Archived: Lilena Residential Care Home

Updated 23 February 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 12 December 2017 and was unannounced. The inspection team consisted of two adult social care inspectors.

The service was previously inspected on 5 and 6 October 2015 when it was found to be fully compliant with the regulations. Prior to the inspection we reviewed the information we held about the service and notifications we had received. A notification is information about important events which the service is required to send us by law.

During the inspection we met and spoke with the four people who used the service, two members of care staff, the registered manager and the provider. Following the inspection we spoke with two people’s relatives by telephone. In addition we observed staff supporting people throughout the service and inspected a range of records. These included two care plans, three staff files, training records, staff duty rotas, meeting minutes and the services policies and procedures.

Updated 23 February 2018

This inspection took place on 12 December 2017 and was unannounced. Lilena Residential Care Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Lilena Residential Care Home accommodates up to 14 people with mental health needs. The service consists of a three story detached house with 13 bedrooms and bungalow where one person can be supported to develop the skills necessary for independent living. At the time of our inspection 14 people were using the service.

The service had a registered manager. 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.

People told us they felt safe living at Lilena and relatives said, “It is very safe” and “There is nothing at all to be worried about.” Staff had received safeguarding training and understood their responsibilities in relation to protecting people from abuse and harm. Records showed the registered manager made appropriate safeguarding alerts to ensure people’s safety.

The atmosphere in the service on the day of the inspection was friendly and calm. People were comfortable approaching staff for support and staff responded promptly to meet people needs. People told us they got on well with the care staff and commented, “I am well looked after here”, “I like it here” and “I am well loved and cared for.” Relatives were also complimentary of the service and told us, “It seems to be the best one so far” and “I am very pleased. It is the best place [Person’s name] has been in. I could not wish for anything better.”

The service was adapted to meet people’s needs and maintained to a reasonable standard. Although, carpets in high traffic areas on the ground floor were discoloured. Fire fighting equipment had been regularly serviced and action taken to address resolve issue identified during a recent fire safety audit.

Risks both within the service and in relation to people’s care needs had been assessed and staff were provided with guidance on how to protect people from identified risks. Where accidents or incidents occurred these had been investigated by the registered manager to identify any further actions that could be taken to improve people’s safety.

People’s medicines were managed safely. But we have recommended that the service review current practices in relation to the dispensing of medicine to ensure people’s dignity was protected at all times.

There were enough skilled staff available to meet peoples’ care needs and records showed planned staffing levels were routinely achieved. Necessary staff pre-employment checks had been completed and there were systems in place to provide new staff with an appropriate induction. Staff training needs had been met and supervision was provided regularly.

People needs were assessed before they moved into the service to ensure those needs could be met. People were encouraged to visit the service before deciding to move in to ensure they understood the service’s routines, rules and policies. Based on information gathered during the assessment process individualised care plans had been developed. These documents provided staff with clear guidance on how to meet each person’s individual needs. People’s care plans had been updated regularly and staff told us, “[The care plans] are well thought out and detailed.”

People were able to choose how to spend their time and to access the community independently if they wished. However, during our inspection we noted that there was a lack of activities for people to engage with within the service. We have recommended that the service reviews staff working practices with the aim of supporting and encouraging people to engage with more meaningful activities.

Management and staff had a good understanding of the Mental Capacity Act 2005 (MCA) and the associated Deprivation of Liberty Safeguards (DoLS). We saw that staff sought people’s consent before providing care and support. Where people had been identified as lacking capacity made certain decisions the service acted in accordance with legal requirements. Necessary DoLS applications had been made and subsequent conditions were complied with.

The registered manager normally worked one shift each week as a carer within the service. This meant the manager had a detailed understanding of both people’s needs and staff working practices. Staff told us they were well supported by the registered manager and commented, “The registered manager] is excellent, very professional”, “very nice, very helpful.” A Health and Social care professional said, “[The registered manager] is a proactive manager, and keen to support residents to rebuild skills, with the hope of greater independence.” The registered manager was expected to be absent from the service for a significant period following the inspection. The provider had made appropriate arrangements to ensure the service was led appropriately during this period.

The service’s complaints procedures were displayed within the home and records showed all complaints received had been appropriately investigated. Residents meetings were held regularly and minutes showed changes had been made to the service’s menu in response to people’s feedback.

Information was stored securely and there were systems in place to monitor the service’s performance and identify where improvements could be made.