Lakeside Watermead Care Home

Updated 11 October 2019

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 Care Act 2014.

Inspection team

The inspection team comprised of two inspectors, one pharmacy inspector, one specialist nurse advisor 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.

Service and service type

Lakeside Care Centre 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 service did not have a manager registered with the Care Quality Commission. The manager was going through the process of registration. The registered manager and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

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. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all this information to plan our inspection.

During the inspection-

We spoke with 13 people who used the service and nine relatives about their experience of the care provided. We spoke with 16 members of staff including the nominated individual, the manager, nurses, team leaders, care assistants, housekeeping staff, activities staff member, maintenance staff, and an agency chef. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We reviewed a range of records. This included 11 people’s care records and 10 people’s medicines records. We looked at four staff files in relation to recruitment and staff supervision records for 49 staff. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at a wide range of information including training data and quality assurance records amongst others.

Updated 11 October 2019

About the service

Lakeside Care Centre is a nursing home registered to provide nursing care for up to 53 older people. At the time of the inspection 27 people were residing in the service. Lakeside Care Centre accommodates people in one adapted building over three floors.

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

During this inspection we found a continued breach of Regulation 12 of the Health and Social Care Act 2008. Although some improvements had been made we still had concerns. This was because the management of risks was not always documented clearly, and medicines were not always safely managed.

At the previous inspection records were not suitably maintained, up to date and accessible. At this inspection we found improvements had been made. However, this was work in progress and there were several areas where improvements were required to be made to records, in order to become compliant. The manager was aware of this shortfall and was working with the staff team to make further improvements. This was a continued breach of regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014

Improvements had been made to the training of staff and how staff responded to concerns of abuse. This meant the service was no longer in breach of Regulation 13 and 18 of the Health and Social Care Act 2008.

During our previous inspection we found a breach of Regulation 11 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, because the service was not following the Mental Capacity Act 2005 (MCA) code of practice. During this inspection we found this had improved. 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.

At the previous inspection in February 2019 we found a breach of Regulation 9 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because person centred care was not promoted, and information was not accessible to people. During this inspection we found improvements had been made and the service was now compliant with the regulation.

During the previous inspection the registered provider had failed to comply with duty of candour Regulation 20 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We also found a breach of Regulation 18 of the Care Quality Commission (Registration) Regulations 2009. During this inspection we found both areas had improved, and they were now compliant.

At the previous inspection in February 2019 we found the care provided to people was not personalised and people’s needs were not always met. During this inspection we found improvements had been made. We made a recommendation about care plans and risk assessments being individualised to people’s needs.

At our previous inspection we found the environment was not always safe, due to corridors being blocked by equipment and fire doors being propped open. During this inspection improvements had been made.

Peoples’ privacy and dignity was respected by staff. People and their relatives spoke positively about the staff and the care they received. Comments included “Couldn’t ask for anything better. The [staff] are absolutely wonderful. Attitude of staff is brilliant.” Where possible people were involved in the review of their care. People had access to other health professionals such as the GP, speech and language therapist, community mental health and palliative care teams. People were supported to participate in activities and maintain interests and hobbies. This went some way towards protecting them from social isolation.

Other improvements implemented by the manager included audits in areas such as care plans, meal audits and medicines audits amongst others. Where improvements were required these were actioned. Staff spoke positively about the manager and the support they were receiving and the changes they had made to the service. Comments included “The manager is present for all of the meetings. They talk through and explain everything”, “Team meetings are more constructive, frequent and issues are addressed”. Staff told us the manager was open to ideas.

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 Inadequate (published 21 March 2019).

This service has been in Special Measures since 20 March 2019. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

At this inspection enough, improvement had not been made and the provider was still in breach of regulations.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Lakeside Care Centre on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to Regulation 12 and Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 at this inspection.

We have issued requirement notices.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.