We undertook this comprehensive inspection on the 13 and 18 November 2015. The first day of this inspection was unannounced.
Abbeyfield Lear House is registered to provide personal care and accommodation for up to 29 people. The home is situated in West Kirby, Wirral. It is within walking distance of local shops with good transport links. There is a small car park and garden available within the grounds. A passenger lift enables access to the bedrooms located on the first floor for people with mobility issues. Communal bathrooms with specialised bathing facilities are available on each floor. On the ground floor, there is a communal lounge and dining room for people to use. Upstairs, there is another small lounge for people to use if they wish. The home is decorated to a good standard throughout.
On the day of our visit, there was a registered manager 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.
People who lived at the home said they were well looked after and they were treated with dignity and respect. We saw people were supported to maintain their independence where possible and they had a choice in how they lived their lives at the home. There was a range of activities on offer at the home and the home had a social and relaxed atmosphere throughout.
People told us they felt safe at the home and had no worries or concerns. From our observations it was clear that staff genuinely cared for the people they looked after and knew them well. Staff spoken with, were knowledgeable about types of abuse and what to do if they suspected abuse had occurred.
People had access to sufficient quantities of nutritious food and drink throughout the day and were given suitable menu choices at each mealtime. People’s special dietary requirements were catered for and people we spoke with told us the food was good.
The home had the majority of medication supplied in monitored dosage packs from the local pharmacy. Records relating medications were accurate and completely legibly. All staff giving out medication were medication trained.
We observed a medication round. We saw that the way in which medicines were administered, required improvement. The staff member undertaking the medication round was constantly interrupted which increased the risk of a mistake being made. Medicines were also observed to be signed for by the staff member before being administered to people who lived at the home. This meant the staff member had recorded that they had observed the taking of this medication before it had been consumed. This was a breach of Regulation 12 (g) of the Health and Social Care Act 2008 (Regulated Activities Regulation 2014) as medicines were not administered safely.
Staff were recruited safely and there were sufficient staff were on duty to meet people’s needs. Staff had received the training they needed to do their jobs safely and were appropriately supported in the workplace.
We reviewed three care records. Care plans were person centred and provided sufficient information on people’s needs and risks. Staff were given clear guidance on how to care for people and meet their needs. We saw that people’s preferences and wishes in the delivery of care had been listened to and care had been designed so that these preferences and wishes were respected.
Regular reviews of care plans took place to monitor any changes to the support people required and we saw from people’s care records that they had prompt access to other healthcare professionals when needed.
We saw that staff asked people’s consent before providing support. Where people had mental health conditions that impacted on their capacity to make specific decisions in relation to their care, care plans contained some information about how these conditions impacted on their day to day life. We found however that people’s capacity to make specific decisions had not been assessed appropriately when their capacity to make a specific decision was in question. This meant that the Mental Capacity Act 2005 legislation had not been followed to ensure people’s legal consent was obtained. This was a breach of Regulation 11 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
We saw that people were provided with information about the service and life at the home. Information in relation to how people could make a complaint was available but required the contact details for the internal and external parties people could contact, in the event of a complaint, to be clarified. No-one we spoke with had any complaints. The manager told us no complaints had been received.
The premises were well maintained and the home’s kitchen had been awarded a five star rating (very good) by Environmental Health. The majority of equipment was properly serviced and maintained with the exception of Elliott House’s electrical system which the provider rectified immediately.
People who lived at the home and staff told us that the home was well led. Staff told us that they felt well supported in their roles and that they were able to express their views. The management of the home was well organised, staff were confident in their roles and were observed to work well as a team. The manager was ‘hands on’ and the culture of the home was homely and inclusive.
There was a range of suitable audits in place to assess and monitor the quality of the service provided. For example, accident and incident audits, medication audits, infection control audit and premises checks. People’s feedback was gained through residents meetings and the use of satisfaction questionnaires. We reviewed a sample of the results of the last satisfaction survey undertaken in 2014 and saw that they were positive.
