Lutterworth Country House Care Home

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• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

We looked at 5 quality statements under this domain: Safe systems, pathways and transitions; Safeguarding; Safe and effective staffing; Infection prevention and control; and Medicines optimisation. We found that people were supported to move safely into the service, having been assessed prior to admission. This helped to ensure any risks were identified in advance so staff could provide safe care and support from the outset. People felt safe because of the presence of staff who they trusted. Staff were trained in safeguarding and managers worked with other agencies and specialists to address any safeguarding issues. Staff followed people’s care plans and risk assessments and completed monitoring chart to document the provision of safe care and support. There were enough staff on duty to meet people’s needs and people made many positive comments about the staff team. Staff were safely recruited and received an induction and ongoing training to ensure their skills were appropriate and up to date. On our first visit there was an issue with flies in the premises which staff said was due to the service’s rural location (surrounded by farms and animals). We asked the provider to address this. On our second visit the provider had purchased and installed multiple fly zappers and flies were no longer a problem at the service.

This service scored 72 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Learning culture during this assessment. The score for this quality statement is based on the previous rating for Safe.

People told us their move into the service was well-managed and safe. A person said, “The staff made it very easy.” Another person told us, ‘It seemed quite smooth when I came in. I can’t remember any problems. A visitor said, “Coming in, it seemed good, quite seamless.”

Managers said they aimed to meet people to assess them before they were admitted to the service. However, if this were not possible due to the person being admitted in an emergency, they gathered as much information as they could by phone or electronically. This was to ensure the service could meet people’s needs. Managers worked closely with partners in health and social care to provide continuity of care. Staff told us they made people welcome when they were admitted to the service and ensured they had everything they needed. A staff member said, “Sometime, in an emergency, people are admitted from hospital with nothing to their name. We keep a stock of clothing and personal items which we give them until proper arrangements are made.” This helped to ease people’s transition into the service.

We did not collect any evidence to score this evidence category as partners had no specific feedback on this area. However, we did meet with and view the records of a person recently admitted to the service, and our observations raised no concerns about how the service managed admission systems, pathways and transitions.

Managers and staff followed the provider’s admissions policy when admitting a person into the service. This acknowledged that moving into a care home can be stressful for people and families and advised staff how to make the procedure as smooth as possible. Records showed admissions were well-managed with each stage of the admission process documented. This included a full assessment of a person’s needs. Emphasis was placed on identifying risk to help ensure the person was safe as they entered and settled into the service. Staff completed an admissions checklist to confirm that all stages of the process were completed.

All the people and a visitor we spoke with said people were safe using the service. People said they felt safe because there were always staff and other people close by. A person told us, “Oh yes, [I feel] very safe. You’ve got friends all around you all the time.” Another person said, “There’s always [staff] to turn to [if you need them].”

Managers and staff knew how to keep people safe and how to report safeguarding concerns both inside the service, and to other agencies. They gave us examples of how they managed safeguarding situations arising from behaviours of concern, for example using positive behaviour support, involving specialists, and increasing observations. They told us about the safeguarding investigations they had carried out and showed us the results of these. Records showed investigation were thorough and that managers and staff took safeguarding seriously and were committed to taking action to keep people safe from abuse and neglect.

People got on well with staff and were happy to approach them for support. Staff were attentive and quick to intervene if people needed anything. They monitored people where necessary, in line with their care plans and risk assessments, to ensure they and others were safe.

There were effective systems, processes, and practices to make sure people were protected from abuse and neglect. These ensured that people’s human rights were upheld, and they were protected from discrimination. Managers worked with partners, including the local authority, in a collaborative way. Staff were trained in safeguarding and understood their responsibilities to protect people’s well-being.

People told us staff supported them to live safely at the service. They gave us example of staff assisting them with daily activities, for example, mobilising, eating and drinking, and personal care. A person told us, “They move me quite safely, I’m never hurt.” Another person said, “I’m not very safe on my own so the staff help me with things like getting up and going to bed.”

Managers and staff knew people well and understood where they might be at risk. They gave us examples of this and told us what they did to prevent people coming to harm. The registered manager had improved risk management strategies at the service by introducing more effective monitoring charts. For example, re-positioning and food and fluids charts had been reviewed and updated to ensure they were fit for purpose and staff were completing them in line with people’s care plans and risk assessments.

Staff supported people in communal areas and regularly checked on those who preferred to stay in their rooms. They used suitable equipment to assist people in transferring and moving about the premises. At mealtimes staff followed instructions in people’s care plans and risk assessments to ensure they could eat and drink safely. If people needed 1-2-1 support at mealtimes this was provided. Staff were vigilant and quick to respond if a person needed support.

The provider ensured risks to people were assessed, and people and staff understood them. People had risk assessments for all aspects of their physical and mental health. These identified where a person might be at risk and what they and staff could do to minimise this. People’s risk assessments included guidance for staff to follow to keep people safe. They were regularly reviewed and updated to meet people’s changing needs.

We did not look at Safe environments during this assessment. The score for this quality statement is based on the previous rating for Safe.

