The Lawns

Updated 2 June 2021

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.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by one inspector.

Service and service type

The Lawns is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a 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 had a manager registered with the Care Quality Commission. This means that they 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

We gave the service 24 hours’ notice of the inspection. This was because the service is small and people are often out and we wanted to be sure there would be people at home to speak with us.

What we did before the inspection

The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We looked at information we had about the service including a complaint which had been investigated by the service and safeguarding information. We used all of this information to plan our inspection.

During the inspection

We spoke with two people who used the service with some limited communication. We received comments from six relatives about their experience of the care provided and interactions with the service. We spoke with two members of care staff on the day of the inspection, the operations manager and registered manager. We did a tour of the premises and observed care in the communal spaces.

We reviewed a range of records. This included two people’s care records, four support plans, all epilepsy management documents and multiple medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, COVID-19 management and policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We also heard from another staff member. We looked at training data and quality assurance records. We also attended a safeguarding meeting.

Updated 2 June 2021

About the service

The Lawns is a residential care home providing personal care and accommodation for up to nine adults living with a learning disability. Services for people with learning disabilities and or autism are supported. At the time of the inspection there were eight people living at The Lawns.

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

People and their families were positive about The Lawns and staff who supported them.

People were treated with kindness and compassion. People spent time in the community within COVID-19 guidelines and at the home, doing activities they enjoyed and had chosen. People's support focused on them having as many opportunities as possible for them to gain new skills and maintain independence.

Risks to people had been assessed and care plans reflected how to support people to keep people safe whilst maximising their independence.

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. Where there were restrictions on people, staff were working within the requirements of the Mental Capacity Act (2005).

There were enough staff to support people. Staff had been recruited safely and completed an induction when they first started. Staff updated training to ensure they were able to support people, following best practice guidance and seeking health professional support for particular medical conditions. For example, epilepsy and VNS systems (a magnet used to manage seizures).

Staff worked in a relaxed manner, ensuring that people had enough time to make decisions for themselves wherever possible in a way they understood.

People were kept safe by a registered manager and staff who were committed to their care and well-being.

Safeguarding issues were reported and investigated appropriately. Lessons were learnt when things went wrong, and actions was taken to reduce the risks of a reoccurrence. Staff had received up to date safeguarding training and knew how to make appropriate referrals.

The home was well-maintained and looked after. The home was clean and we were assured that staff were following COVID-19 national guidelines. There were policies and procedures to ensure the risks of infection was minimised with particular focus on COVID-19.

Medicines were well managed and organised.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

This service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.

Right support:

• Model of care and setting maximises people’s choice, control and independence.

Right care:

• Care is person-centred and promotes people’s dignity, privacy and human rights.

Right culture:

• Ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive and empowered lives.

The service was a large home, bigger than most domestic style properties. It was registered for the support of up to nine people. At the time of this inspection eight people were using the service. This is larger than current best practice guidance. However, the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area and the other large domestic homes of a similar size.

There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.

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 Good (published 7 March 2018)

Why we inspected

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.

The inspection was prompted in part due to concerns received about the care of people with epilepsy. Concerns had also been raised about the registered manager. A decision was made to inspect and examine those risks. We have found evidence that the provider has made improvements to mitigate any risks. Please see the safe and well led sections of this report. We found no evidence during this inspection that people were at risk of harm from this concern. There was a whole home safeguarding process which is now closed and an individual safeguarding process which is ongoing. The provider has been fully co-operative with this process.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

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

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.