Market Lavington Care Home

Updated 11 July 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection, we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

This inspection was carried out by 3 inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Market Lavington Care Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Market Lavington Care Home is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with CQC to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 6 people and 2 relatives about their experiences of care received. We also spoke with the registered manager, deputy manager, clinical lead, area director and 6 members of staff. We reviewed care records for 14 people, including monitoring and medicines records. We also reviewed 4 staff recruitment files, incident forms, meeting minutes, falls summaries and analysis, quality monitoring records, safeguarding log, health and safety records, fire records and records for staff fire drills.

Following the site visit we spoke with a further 5 members of staff and 3 relatives on the telephone. We also spoke with 3 healthcare professionals for their feedback about the care and support provided.

Updated 11 July 2023

About the service

Market Lavington Care Home is a residential care home providing accommodation for persons who require nursing or personal care and treatment of disease, disorder or injury for up to 87 people. The service provides support to people over and under 65 years, people with physical disabilities and people living with dementia. At the time of our inspection there were 52 people using the service.

Accommodation was provided across 2 buildings on the same site. People had their own rooms and there were communal rooms available in both buildings, such as lounges, dining rooms and bathrooms. There was outdoor space available for people to use accessed from ground floors.

People’s experience of using this service and what we found

Medicines were managed safely but improvement was needed to make sure all medicines records were transcribed accurately. We have made a recommendation about this. People who needed their medicines regularly on time did not always experience this. We saw no impact for people of medicines being late. However, times of administration required a review. The registered manager told us they would act without delay to address this shortfall.

Some people relied on staff for their food and fluid as they were not able to do this for themselves. Records for fluids did not always demonstrate staff had offered or helped people to drink enough during very warm weather. The registered manager provided assurance this was a recording issue and people were being offered regular drinks. During our inspection the provider cascaded out a new dehydration risk tool for staff to use. The provider told us this tool, where needed, would be used to assess dehydration risks and staff would be provided with training on how to use it.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Risk management plans recorded measures in place for staff to follow. These were reviewed regularly and updated when needed. Health and safety checks were carried out and recorded. Staff and external contractors checked areas such as fire systems, moving and handling equipment and emergency lighting for safety.

The service was clean and smelt fresh. We observed staff using personal protective equipment safely. The provider had carried out a programme of refurbishment since our last inspection which had improved the environment. Communal areas had been redecorated and had new soft furnishings. Windows had been replaced and the outside space had been improved for people to enjoy sitting out in nice weather.

People could have visitors when they wished. People and relatives told us staff were caring and took time to understand and get to know people. People told us at times staff were busy and their call bells took time to be answered. We observed, during our inspection, there were enough staff available to meet people’s needs and call bells were answered promptly. Staff we spoke with told us there was enough staff and the registered manager was able to increase staff if needed. Call bell response times were monitored and analysed by management. Staff had been recruited safely.

People’s health needs were identified, and timely referrals made to local healthcare professionals. Feedback from healthcare professionals was positive and we were told improvements had been made to areas such as communication.

There was a registered manager in post who had notified Care Quality Commission (CQC) of events and injuries as required by law. There were systems to assess and monitor quality and safety. Staff carried out audits and any actions were added to the service improvement plan. The provider, central support staff and the registered manager took responsibility for making sure all identified actions were addressed.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 16 March 2021) and there was 1 breach of regulation 17. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of this regulation.

Why we inspected

We carried out an unannounced focused inspection of this service on 26 January 2021. A breach of legal requirements was found. The provider completed an action plan after that inspection to show what they would do and by when to improve regulation 17 (good governance).

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Market Lavington Care Home on our website at www.cqc.org.uk.

Recommendations

We have made 1 recommendation about handwritten recording of medicines.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.