Background to this inspection
Updated
3 September 2019
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 Care Act 2014.
Inspection team
The inspection was undertaken by one inspector 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
Littlebourne House 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.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
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. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
We spoke with 12 people who used the service and five relatives about their experience of the care provided. We spoke with ten members of staff including the provider, registered manager, deputy manager, senior carer workers, care workers and administration staff. We observed the interactions between staff and people in the communal areas of the service.
We reviewed a range of records. This included nine people’s care records and multiple medicines records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
Updated
3 September 2019
About the service
Littlebourne House is a residential care home providing personal and nursing care to 64 older people who may be living with dementia at the time of the inspection. The service can support up to 64 people, in two adapted buildings.
People’s experience of using this service and what we found
People told us they felt safe and happy living at the service. Potential risks to people’s health, welfare and safety had been assessed and there was guidance in place to mitigate risks.
Accidents and incidents had been recorded and analysed, action had been taken to reduce the risk of them happening again. The registered manager and staff understood their responsibilities to keep people safe from discrimination and abuse.
People’s medicines were managed safely. Staff monitored people’s health and referred people to relevant healthcare professionals and followed their guidance to keep people as healthy as possible.
People were supported by staff who had been recruited safely and received training appropriate to their role. Staff received supervision and appraisal to continue to develop their knowledge and skills.
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.
People met with the provider before moving to the service to check that staff were able to meet their needs. Each person had a care plan that contained details about their choices and preferences. These plans had been reviewed regularly and updated when needed.
People were supported to eat a balanced diet, people had a choice of meals. People’s preferences and dietary needs were catered for. People had access to activities that they enjoyed including minibus trips.
People were treated with dignity and respect. People were supported to be as independent as possible and express their views about their care and support. People’s end of life wishes were recorded. Staff worked with the GP and district nurse to support people at the end of their life.
The registered manager completed checks and audits on the quality of the service and acted when shortfalls were found. There was an open and transparent culture within the service, people were asked their views about the service and these were acted on.
Relatives told us they knew how to complain. The registered manager recorded all concerns raised and had investigated them according to the providers policy. People received information in formats they could understand.
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 30 August 2018) and there were multiple breaches of regulation. 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 regulations.
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.