We carried out a review of the data available to us about Lansdowne Care Home on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Lansdowne Care Home, you can give feedback on this service.
Lansdowne Care Home is a service for older people who need nursing care. Lansdowne Care Home provides accommodation to a maximum of ninety-two people some of whom may have dementia. The home is split into 3 units. On the day we inspected there were 91 people living in the home.
People’s experience of using this service and what we found
The service demonstrated a compassionate awareness and understanding to end of life care. They had made improvements to end of life support for people since our last inspection.
People had access to healthcare services and were involved in decisions about their care. Partnerships with other agencies and health professionals enabled effective outcomes for people.
People's care was planned and risks to their safety and wellbeing were assessed. The service reviewed these plans regularly, involving people in these reviews and asking for their opinions.
Staff had completed safeguarding training and understood their role in identifying and reporting any concerns of potential abuse or poor practice. Medicines were managed safely.
People told us they enjoyed the food and were referred to dieticians when required, however the recording of daily fluid charts were not always accurately recorded .The registered manager took immediate action after our inspection to address this issue.
People and staff praised the managers of the service and agreed that they were approachable, knowledgeable, fair and did their job well. The staff team worked well together and supported the registered manager.
The staff team was committed to providing a high-quality service. They had undertaken training so that they were skilled and knowledgeable to effectively meet people’s needs. Staff understood their responsibilities to report any concerns.
Staff encouraged people to be as independent as possible and respected people’s privacy and dignity.
Staff consistently strived to ensure that people had the best possible care, and that they were supported in a compassionate, dignified and safe way
People were given choices about the way in which they were cared for. Staff listened to them and knew their needs well.
Care plans contained information about each person’s individual support needs and preferences in relation to their care and we found evidence of good outcomes for people.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
Recruitment practices were safe and relevant checks had been completed before staff worked at the service.
The managers of the service actively sought the views of people and their relatives about the running of the service and they dealt promptly with any concerns that people raised.
The provider had systems in place to monitor and improve the quality and safety of the service provided. There was a positive culture throughout the service. Staff told us they enjoyed working at the service and felt valued.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
At the last inspection we rated this service Good. The report was published on 31 October 2019.
Why we inspected
This inspection was prompted by a review of the information we held about this service. This report only covers our findings in relation to the Key Questions Safe, Effective, Responsive and Well Led. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
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.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
We found the following examples of good practice.
The registered manager and support team worked co-operatively with other people in their network, to ensure the spread of COVID-19 was minimised.
Robust policies and processes were in place to ensure infection control was prioritised in communal areas, and people were supported to practice good infection control processes in their own rooms. Staff were trained in infection control management. Additional care staff had been deployed and use of agency staff was minimal and only regular agency staff were used to support the rota.
Staff had received training on how to keep people safe during the COVID-19 pandemic and people were regularly tested for COVID-19. The building was clean and free from clutter. The environment was conducive to social distancing. Communal areas were arranged to enable enough space between people. Systems were in place to isolate people if required, to minimise the risk of COVID-19 transmission.
Additional domestic staff had been employed to ensure enhanced cleaning of communal areas took place. This included swab testing of surfaces and regular auditing of infection prevention processes were carried out.
Care and support arrangements were provided to those people required to isolate within their rooms. Staff were deployed to work on one floor only and activities also took place separately for each floor.
The service had good supplies of PPE which were readily available at stations throughout the service.
The service ensured that any risks of infection from visitors entering the home were minimised. Visitors were asked a series of screening questions, had their temperature checked on arrival and were subject to rapid lateral flow testing.
We were assured that this service met good infection prevention and control guidelines and had no concerns regarding the management of COVID-19.
Lansdowne Care Home is a service for older people who need nursing care. Lansdowne Care Home provides accommodation to a maximum of 92 people some of whom may have dementia. The home is split into 3 units. On the day we inspected there were 90 people living in the home.