We undertook this comprehensive inspection on the 13 and 18 November 2015. The first day of this inspection was unannounced.
Abbeyfield Lear House is registered to provide personal care and accommodation for up to 29 people. The home is situated in West Kirby, Wirral. It is within walking distance of local shops with good transport links. There is a small car park and garden available within the grounds. A passenger lift enables access to the bedrooms located on the first floor for people with mobility issues. Communal bathrooms with specialised bathing facilities are available on each floor. On the ground floor, there is a communal lounge and dining room for people to use. Upstairs, there is another small lounge for people to use if they wish. The home is decorated to a good standard throughout.
On the day of our visit, there was a registered manager 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.
People who lived at the home said they were well looked after and they were treated with dignity and respect. We saw people were supported to maintain their independence where possible and they had a choice in how they lived their lives at the home. There was a range of activities on offer at the home and the home had a social and relaxed atmosphere throughout.
People told us they felt safe at the home and had no worries or concerns. From our observations it was clear that staff genuinely cared for the people they looked after and knew them well. Staff spoken with, were knowledgeable about types of abuse and what to do if they suspected abuse had occurred.
People had access to sufficient quantities of nutritious food and drink throughout the day and were given suitable menu choices at each mealtime. People’s special dietary requirements were catered for and people we spoke with told us the food was good.
The home had the majority of medication supplied in monitored dosage packs from the local pharmacy. Records relating medications were accurate and completely legibly. All staff giving out medication were medication trained.
We observed a medication round. We saw that the way in which medicines were administered, required improvement. The staff member undertaking the medication round was constantly interrupted which increased the risk of a mistake being made. Medicines were also observed to be signed for by the staff member before being administered to people who lived at the home. This meant the staff member had recorded that they had observed the taking of this medication before it had been consumed. This was a breach of Regulation 12 (g) of the Health and Social Care Act 2008 (Regulated Activities Regulation 2014) as medicines were not administered safely.
Staff were recruited safely and there were sufficient staff were on duty to meet people’s needs. Staff had received the training they needed to do their jobs safely and were appropriately supported in the workplace.
We reviewed three care records. Care plans were person centred and provided sufficient information on people’s needs and risks. Staff were given clear guidance on how to care for people and meet their needs. We saw that people’s preferences and wishes in the delivery of care had been listened to and care had been designed so that these preferences and wishes were respected.
Regular reviews of care plans took place to monitor any changes to the support people required and we saw from people’s care records that they had prompt access to other healthcare professionals when needed.
We saw that staff asked people’s consent before providing support. Where people had mental health conditions that impacted on their capacity to make specific decisions in relation to their care, care plans contained some information about how these conditions impacted on their day to day life. We found however that people’s capacity to make specific decisions had not been assessed appropriately when their capacity to make a specific decision was in question. This meant that the Mental Capacity Act 2005 legislation had not been followed to ensure people’s legal consent was obtained. This was a breach of Regulation 11 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
We saw that people were provided with information about the service and life at the home. Information in relation to how people could make a complaint was available but required the contact details for the internal and external parties people could contact, in the event of a complaint, to be clarified. No-one we spoke with had any complaints. The manager told us no complaints had been received.
The premises were well maintained and the home’s kitchen had been awarded a five star rating (very good) by Environmental Health. The majority of equipment was properly serviced and maintained with the exception of Elliott House’s electrical system which the provider rectified immediately.
People who lived at the home and staff told us that the home was well led. Staff told us that they felt well supported in their roles and that they were able to express their views. The management of the home was well organised, staff were confident in their roles and were observed to work well as a team. The manager was ‘hands on’ and the culture of the home was homely and inclusive.
There was a range of suitable audits in place to assess and monitor the quality of the service provided. For example, accident and incident audits, medication audits, infection control audit and premises checks. People’s feedback was gained through residents meetings and the use of satisfaction questionnaires. We reviewed a sample of the results of the last satisfaction survey undertaken in 2014 and saw that they were positive.