, right care, right culture guidance which meant staff were not knowledgeable about the guidance.

People had risk assessments in place. People received their medicines when they needed them. Staff received training that covered aspects of their role, however staff felt they needed additional training such as learning disability and autism.

People and relatives felt staff provided care that was safe, and systems were in place to report concerns. The staff team had been safely recruited. Systems were in place to report and respond to accidents and incidents.

People were supported by staff who offered them choices and supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

The manager had built positive relationships with professionals that were involved with the service. Relatives felt that they could contact the management if they needed to and that they were responsive.

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

Rating at last inspection

The last rating for this service was good (published 16 November 2018).

Why we inspected

We initially undertook a targeted inspection to specifically look at infection prevention control. A decision was made for us to inspect and examine those risks. We inspected and found there was a concern with the service applying the principles of Right support, right care, right culture, so we widened the scope of the inspection to become a focused inspection which included the key questions of safe, effective and well-led.

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. This included checking the provider was meeting COVID-19 vaccination requirements.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to person centred care and good governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

At our last inspection on 25 November 2015 we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Lavender Fields - Care Home with Nursing 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.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.” Registering the Right Support CQC policy

The registered manager was registered for two locations both these locations were on the same site. Service users, used both facilities for socialising and activities. Each location had a deputy manager in place.

Lavender fields design enabled good access for wheelchair users. Communal areas included: Lounge, kitchen dinner, study/activity room and a sensory bathroom. All bedrooms were of a good size and decorated to people's taste. All bedrooms had an en-suite facility.

The service was safe. Staff received training about safeguarding and were competent to report any concerns they had. Safe recruitment practices were in place to employ suitable staff. There were enough staff to deliver support at a time people wanted. Care plans contained good risk assessments with appropriate guidance for staff. People were supported to take their medicines safely by competent staff. Staff understood the importance of good infection control.

The service was effective. New staff completed induction and training to meet people’s needs effectively. Staff had access to regular supervision and meetings. The registered manager, deputy manager and staff worked in line with the Mental Capacity Act 2005 (MCA) principles, staff understood the importance of promoting people’s choice. People’s care needs were assessed and supported people’s preferences. Staff supported people with their nutrition and hydration needs. People were encouraged to cook and be involved in their daily support.

The service was caring. Staff knew people well and staff cared for them in a compassionate way. Staff respected people’s privacy and dignity and supported people to maintain relationships. Staff delivered care that was supportive, kind and caring. People were involved in deciding how their care was provided.

The service was responsive. People`s needs were assessed to ensure people received the support they required. Staff used a variety of techniques to communicate and support people’s independence and ensure people had a voice. People were supported to raise concerns and complaints if required. People and relatives where appropriate, confirmed they were involved with care reviews.

The service was well-led. Staff understood their roles and responsibilities. The registered manager was clear about their vision and values for the service and what they wanted to achieve. There were effective systems to monitor the quality of the service, identified issues were actioned. Regular surveys and quality checks were completed to ensure people’s views were sought.

During our inspection on 20 August 2013, we found that necessary improvements had been made. Records we looked at showed that people had been involved in the planning and delivery of their care.

One person told us, 'Care plans are a good idea and I enjoy getting involved.' Another said, 'I love living here, it's great.' We saw that staff delivered appropriate levels of care and treated people with respect and kindness.

The provider had put improved systems in place to ensure that medicines were managed safely and the quality of services provided could be assessed and monitored on a regular basis.

During our inspection on 22 March 2013 we spoke with three people who used the service and five members of staff. Many of the people who used the service were either out at school or at other activities. We saw that the rooms were personalised to each person.

We found that the service could not evidence how it used people's involvement and views in the delivery of the regulated activity. We also found that people's dignity and privacy was not always respected.

We saw that care was not always assessed to protect people from harm. One person told us they liked living there. When asked if they were happy they said, "Yes."

We found that medication was not managed in a way that minimised risks and was not in accordance with the services policy. We saw that staff were supported and had regular training. This included the opportunity for further development. We saw plans for a 'healthy eating' training month.

We found that the service did not have effective systems in place to monitor the effectiveness of the service provided to people.