Background to this inspection
Updated
20 June 2023
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 Health and Social Care Act 2008.
As part of this inspection, we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
Inspection team
The inspection was carried out over two the days. On the first day of this inspection 2 inspectors carried out the inspection and on the second day of the inspection 1 inspector and 1 pharmacist inspector carried out the inspection.
Service and service type
Lee Valley Support Services is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Lee Valley Support Services is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
Registered Manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was a registered manager in post.
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. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.
During the inspection
We spoke with 3 people who used the service to provide us with their experiences of receiving care at the service. We spoke with 5 staff including the registered manager.
We viewed 3 care plans and risk assessments, 4 staff recruitment and training records and 4 records in the relation to the management and administration of medicines and various records and documents in relation to the management of the service.
Updated
20 June 2023
Lee Valley Support Services (LVSS) is a residential care home for older people with mental health needs. The regulated activity is accommodation for people who require nursing or personal care. Lee Valley Support Services is registered to provide support to 7 people. At the time of our inspection there were 6 people using the service.
People’s experience of using this service and what we found
Risks in relation to people receiving treatment and care were not managed appropriately. Medicines were not always managed safely, as guidance for the administration of specific medicines were not available. Quality assurance systems were in place, but these were not effective as they did not identify some of the shortfalls identified during our inspection. The registered manager acted upon feedback from the inspection and were in the process of addressing the issues identified.
People told us they felt safe at the service, and they could find a member of staff to help them. Staff rotas showed shifts were covered. People told us they were kept informed about their medicines and why they needed to take them.
Staff demonstrated they were aware of their safeguarding responsibilities and how to report concerns. Lessons learnt took place at the service after an incident and staff confirmed they took part in meetings to learn from incidents.
Staff were supported in their role and mostly received appropriate training.
People were able to enjoy food they liked and were supported to have enough to drink.
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. Consent to care and treatment was requested and staff did not force people to do something they did not want to.
The service worked well with external health professionals to ensure people received support when they became unwell.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was good (published 26 June 2019).
Why we inspected
We received concerns in relation to poor management of medicines, poor maintenance of the environment and poor record keeping. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.
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. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.
You can see what action we have asked the provider to take at the end of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Lee Valley Support Services on our website at www.cqc.org.uk.
Enforcement and Recommendations
We have identified breaches in relation to the management of risk, safe management of medicines and governance within the service.
We recommended that the service sought further guidance form a reputable source around the assessment of needs for people who used the service and training for staff to have the skill and knowledge to support people with specific health care needs.
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.