Laxton Hall

Laxton Hall is a residential care home for up to 30 older people and people living with dementia. At the time of inspection there were 27 people living at the home.

Laxton Hall is a care home for older Polish people. The home is a 17th Century Grade II-listed building, situated between Laxton and Corby in Northamptonshire. It has been converted into a residential care home whilst keeping the integrity of the original architecture intact. It is set in 97 acres of land and gardens. It is staffed by the Polish Sisters of Mary Immaculate and Polish care staff. This Polish community provides for the religious, cultural and the physical needs of people using the service.

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

People were supported to live in a Polish community where their culture, religion and traditions were practiced daily.

The registered manager had systems to assess, monitor and improve the safety and the quality of the service.

The provider reviewed information from safeguarding incidents, complaints and accidents to learn and prevent reoccurrences.

People received food and drink that met their physical and cultural needs and preferences. People received their prescribed medicines.

People’s risks were assessed, and staff had the information they required in English and Polish to mitigate these known risks. People’s risk assessments and care plans were reviewed regularly or as their needs changed.

The registered manager followed safe recruitment practices to ensure staff were of good character. Staff received induction, training and supervision to carry out their roles and meet people’s specific needs. Staff training was adapted to meet staff training needs.

People were protected from harm and abuse as staff received training in safeguarding. The registered manager reported and investigated concerns.

Staff identified when people were unwell and referred them to healthcare professionals promptly. People were supported by staff who spoke English and Polish to access healthcare appointments when they needed them.

People were cared for by staff that knew them well, who knew their needs and preferences. People’s privacy and dignity was respected, and people were supported to be independent. People and their relatives were involved in their care planning and reviews.

People and relatives knew how to make a formal complaint. The provider’s complaints policy had been followed and complaints had been resolved.

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.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last inspection was rated good, published 19 April 2022.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Laxton Hall is a care home for older Polish people. The home is a 17th Century Grade II-listed building, situated between Laxton and Corby in Northamptonshire. It has been converted into a residential care home whilst keeping the integrity of the original architecture intact. It is set in 97 acres of land and gardens. It is staffed by the Polish Sisters of Mary Immaculate and Polish care staff. This Polish community provides for the religious, cultural and the physical needs of people using the service.

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

People and family members spoke highly of the staff who supported them. They spoke of staff understanding their individual needs and wishes and of being happy at the home. There was a strong sense of community. One person said, “I would recommend this home to other Polish people because they [staff] follow the Polish culture.”

We observed staff and people at the home enjoying each other’s company, we heard much conversation and laughter. A family member said, “Laxton Hall is a fantastic home. The staff seem to love the people here, it’s seamless care and support, the staff do great activities to stimulate people, picnics, spiritual talks. They really embrace the polish culture.”

Systems and processes were in place to support people’s safety. People’s needs, including their safety in relation to care were assessed and monitored. Timely referrals were made to health care professionals where required to promote people’s safety and well-being.

Protocols and procedures were in place to ensure medicines were safely managed and administered by staff that had received training and had their competency to administer medicines assessed.

People were supported by staff that had full recruitment checks. The staff were committed to providing timely care that was person-centred. People and their family members spoke of the staff’s kind and caring approach. At the time of the inspection the provider was actively seeking to recruit more Polish speaking staff to increase the staffing levels.

Staff worked consistently within the providers policy and procedure for infection prevention and control and followed current government guidance related to COVID-19.

People’s views, and that of family members were sought, which included involvement in decisions relating to people’s care.

People, family members and staff spoke of the registered manager having an open-door policy. Staff were enthusiastic about their role, and of their commitment to continually improve people’s care. Quality monitoring was undertaken on all aspects of the service and kept under review by the registered manager to drive improvement.

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

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 20 December 2019) and there was breaches of regulation. At this inspection we found enough improvement had been made and the provider was no longer in breach of the regulations.

Why we inspected

We carried out an unannounced comprehensive inspection of this service in September 2019 and breaches of legal requirements were found under Regulation 12 Safe Care and Treatment and Regulation 17 Good Governance of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

The registered manager completed an action plan after the last inspection to show what they would do and by when to improve. We undertook this focused inspection to check they had followed their action plan and to confirm they now met the legal requirements. This report only covers our findings in relation to the key questions, safe and well-led which contain those requirements.

