13 June 2023
During an inspection looking at part of the service
About the service
Market Lavington Care Home is a residential care home providing accommodation for persons who require nursing or personal care and treatment of disease, disorder or injury for up to 87 people. The service provides support to people over and under 65 years, people with physical disabilities and people living with dementia. At the time of our inspection there were 52 people using the service.
Accommodation was provided across 2 buildings on the same site. People had their own rooms and there were communal rooms available in both buildings, such as lounges, dining rooms and bathrooms. There was outdoor space available for people to use accessed from ground floors.
People’s experience of using this service and what we found
Medicines were managed safely but improvement was needed to make sure all medicines records were transcribed accurately. We have made a recommendation about this. People who needed their medicines regularly on time did not always experience this. We saw no impact for people of medicines being late. However, times of administration required a review. The registered manager told us they would act without delay to address this shortfall.
Some people relied on staff for their food and fluid as they were not able to do this for themselves. Records for fluids did not always demonstrate staff had offered or helped people to drink enough during very warm weather. The registered manager provided assurance this was a recording issue and people were being offered regular drinks. During our inspection the provider cascaded out a new dehydration risk tool for staff to use. The provider told us this tool, where needed, would be used to assess dehydration risks and staff would be provided with training on how to use it.
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.
Risk management plans recorded measures in place for staff to follow. These were reviewed regularly and updated when needed. Health and safety checks were carried out and recorded. Staff and external contractors checked areas such as fire systems, moving and handling equipment and emergency lighting for safety.
The service was clean and smelt fresh. We observed staff using personal protective equipment safely. The provider had carried out a programme of refurbishment since our last inspection which had improved the environment. Communal areas had been redecorated and had new soft furnishings. Windows had been replaced and the outside space had been improved for people to enjoy sitting out in nice weather.
People could have visitors when they wished. People and relatives told us staff were caring and took time to understand and get to know people. People told us at times staff were busy and their call bells took time to be answered. We observed, during our inspection, there were enough staff available to meet people’s needs and call bells were answered promptly. Staff we spoke with told us there was enough staff and the registered manager was able to increase staff if needed. Call bell response times were monitored and analysed by management. Staff had been recruited safely.
People’s health needs were identified, and timely referrals made to local healthcare professionals. Feedback from healthcare professionals was positive and we were told improvements had been made to areas such as communication.
There was a registered manager in post who had notified Care Quality Commission (CQC) of events and injuries as required by law. There were systems to assess and monitor quality and safety. Staff carried out audits and any actions were added to the service improvement plan. The provider, central support staff and the registered manager took responsibility for making sure all identified actions were addressed.
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 requires improvement (published 16 March 2021) and there was 1 breach of regulation 17. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of this regulation.
Why we inspected
We carried out an unannounced focused inspection of this service on 26 January 2021. A breach of legal requirements was found. The provider completed an action plan after that inspection to show what they would do and by when to improve regulation 17 (good governance).
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.
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 requires improvement to good. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Market Lavington Care Home on our website at www.cqc.org.uk.
Recommendations
We have made 1 recommendation about handwritten recording of medicines.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.