The inspection took place on 1 and 2 November 2016 and was unannounced.Lydia Eva Court provides residential care for up to 89 older people, some of whom may be living with dementia. At the time of our inspection there were 88 people living within the home. The accommodation is over two floors with three separate, smaller units on each floor. There are a number of communal areas throughout the home and all bedrooms have en suite facilities. The home has a number of enclosed outdoor spaces.
There was 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.
At this inspection, we found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This breach related to the governance of the service.
You can see what action we told the provider to take at the back of the full version of the report.
The risks to people who used the service had not consistently been identified, assessed, reviewed or managed appropriately. People who required specialist diets were also at risk of not having their nutritional needs met. This put people at risk of potential harm.
Although staff knew the needs and preferences of those they supported and delivered this in an individual manner, care plans were not always accurate, complete or person centred. Discrepancies within the care plans put people at potential risk of not receiving the appropriate care and support they needed to maintain their health and wellbeing. Documentation associated with each person’s care was located in various places throughout the building and this made it difficult for staff to have a full picture of a person’s health, wellbeing and care and support needs.
Fully effective systems were not in place to monitor the quality of the service and drive improvement. Although some audits had been carried out on a regular basis and were effective, others had failed to identify and rectify the issues highlighted within this report.
Procedures were in place to mitigate the risk of employing unsuitable staff and these were adhered to. These included the completion of references from previous employers and a criminal police check. The records we viewed confirmed these were in place prior to staff starting in post.
Staff received an induction, ongoing training and support in their roles.
People spoke of the caring and kind nature of the staff. They also told us there were enough of them to meet their needs. People’s dignity was maintained and their independence encouraged. Staff respected people’s privacy and understood the importance of confidentiality and supporting people with making choices.
The service had processes in place to help protect people from the risk of abuse. Staff had received training in safeguarding vulnerable people. They were able to explain to us how they helped to protect, prevent, identify and report any concerns they many have. The service had made appropriate referrals to the local authority safeguarding team and records showed that the service had followed their recommendations as required.
The risks associated with the premises and working practices had been identified and managed. These had been regularly reviewed and a comprehensive schedule of regular maintenance checks was in place and completed as required. The potential negative impacts associated with adverse events such as loss of utilities or a fire had also been identified and plans put in place in the event of such incidents.
People received their medicines as the prescriber intended and the service followed good practice in regards to the administration and management of medicines. Robust auditing of the medicines management system was in place and completed on a regular basis.
The people living within the home benefited from an environment that stimulated their senses and supported them with orientation. A café area was available to relatives and visitors and people were made to feel welcome.
The CQC is required to monitor the Mental Capacity Act (MCA) 2005 Deprivation of Liberty Safeguards (DoLS) and report on what we find. The service had made appropriate referrals for consideration to legally deprive some people of their liberty and care and support was being delivered in ways that did not overly restrict people.
People received enough to eat and drink and were given choice in this. Those people that required assistance, received it at a time they needed it. The service was flexible in its approach to providing food and drink and this was available to people when they wished for it. Most people received healthcare intervention as and when required or when they requested it.
The management team was visible and approachable. People told us they saw them regularly and had confidence in them. The registered manager felt supported and encouraged by the provider.
People’s feedback on the service had been sought on a regular basis and in a variety of ways. This was used to develop and improve the service. Staff told us they were encouraged to make suggestions and felt listened to. People felt comfortable in raising any concerns they may have and complaints had been fully investigated and appropriately responded to.
People told us that they would recommend the service.