This unannounced inspection took place on 14 October 2016. Lowfield House Limited is located in the centre of Clitheroe in Lancashire. The service is registered for up to 24 people. All bedrooms are single occupancy and 21 have ensuite facilities. Accommodation is provided over two floors for people who require personal care. 19 people lived at the home at the time of the inspection visit.
There was a registered manager in place. 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.
The service was last inspected on 14 October 2013. We identified no concerns at this inspection and found the provider was meeting all standards we assessed.
At this inspection carried out in October 2016, people who lived at the home, friends and relatives told us they were happy with the care provided from staff. They told us people were safe at the home and were supported by staff who knew them well.
Although people told us they felt safe, we identified risks to the environment were not always suitably addressed and managed. During the inspection visit we identified concerns which posed risks within the environment. We discussed these concerns with the deputy manager at feedback and immediate action was taken following the inspection visit to rectify the concerns. We have made a recommendation about this.
Infection control procedures were inconsistently managed by the service and there was no identified person responsible for infection control processes within the service. This was a breach of Regulation 12 of the Health and Social Care Act 2008, (Regulated Activities) 2014.
Staff had knowledge of safeguarding procedures and were aware of their responsibilities for reporting any concerns; however staff were not fully aware of reporting procedures to external agencies. This was a breach of Regulation 13 of the Health and Social Care Act 2008 (Regulated Activities) 2014.
We found improvements were required to ensure the service was consistently well led. Audits of the service were carried out between the owner and the registered manager. However, auditing systems in place were ineffective and had failed to identify the concerns identified as part of the inspection visit. This was a breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) 2014.
Arrangements were in place for safe management and administering medicines. However these were not consistently applied. We have made a recommendation about this.
Staff were kind and caring. We observed positive interactions throughout the inspection visit. Relatives praised staff for their caring natures.
The service ensured visitors were welcomed to the home. Relationships with families were encouraged.
We found suitable recruitment procedures were in place which meant staff were checked before starting employment.
The service had established links with health professionals to enable people to maintain good health. Care plans were developed and maintained for people who used the service. Care plans covered support needs and personal wishes. Plans were reviewed and updated at regular intervals and information was sought from appropriate professionals as and when required.
Feedback on the quality of food provided was positive. People were happy with the variety and choice of meals available to them. People’s nutritional needs were addressed and monitored.
We received mixed feedback about the range of activities on offer at the home. Staff said activities were offered but people often declined to take part. We have made a recommendation about this.
Staff told us they were provided with training which allowed them to carry out their tasks effectively. Ongoing training was provided for staff to enable them to carry out their tasks proficiently.
Staff had received training in The Mental Capacity Act 2005 and the associated Deprivation of Liberty Standards (DoLS.) We saw evidence these principles were put into practice when delivering care.
The service fostered an open and transparent culture. Concerns were dealt with in a timely manner which meant formal complaints never arose. Feedback was gained from people as a means to develop and improve the service.
Staff were positive about ways in which the service was managed and the support received from the management team. They described a positive working environment. Staff described teamwork as “Good.” Staff praised the regular communication between management and staff.
You can see what action we have asked the provider to take at the back of the full report.