Larkhill Hall

Updated 21 September 2023

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 Health and Social Care Act 2008.

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

Two inspectors carried out the inspection.

Service and service type

Larkhill Hall is a 'care home'. People in care homes receive accommodation and nursing and/or personal care as a single package under 1 contractual agreement dependent on their registration with us. Larkhill Hall is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used all of this information to plan our inspection. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.

During the inspection

We spoke with five people about their experience of the care provided. We also spoke with eight members of staff including a regional manager, the registered manager, a deputy manager, care staff and support staff.

We reviewed a range of records. This included four people's care records, and seven people's medication records. We looked at staff files in relation to recruitment. A variety of records relating to the management of the service, including policies and procedures were reviewed.

Updated 21 September 2023

About the service

Larkhill Hall provides accommodation and personal care to up to 66 older people; including people with dementia. At the time of our inspection there were 63 people living in the home.

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

At the last inspection areas of improvement were needed to the management of people's prescribed medicines. At this inspection we identified further concerns with the management of medicines and governance.

Medication practices observed placed people at risk of harm through not receiving their medicines as prescribed or on time. We had concerns about medication management for some people, so we referred our concerns to the Local Authority Safeguarding Team to investigate. After the inspection, the provider submitted an audit of all medication within the service and outlined the immediate improvements they intended to take with regards to medicines.

The provider's governance systems were mostly effective at driving necessary improvements however, audits had failed to identify some of the issues we found in relation to medicines management. We have made a recommendation in relation to this.

People's care plans contained inconsistent information in relation to planned care. Some people were at risk of weight loss and required weekly weight monitoring and records did not evidence this. We identified inconsistencies with the recording of modified diets and were not assured people were in receipt of the correct modified diets in accordance with their assessed care needs.

Feedback we received from staff, people and relatives we spoke with during the inspection was positive. We were told by the relatives we spoke with that the care staff communicated with families regularly. There were enough staff on duty to support people, and staff were recruited safely. Care staff were friendly, and treated people kindly. People's relatives confirmed this and felt their loved ones were well looked after.

Infection control standards were monitored and managed appropriately. Accidents and incidents were recorded and reviewed in order to minimise the risk of reoccurrence.

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 21 December 2022).

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 the provider remained in breach of regulations.

Why we inspected

This inspection was prompted by a review of the information we held about this service. As a result, we undertook a focused inspection to review the domains of 'safe’, and' well-led’.

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 Larkhill Care Home on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to safe care and treatment, and good governance.

You can see what action we have asked the provider to take at the end of this full report.