This inspection was carried out on 28 March 2017. The inspection was unannounced.Loose Court is registered to provide accommodation and personal care for up to 42 older people. Some people were living with dementia, some had mobility difficulties, and sensory impairments. Accommodation is provided on two floors with a lift between floors for easy access. The home has a garden area which provides a safe outdoor space. The premises are situated on the outskirts of Maidstone. At the time of our inspection there were 38 people living at the service.
The service had a registered manager. 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 our previous inspection on 26 April 2016, we found breaches of Regulation 11, 12, 17 and 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We found that people had not received their medicines as required or as prescribed. The provider had failed to operate an effective quality assurance system and failed to maintain accurate records. Steps taken in the home did not follow the principles of the Mental Capacity Act (MCA) 2005. Staff had not received appropriate support, training, professional development, supervision and appraisal as is necessary to enable them to carry out the duties they are employed to perform. We asked the provider to take action to meet the regulations.
We received an action plan on 27 June 2016 which stated that the provider would be meeting the regulations by mid July 2016.
People and their relatives told us that they received safe, effective, caring and responsive care and the service was well led.
Medicines were not well managed. Medicines had not been stored appropriately. Medicines records did not always detail why people had ‘as and when required’ (PRN) medicines.
Staff had a good understanding of what their roles and responsibilities were in preventing abuse. The safeguarding policy gave staff all of the information they needed to report safeguarding concerns to external agencies.
The provider followed safe recruitment practice. Essential documentation was in place for all staff employed. Gaps in employment history had been explored to check staff suitability for their role. There were suitable numbers of staff deployed on shift to meet people’s assessed needs.
The premises were well maintained, clean and tidy. The home smelled fresh.
Staff had undertaken training relevant to their roles. Staff were supported to gain qualifications and were supported in their roles. They had received regular supervision meetings and those that had worked longer than one year had received an appraisal to discuss their performance, training and support.
Meals and mealtimes promoted people’s wellbeing, meal times were relaxed and people were given choices.
Staff had a good understanding of the Mental Capacity Act 2005 and supported people to make choices. Deprivation of Liberty Safeguards (DoLS) applications had been made to the local authority by the registered manager.
People received medical assistance from healthcare professionals when they needed it. Staff knew people well and recognised when people were not acting in their usual manner. Feedback from healthcare professionals was positive.
People were supported to maintain their relationships with people who mattered to them. Relatives and visitors were welcomed at the service at any reasonable time and were complimentary about the care their family member’s received.
Staff were cheerful, kind and patient in their approach and had a good rapport with people. The atmosphere in the home was calm and relaxed. Staff treated people with dignity and respect.
People’s care was person centred. Care plans detailed people’s important information such as their life history and personal history and what people can do for themselves.
People were encouraged to take part in activities that they enjoyed. People were supported to be as independent as possible.
People’s views and experiences were sought through surveys and meetings. People were listened to. People and their relatives knew how to raise concerns and complaints.
There were quality assurance systems in place. The registered manager and provider carried out regular checks on the home. Action plans were put in place and completed quickly. Staff told us they felt supported by the registered manager.
The registered manager demonstrated that they had a good understanding of their role and responsibilities in relation to notifying CQC about important events such as injuries, safeguarding concerns and deaths.
We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.