People’s experience of using this service and what we found
Systems and processes were in place to keep people safe and risks associated with people's care needs had been assessed. There were enough staff to meet people's needs and recruitment processes and procedures were safe. The service was clean, and there were appropriate procedures to ensure any infection control risks were minimised.
Staff received training and supervision for them to perform their role. People's nutrition and health were supported and promoted. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
Staff knew people well and care plans provided staff with guidance on how to meets people's needs. However, some of the care plans we looked where not set out well as others and some information was difficult to locate.
Staff respected people privacy and dignity and encouraged people to remain independent. People and relatives could express their views about the running of the home.
People received personalised care and support which met their needs, reflected their preferences. People benefited from a variety of activities, events and trips out that were available to reduce social isolation, give meaning and purpose and enhance their wellbeing.
The provider had a system in place to ensure people received their medicines as prescribed. We have made a recommendation about the management of medicines of people no longer living at the service.
The service was well led. People, staff and relatives spoke extremely positively about the new registered manager. There was a positive culture throughout the service which focused on providing care that was personalised. The management team used a variety of methods to assess and monitor the quality of the service. They were aware of their regulatory responsibilities associated with their role.
More information is in the full report.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
The last rating for this service was requires improvement (report published September 2018). There was a lack of meaningful activities for some people who used the service and staff had told us that they felt the registered manager was not always approachable because they were sometimes abrupt in the way they spoke to staff. At this inspection we found improvements had been made and the service has now been rated good.
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per us nspection programme. If we receive any concerning information we may inspect sooner.
We carried out an unannounced comprehensive inspection of this service on 13 April 2017 where one breach of legal requirement was found. We found that the service was not managing medicines safely. At our focused inspection on 11 July 2017, we judged that the provider had made improvements and had now met legal requirements. Whilst improvements had been made we were unable to change the rating for safe and well-led because there were still issues with medicines management and the service was rated as Requires Improvement.
The service had a registered manager in post. 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.
People were positive about the service and the staff who supported them. People told us they liked the staff and that they were treated with dignity and kindness.
Staff treated people with respect and as individuals with different needs and preferences. Relatives told us they felt welcome at any time in the home; they felt involved in care planning and were confident that their comments and concerns would be acted upon. The care records contained information about how to provide support, what the person liked, disliked and their preferences and interests.
The staff demonstrated a good knowledge of people’s care needs, significant people and events in their lives, and their daily routines and preferences. They also understood the provider’s safeguarding procedures and could explain how they would protect people if they had any concerns.
Most staff told us that they enjoyed working in the home and most staff spoke positively about the management of the service. Staff had the training and support they needed.
Risk assessments were in place for a number of areas and were regularly updated, and staff had a good knowledge and understanding of many health conditions.
There were sufficient numbers of suitably qualified, skilled and experienced staff to care for the number of people home.
Robust recruitment and selection procedures were in place and appropriate checks had been undertaken before staff began work.
People were satisfied with the food provided at the home and the support they received in relation to nutrition and hydration.
There was an open and transparent culture and encouragement for people to provide feedback. The provider took account of complaints and comments to improve the service. People told us they were aware of how to make a complaint and were confident they could express any concerns and these would be addressed.
Improvements had been made in medicines management and there was evidence of some good practice.
The service was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS). People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
The registered manager understood their responsibilities and ensured people, relatives and most staff felt able to contribute to the development of the service
The provider’s governance framework ensured quality performance, risks and regulatory requirements were understood and managed. There was good use of a number of monitoring tools in support of this. The service learnt and made improvements when things went wrong.
After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breach.
We undertook a focused inspection on 11 July to check that they had followed their plan and met legal requirements.
This report only covers our findings in relation to this topic. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Lansdowne Care Home on our website at www.cqc.org.uk.
Lansdowne Care Home is a service for older people who are in need of nursing care. Lansdowne Care Home provides accommodation to a maximum of ninety-two people some of who may have dementia.
The home has a registered manager. 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 and associated Regulations about how the service is run.