Most people and a visitor said the service was well-staffed. A person told us, “I think staff numbers are fine.” Another person said, “I have a call bell here [in my room], if I use it, they [staff] are there.” A visitor said, “The staff are great. There always seems to be staff around and there’s always carers in the lounge with [person].” People made many positive comments about the staff. One person told us, “The staff know their duties and look after me quite well. If they don’t know they ask someone who does. They are excellent, they do the best they can.” Other comments included, ‘they are good, like family’ and ‘they are all competent’.

Staff said the registered manager had improved the way staff were deployed at the service. Staff had previously alternated between the ground and first floors. They said this been confusing for people. The registered manager agreed and changed the rota so staff worked on one floor only. This meant people had continuity of care and could get to know the staff who were supporting them. The registered manager had increased staffing numbers at night to ensure people had their needs met promptly and a senior was available to administer medicines. Staff said they had the training and supervision they needed to provide safe and effective care and support.

There were enough staff on duty to support people safely. Staff were available in the lounges and dining areas while other staff checked on people in their rooms. Staff treated people with kindness and patience, and no-one was rushed. During quiet times staff sat and socialised with people and took an interest in them. Relationships between staff and people were good and staff were always respectful to the people they supported.

Staff were safely recruited and had the necessary safety checks to ensure they were fit to work with people who use care services. These included criminal records checks. Staff received an induction when they first started working at the service and further training relevant to their roles. Training was up-to-date and relevant, for example staff had recently completed courses in Positive Behaviour Support (PBS) to enhance their skills when working with people with behaviours of concern. registered manager used a dependency tool to calculate staff numbers based on the needs of people using the service. There were systems in place to monitor staffing levels and adjust them as necessary.

On our first visit, two people and two visitors raised concerns about the number of flies on the premises. A person showed us flies coming in and out of their bedroom window and landing on them. On our second visit this issue had been resolved. The person who had shown us the flies said the new fly zapper in their room was ‘brilliant’ and flies were no longer a problem at the service. People told us the cleaning staff at the service worked hard. A person said, “There’s a cleaner every day, it’s a nice room [person’s bedroom], and nice and clean.” Another person told us, “My room is lovely and clean.” A visitor said, “I do go to [person’s] room sometimes, it always seems nice and clean.”

On our first visit to the service, we discussed the fly issue. Managers and staff told us this was an ongoing problem due the rural location of the service which were surrounded by farms and animals. They said the premises were always clean and tidy, but the flies continued to be a problem despite the presence of fly zappers in the corridors and fly paper in some people’s bedrooms. They agreed to raise this issue with the provider to see if a solution could be found. One our second visit this issue had been resolved with the purchase of individual fly zappers for people’s bedrooms, fly screens, and citrus-based air fresheners. Managers told us the local authority carried out an infection prevention and control (IPC) audit of the service in May 2024. The service scored 92%. The local authority commended the staff and noted the improvements made since their previous audit.

On our first visit there were fly zappers in corridors and kitchens, but these did not prevent flies getting into people’s bedrooms. Some people had fly paper in their bedrooms, but this was unsightly and not always effective. One person had sore legs and flies were landing on their skin. On our second visit this issue had been resolved and flies were no longer a problem at the service. All areas of the service were cleaned to a good standard. We checked four people’s bedrooms, and all were clean, tidy, and fresh. Staff had access to personal protective equipment (PPE), and handwashing facilities.

Although the fly issue had been ongoing at the service the provider’s systems and processes has failed to resolve it, and it was not fully addressed until our visits to the service. This showed the providers IPC policies and procedures were ineffective on this occasion. In other IPC areas the risk of infection was safely managed. Cleaning and care staff had clear roles and responsibilities around infection prevention and control. IPC was audited monthly with most shortfalls identified and addressed. Staff were trained in IPC and a cleaning rota was in place to ensure all areas the premises were regularly cleaned.

People were satisfied with how staff supported them with their medicines. A person said, “They [staff] are very good with my medication no problems with that.” Another person told us, “I take a tablet and some others every day. I get them when needed.” People confirmed that staff stayed with them while they took their medicines to ensure they had had them as prescribed. We saw staff administering medicines safely. The wore red ‘do not disturb’ tabards during the medicines round so people and visitors could see they were busy. They explained to people what each medicine was for and supported people to take them in their own time.

The deputy manager and a senior carer had delegated responsibility for overseeing medicines management at the service. They ensured that medicines were safely received, stored, administered, and disposed of with clear audit trails to show this had been done safely. The registered manager told us they had improved the way ‘as required’ (PRN) medicines were managed. Records were more detailed and showed why each medicine was given, how much (if a variable dose was prescribed), the time of administration, and the outcome as to whether the medicine was effective. This helped to ensure that PRN medicines were only given when necessary.

Staff followed the provider’s safe handling of medicines policy and procedures. These set out the steps staff needed to take to ensure medicines were safely managed at the service. Only trained staff administered medicines. They had annual training and competency checks to ensure their skills remained up to date and effective. Managers oversaw medicines management, carrying out daily, weekly, and monthly audits to check medicines had been given as prescribed with accurate records kept.