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.

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.

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

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

We found the following examples of good practice.

¿ Safe arrangements were in place for professional visitors to the service. This included temperature checks, risk questionnaire, hand sanitisation and wearing a mask. Visitor plans were being developed to support visits by relatives when it became safe to do so. An indoor visiting room was being prepared which included a perspex screen to reduce the risk of cross infection.

¿ Isolation, cohorting and zoning was used to manage the spread of infection. This meant people self-isolated in their rooms when necessary and staff were allocated to work in certain areas of the service. For example, staff used different sets of staircases depending on which area of the service they were supporting.

¿ Enhanced cleaning and disinfection of all areas of the service continued to take place to reduce the risk of cross contamination.

¿ There was plenty of personal protective equipment (PPE) including masks, gloves, aprons and hand sanitiser available. PPE stations were located around the corridors and nearby all of the rooms where people were isolating.

¿ A regular programme of testing for COVID-19 was in place for staff and people who lived in the service. This meant swift action could be taken if anyone received a positive test result.

¿ Staff did not work in any other care setting which reduced the risk of infection spread between services.

¿ The registered manager had good oversight of infection prevention and control and planned to strengthen the quality assurance documentation to reflect this. They also planned to make improvements to some other COVID-19 documentation. This included best interest decisions for people who did not have capacity to consent to a regular programme of testing and individual assessments of anyone at higher risk should they contract an infectious illness.

Further information is in the detailed findings below.

Laxton Hall is a residential care home for up to 29 older people and people living with dementia. At the time of inspection there were 28 people living at the home.

Laxton Hall is a care home for older Polish people. It is staffed by the Polish Sisters of Mary Immaculate and Polish care staff. This Polish community provides for the religious and cultural as well as the physical needs of people.

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

There was a registered manager who had been the manager of the service since it registered with CQC in January 2011.

The provider did not always take prompt action to make changes where audits identified people could be at risk from environmental issues. People were at risk of accessing areas that contained hot surfaces or cleaning materials. The provider had not ensured there were window restrictors on bedroom windows on the first floor. Following our inspection, the provider took immediate action to ensure people were safe. Further improvement was required to improve the management oversight of the environment to ensure people did not have access to areas that contained items that could cause them harm.

Although people received their prescribed medicines as planned, further improvement was required to ensure staff had clear instructions for ‘as required’ medicines.

People were very happy living with other Polish people who had experienced similar lives. Polish staff supported people to reflect on their lives using story-telling, song and crafts, creating a safe culture. There was a strong sense of community.

Staff understood their roles and responsibilities to safeguard people from the risk of harm. People were supported to access relevant health and social care professionals.

There were enough staff deployed to meet people’s needs. People’s risks were assessed at regular intervals or as their needs changed. Care plans informed staff how to provide care that mitigated these known risks.

People received care from staff they knew. Staff had a good understanding of people's needs, choices and preferences. People were encouraged to make decisions about how their care was provided and their privacy and dignity were protected and promoted. Staff gained people's consent before providing personal care.

People were involved in the planning of their care which was person centred and updated regularly. People were supported to express themselves, their views were acknowledged and acted upon. There was a complaints system in place and people were confident that any complaints would be responded to appropriately.

Staff were recruited using safe recruitment practices. Staff received training to enable them to meet people’s needs and were supported to carry out their roles.

The management team continually monitored the quality of the service, identifying issues and making changes to improve the care.

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.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Outstanding (published 4 April 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified two breaches in relation to health and safety of the environment and management oversight of these at this inspection.

Please see the action we have told the provider to take at the end of this report.

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.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 strong cultural and compassionate ethos of the service provided at Laxton Hall was evident in all areas. Everyone living there received person centred and culturally specific care, which promoted all aspects of being Polish and created a positive healing environment.

The provider had created a community where people who had shared experiences in their early life (during World War II) could be together, talk to each other where little explanation was needed for an immediate understanding and deep cultural bond. People consistently told us this was very important to them.