At our focused inspection on 11 July 2017. We judged that the provider had made improvements in medicine management and had now met legal requirements. However we found that improvements were still required in relation to protocols for the administration of medicines disguised in food or drink and the monitoring of fridge temperatures for medicines.
While improvements had been made we have not revised the rating for this key questions; to improve the rating to ‘Good’ would require a longer term track record of consistent good practice
We will review the ratings for the service at our next comprehensive inspection.
Lansdowne Care Home is a service for older people who are in need of nursing care. Lansdowne Care Home provides accommodation to a maximum of ninety-two people some of who may have dementia. The home has 92 beds split into 3 units. On the day we inspected there were 91 people living in the home.
The service had a registered manager who had been in post since April 2015. 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.
People were positive about the service and the staff who supported them. People told us they liked the staff and that they were treated with dignity and kindness.
Staff treated people with respect and as individuals with different needs and preferences. Staff understood that people’s diversity was important and something that needed to be upheld and valued. Relatives we spoke with said they felt welcome at any time in the home; they felt involved in care planning and were confident that their comments and concerns would be acted upon. The care records contained detailed information about how to provide support, what the person liked, disliked and their preferences. People who used the service along with families and friends had completed a life history with information about what was important to people. The staff we spoke with told us this information helped them to understand the person.
The staff demonstrated a good knowledge of people’s care needs, significant people and events in their lives, and their daily routines and preferences. They also understood the provider’s safeguarding procedures and could explain how they would protect people if they had any concerns.
Risk assessments were in place for a number of areas and were regularly updated, and staff had a good knowledge and understanding of many complex health conditions.
There were sufficient numbers of suitably qualified, skilled and experienced staff to care for the number of people with complex needs in the home.
Robust recruitment and selection procedures were in place and appropriate checks had been undertaken before staff began work.
We found errors with medicines administration, recording and reviewing for some people using the service. We have asked the provider to take urgent action to address this.
People were satisfied with the food provided at the home and the support they received in relation to nutrition and hydration.
There was an open and transparent culture and encouragement for people to provide feedback. The provider took account of complaints and comments to improve the service. People told us they were aware of how to make a complaint and were confident they could express any concerns and these would be addressed.
The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that as far as possible people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible.
People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA.The application procedures for this in care homes and hospitals are called the Deprivation of Liberty Safeguards (DoLS).We found that the service was working within the principles of the MCA, and conditions on authorisations to deprive people of their liberty were being met.
The management team provided good leadership and people using the service, relatives and staff told us they were approachable, visible and supportive. We saw that regular audits were carried out to monitor the quality of care.. However that the system of quality management of the service had not identified the shortfalls found during the inspection relating to the medicines.
There was one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have told the provider to take at the back of the full version of this report
We inspected Lansdowne care home on the 9 June 2015. This was an unannounced inspection which meant the staff and the provider did not know we would be visiting.
Before we visited the home we checked the information that we held about the service and the service provider. This included statutory notifications and safeguarding alerts. No concerns had been raised and the service met the regulations we inspected against at their last inspection which took place on 17 January 2014.
Lansdowne Care Home is a service for older people who are in need of nursing care. Lansdowne Care Home provides accommodation to a maximum of 92 people some of who may have dementia. The home has 92 beds split into three units. On the day we inspected there were 87 people living in the home.
The registered manager had been in place since April 2015. 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 and associated Regulations about how the service is run.
People who used the service were supported by staff that were kind, caring and respectful of their privacy.
The care staff we spoke with demonstrated a good knowledge of people’s care needs, significant people and events in their lives, and their daily routines and preferences. They also understood the provider’s safeguarding procedures and could explain how they would protect people if they had any concerns.
Staff spoke positively about the culture and management of the service. Staff said that they enjoyed their jobs and described management as supportive. Staff confirmed they were able to raise issues and make suggestions about the way the service was provided in one-to-ones and staff meetings and these were taken seriously and discussed.
The registered manager provided good leadership and people using the service, relatives and staff told us the manager promoted high standards of care.
