Archived: Lashbrook House Care Home

Below is a summary of what we found. The detailed evidence supporting our summary can be read in our full report.

Is the service safe?

We found the service to be safe.

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The home had recently submitted one application to their Supervisory Body. The deputy manager told us they had recently applied for Deprivation of Liberty Safeguard (DoLS) for one person. We reviewed the application and found it was completed appropriately. The person’s was deprived of their liberty in order to maintain their safety and wellbeing. This was done in the least restrictive way and in the person’s best interest.

We spoke with three people and one relative. People told us staff protected their dignity. We heard various comments such as, “They always knock on the door”, “Speak to me politely” and “They address me by the name I want to be called.” This was supported by the staff we spoke with. One staff member commented, “I knock on people’s door, explain the care I want to give, close the door and pull down the blinds when carrying out personal care. I do not share any information about people with anyone who is not a part of the care team.” We observed staff knocking before entering people’s rooms and speaking with people in a respectful manner.

Risk assessments identified the risks to people and the control measures to minimise them. For example, in one care plan an assessment identified the person’s aggressive behaviour as high risk to people who used the service, staff and visitors. We saw appropriate measures in place to address and reduce the number of incidents. This meant the service identified risks and showed how they would be managed. One person told us, “No one upsets me. They all look after me.”

Staff demonstrated good understanding of what to do when dealing with suspect or alleged abuse. One staff told us, “If I suspected someone was being abused I have to write a report and inform my line manager or deputy if they are not available.” Another staff commented, “If I suspected abuse I will inform my manager, if my manager is not available I will inform safeguarding.” Training records confirmed staff had attended the relevant training. This meant people were supported by staff that could report and respond appropriately to suspect or actual abuse.

Medicines were safely administered. One staff member told us, “It is the responsibility of one staff to administer prescribed medication and to ensure they have signed and dated to confirm they had done so correctly. The administration of control drugs is carried out by two staff members.” We reviewed the ‘control drugs checking form’. This document was used by registered general nurses to confirm that at shift handovers the correct amount of control drugs were in storage. We noted dates and signatures of staff who undertook the checks. One staff member commented, “Medicines are kept locked away in trolleys and controlled drugs are kept in a double locked cupboard. This was supported by our observations. This meant medicines were handled safely, securely and appropriately.

Is the service effective?

We found the service to be effective.

The provider promoted people’s rights and choices. We heard various comments from staff such as, “People’s choices are documented in care plans. For example, we record their likes and dislikes and try to ensure they get what they like. With personal care we let them choose what clothes they want to wear” and “Listening is the main key. I allow them to choose.” Care records reviewed supported this. This meant people were supported by staff who understood the various choices people who used the service made.

‘Pre-admission assessments’ were carried out to establish people needs. One staff told us, “It help us to assess if we can meet the needs of people and ensure we have the right things in place to meet their needs.” Another staff commented, “It helps us to know the person we want to care for and their required needs. We assess various aspects such as, mobility, nutrition, what type of bed they need. When they move into the home we observe them to see if there are changes and make adjustments accordingly.” This meant the provider assessed the needs of people before they began to use the service.

Is it caring?

We found the service to be caring.

We observed staff speaking sensitively to people who were distressed. Staff told us how they protected people’s privacy. One staff commented, “When carrying out personal care, I always shut the windows, and put a towel over them when I give them a strip wash. I see to their wishes, trying to do what they want rather than what I want.”

Care was developed to meet people’s individual needs. The provider involved people and their representatives in the review of care to ensure their care needs were met. The carers we spoke with demonstrated a good understanding of people’s care needs. One relative commented, “We never had any concerns about the home. X has good relationships with staff and loves the interaction.”

Is it responsive?

We found the service to be responsive.

People’s choices was respected and acted upon. This was evidenced in the care plans reviewed. One staff told us, “People’s choices are documented in care plans. For example, we record their likes and dislikes and try to ensure they get what they like. With personal care we let them choose what clothes they want to wear. Listening is the main key. I allow them to choose.” This meant people are supported by staff who understood the various choices people who used the service could make.

One person told us they preferred their personal care to be carried out by one member of staff. We reviewed their care record and saw it clearly recorded that one staff member should assist with personal care. We also noted the person preferred not to be checked at night time as they did not want to be disturbed. Staff were instructed to ensure the call bell was within their reach. This showed the care provided reflected people’s preferences and needs.

Is it well-led?

We found the service to be well-led.

The deputy manager told us, “All staff have received training and attend regular meetings where they are encouraged to promote and respect people’s dignity and human rights. For example, they are encouraged to ensure when carrying out personal care, this is completed behind closed doors and to always do what people prefer.” This meant the service upheld and maintained the privacy, dignity and independence of people who used the service.

We reviewed the complaint policy. This outlined procedures to be followed when people wanted to make a complaint. One staff told us, “We always tell people to speak with the manager or someone they feel comfortable with.” Another staff commented, “People can give their complaints in writing or speak with the manager.” This was supported by one person who commented, “I did make a complaint some time ago. I spoke with the manager about the issue and it was dealt with. I don’t have that problem anymore.” This demonstrated the provider took into account complaints to improve the service.