The registered manager was a trusted and respected leader who involved people in creating their community by having their say in how the home was run.

The provider staffed the home with Polish Sisters of Mary Immaculate an order that was recognised for their humanity, compassion. The Sisters were sent from the Mother House in Poland, they were experienced in care for the elderly, particularly those who have been affected by events of World War II. The sisters provided supervision and guidance to all staff, who also had a deep understanding of Polish culture, traditions and language.

People experienced warm caring relationships with staff where conversation and sharing traditional Polish pastimes including story-telling and singing incorporated people’s need to feel at home and promoted close bonds. Staff helped people to explore their life paths, successes and difficulties through reminiscence and conversation during activities. People described how living at Laxton Hall had brought them comfort and a sense of home. People could choose to actively practice their religious faith in the on-site chapel, accessible to all, and the priest was also an integral part of their community.

People received care and support from staff that had a deep understanding of their physical and psychological needs. Staff took time to get to know people and build relationships. People’s healthcare needs were met by staff who were competent at closely monitoring people’s clinical observations which enabled them to identify any deterioration in health quickly and respond. Staff referred people to health professionals for assessment of their mental and physical health where necessary. People were assisted to attend health and dental appointments and request that staff provided translation for them in medical appointments if they chose.

People chose whether they stayed at Laxton Hall when their health deteriorated. Experienced staff facilitated people’s wishes and provided end of life care that met their individual needs with kindness, compassion and understanding.

People’s visitors were always made to feel welcome; staff helped to maintain family relationships that were important to people. There was a room where relatives who had travelled a long way to see their relatives could stay overnight.

People felt safe at Laxton Hall; all staff understood their responsibilities to safeguard people and knew how to raise any concerns with the right person if they suspected or witnessed ill treatment or poor practice.

People’s needs were regularly reviewed so that risks were identified and acted upon as their needs changed and people’s care plans provided instruction to staff on how to mitigate people’s risks to ensure people’s continued safety. Staff understood the importance of maintaining people’s mobility and encouraged people to walk and keep active. People’s care was planned and delivered in line with their individual preferences, choices and needs.

People were cared for by staff that had received an induction that built their understanding of the key values and culture of the service. Staff received on-going training that enhanced their knowledge and behaviours to provide compassionate, safe and high quality care that supported people’s needs.

People’s meals were tailored to their cultural and religious beliefs which played a vital part in creating the feeling that they were at home. Traditional Polish food was made by the Sisters with fresh ingredients every day; they observed all the festivals that involved food including a Christmas Eve 12 course dinner. People received food they liked and staff catered for people’s special diets.

People and their representatives were involved in decisions about the way that care was delivered and staff understood the importance of obtaining people’s consent when supporting them with their daily living needs. The registered manager and care staff were aware of, and understood their responsibilities under the Mental Capacity Act 2005 (MCA 2005) and in relation to Deprivation of Liberty Safeguards (DoLS) and applied that knowledge appropriately.

People knew how to raise a complaint and there were procedures in place to manage these in a timely way. Records relating to all aspects of care and management were fit for purpose and provided clear instruction to care staff; these were maintained in Polish and English.

Staff demonstrated a good understanding of policies which underpinned their job role such as safeguarding people, health and safety and confidentiality.

Regular quality monitoring of all aspects of the service informed the provider of any improvements that were required and prompt action was taken where these were found.

We take an expert by experience to inspections so they can talk to the people using the service to help us gain a good understanding of the experience people have in living there.

The expert by experience spoke with six people. They said that staff were friendly and were meeting their care needs. They said there was good access to medical services, staff encouraged independence and choice, there were lots of activities and Polish language and culture was respected. One person said: 'the carers are all very nice and they look after for us very well. They speak and treat us with respect'.

The expert by experience also spoke with four relatives of people living in the home. They told her that the care that staff provided was very good. One relative said: ' I think it's lovely here' The dedication of the staff is excellent'. We also spoke with a relative. She also confirmed that the care was excellent.

We also carried out an observation for one and a half hours. Staff were seen to be generally friendly and caring.

This was a positive inspection. People said that they were satisfied with the care they received. Relatives we spoke with said that care was very good. The essential standards we inspected were found to have been met.