There were safeguards in place to help protect the people who lived there. People were able to make choices about the way in which they were cared for and the staff listened to them and knew their needs well. The staff had the training and support they needed. Relatives of people living at the home were happy with the service. There was evidence that the staff and manager at the home had been involved in reviewing and monitoring the quality of the service to make sure it improved.
The procedures to manage risks associated with the administration of medicines were followed by staff working at the service. There were suitable arrangements for the safe storage, management and disposal of medicines.
Staffing levels were sufficient to meet people’s needs. Recruitment practices were safe and relevant checks had been completed before staff worked at the home.
CQC monitors the operation of the Mental Capacity Act (MCA) Deprivation of Liberty Safeguards (DoLS) and reports on what we find. DoLS are a code of practice to supplement the main Mental Capacity Act. These safeguards protect the rights of adults by ensuring that if
there are restrictions on their freedom and liberty these are assessed by appropriately trained professionals. The manager had knowledge of the MCA 2005 and DoLS legislation and referrals for a DoLS authorisation had been made so that people’s rights would be protected.
Activities provided entertainment and stimulation for people living in the home including those unable to leave their rooms.
There was a system in place to monitor the quality of the service and action had been taken when necessary to make any improvements.
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People and relatives confirmed that the service made sure they had access to a range of medical professionals to meet their care and treatment needs. One person told us that, "I am seeing a physiotherapist and staff here had arranged this for me." People's care records showed that where there had been admitted to hospital an appropriate plan had been put in place when they were discharged to ensure they received the care and treatment they needed. Where people's needs had changed they had been assessed and referred to the appropriate professional promptly.
The manager explained that they carried out regular audits of the care provided to people with dementia. We looked at two recent examples of care plan audits, and these showed that checks were carried out to make sure that people were receiving appropriate care and treatment. Risk assessments were in place for each individual and showed how people could be supported safely to do the things they wished. The manager explained that there were regular meetings with relatives and people with dementia so that they could give their views of their care and treatment.
People were provided with a choice of suitable nutritious food and drink. One person told us, "I can eat what I want, there's always a choice at mealtimes." People's preferred meals were recorded in their initial assessment and care plans. Staff spoken with understood the importance of providing meals that people liked to eat and in the quantity they preferred. There were enough staff available to met people's needs. People told us that there were always enough staff to meet their needs. A person said, "there's always someone there to help me when I need it.'
We observed that people who use the service appeared comfortable and appropriately dressed. Staff were seen assisting them with their meals and drinks. Their care needs had been carefully assessed and plans of care had been prepared for them. The care provided had been carefully monitored and there was evidence that the healthcare needs of people who use the service had been attended to. There were arrangements to ensure that pressure sores are attended to.
The nutritional needs of people who use the service had been assessed and there were arrangements to ensure that they are provided with nourishing food and drinks at intervals. Monitoring forms and charts had been completed. We however, noted that one person who use the service had to wait several minutes before being fed.
Arrangements were in place to ensure that people who use the service are protected from abuse. People who use the service indicated that staff were responsive and we noted that staff responded promptly when the call bell was activated. However, some staff indicated that staffing levels were affected when staff did not turn up on duty at short notice due to sickness or for other reasons.
There were arrangements to ensure that staff received regular supervision and support from the manager and deputy manager. Essential staff training had been provided. We observed that staff communicated with each other and they worked as a team.
People told us that the meals provided were good. We were told by the people that their dietary and cultural needs were met by the meals provided at the home. People confirmed that they were consulted about the meals. They told us that they had drinks and jugs of water in their rooms. People said that staff were available to support them with their meals.
People felt that the home was clean. For example, one person commented: 'I like my room; my bedroom is always clean," and 'The home always smells fresh." The visitors also told us that whenever they visited they found bedrooms clean and tidy.
People felt that they knew how to make complaints if they were not satisfied with the service they were getting. One person said: "I had complained before and the issue was dealt with".
People were confident that their medication was given to them on time. They said they knew their medicines and why they were taking them. For example, one person said: 'I know the medicines I am taking'.