Archived: Lowenva Care

We inspected Lowenva Care on 31 October 2018, the inspection was announced 48 hrs in advance. This was because the service is small and people are often out. We needed to be sure someone would be available to talk with us. At our last inspection on 3 June 2016 and we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The service was operating in line with the values that underpin the CQC ‘Registering the Right Support’, and other current best practice guidance. This guidance includes the promotion of the values of; choice, independence and inclusion. The service was working with people with learning disabilities that used the service, to support them to live as ordinary a life as any citizen. Staff supported people to access the community regularly. People’s independence was respected and they were encouraged to develop and maintain skills. Although the registered manager shared these values they were unaware of the guidance. Lowenva Care is a small care home and there were limited opportunities for the management team to keep abreast of changes and developments in the care sector. We have made a recommendation about this in the report.

People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice. Applications for DoLS authorisations had been made and the registered manager updated the local DoLS team when further restrictive practices were introduced. There was no evidence to show these decisions had been taken in line with the best interest process and we have made a recommendation about this in the report.

At our last inspection in June 2016 we found supervisions were not being effectively recorded and we made a recommendation. At this inspection we found staff supervisions were taking place regularly and these were recorded and kept on file. Records showed the meetings were an opportunity to identify any gaps in training and discuss working practices. Staff told us they were well supported and received regular training updates.

People were protected from identified risk. Staff were aware of the support people needed to help keep them safe and were confident at all times. When concerns were raised with the registered manager they took immediate and effective action to mitigate any risks. People and relatives told us they believed Lowenva Care provided care and support safely.

The premises were clean and well maintained. People’s bedrooms were personalised and reflected their tastes and interests.

There were quality assurance systems in place to monitor the standards of the care provided. Audits were carried out regularly by the registered manager. Staff roles and responsibilities were clearly defined and understood.

Lowenva Care is a registered care home owned by a private provider and provides accommodation and personal care for up to six adults with or without a learning disability. Lowenva Care is located in a rural area, approximately four miles from the town of St. Austell. Relatives of people who lived at the service told us, “It is a very caring, friendly service and we are happy with the quality of the service.”

The service is required to have a registered manager and there was one in post. 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.

Not everyone who used the service could tell us their views due to their health needs. We spoke with three people who lived at Lowenva Care and observed support provided. People told us they felt safe at the service and with the staff who supported them. People told us, “I love it here” and “Staff are lovely. Very kind.” A relative told us, “Staff are very caring” and “I feel fortunate that [my relative] lives at Lowenva. It is a genuinely homely and caring place.”

People told us they received their medicines on time. The completion of medicine administration records was thorough and accurate. Medicines were stored appropriately and staff were trained to safely administer medicines.

There were adequate numbers of staff available to support people. Relatives of people who lived at the service told us, “There are enough staff around when I visit. There aren’t many changes in the staff group, I think that is a good thing.”

Staff had been suitably trained to recognise potential signs of abuse. Staff told us they would be confident to report concerns to management, and thought management would deal with any issues appropriately.

Staff told us the training they had received was delivered to a good standard and management were supportive of their work. Formalised supervision and appraisal systems were not in place. We have made a recommendation regarding this.

Recruitment processes were satisfactory as pre-employment checks had been completed to help ensure people’s safety. This included written references and an enhanced Disclosure and Barring Service check, which helped find out if a person was suitable to work with vulnerable adults.

People had access to medical professionals such as a general practitioner, dentist and optician when required. People said they received enough support from these professionals and this was evidenced by detailed records kept by the service.

The service had a personalised social and activity programme for each person. This reflected things each person liked to do. For example, one person enjoyed going out for day trips and a relative confirmed these activities were scheduled and completed each week.

Care files contained information such as a care plan and these were regularly reviewed. The service had appropriate systems in place to assess people’s capacity in line with legislation and guidance, such as the Mental Capacity Act (2005).

People told us they were happy with their meals and had a good choice of nutritious well balanced meals. One person took an active role in helping with cooking for themselves and others each week. People said they had enough to eat and drink and a good variety of choice. Comments received about the meals included, “The food is very good,” and “There is lots of choice of meals and people choose what they like.”

People and relatives told us if they had any concerns or complaints they would feel confident discussing these with staff members or management. Records showed that when a complaint was raised it was handled quickly and appropriately by management.

Relatives and external professionals familiar with the service said they felt the service was well managed. A relative described the manager as, “Very approachable.” Staff told us the manager was, “Supportive and wants the best for everyone living at Lowenva”. There were satisfactory system in place to monitor the quality of the service.