This inspection took place on 10 May 2017 and was unannounced.

The home is situated in a semi-rural area of Solihull, West Midlands. It is part of The Foundation of Lady Katherine Leveson and provides accommodation and personal care for up to 30 older people. On the day of our visit there were 26 people living in the home.

Communal areas included a large lounge area, a dining room, a room where people could follow their interests and hobbies, a small shop and a library. The home also had large well maintained gardens.

A registered manager who had over 30 years of experience in health and social care had been in post at the home for two years. 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.

We received exceptional feedback about how the service was personalised and responded to people's individual needs. It was clear that significant improvements had been made since our last inspection. People always received care which was in line with their wishes and preferences. People worked in partnership with the staff to plan their care which meant staff had an in-depth knowledge of people's preferences and support needs.

Clear values and vision for providing high quality care for people was embedded throughout the home. People received a high standard of care because the enthusiastic, passionate and caring management team led by example and set high expectations of staff about the standards of care people should receive.

People told us the hard work and determination of the management team to continually make improvements had a positive impact on their quality of life. There was a strong emphasis on continually looking for ways to improve the service people received. There was an open and transparent culture and the management team were responsive to people's feedback and used this to develop and improve the service. People felt listened to and informed of what was happening in their home. They told us the communication between them and the staff was very good and they felt assured any complaints would be taken seriously and acted upon.

The ethos of the home is to offer care, comfort, nurture, respect and dignity within an environment which is both safe and stimulating. It was clear that the provider, registered manager and staff embraced this ethos and the on-going improvement to all people's lives and well-being was a fundamental aim of this service. People mattered and all staff spoke with pride about the people they cared for and celebrated their individual achievements. Staff understood their roles and responsibilities and were continually supported to increase their knowledge and skills to improve their work practices. Staff received recognition for their work and they felt supported, empowered and valued in their roles.

Staff continually embraced people’s individual lifestyle choices in line with the provider’s vision which included making people feel valued. Staff encouraged people to maintain or develop interests which were important to them and to support them to lead meaningful lives. People maintained positive links with their community that enhanced and benefitted their lives. People spoke very positively about the social activities that were available to them. Staff spoke passionately about the importance of activities being outcome based and meaningful to people. This approach to activities was innovative, person centred and inclusive.

People's religious and spiritual needs were always recognised and embraced which meant people continued to practice their religion how they wished to do so. Whilst the service was part of a Christian foundation the home demonstrated it welcomed people’s differing and diverse cultures.

Audits and

This inspection took place on 28 October 2014 and was unannounced.

The Foundation of Lady Katherine Leveson provides care for older people. The home can support a maximum of 30 people. On the day of our visit there were 28 people living in the home. Eleven people lived in the main house and 17 people lived in ground floor flats around a cobbled central courtyard attached to the main building. There were also 13 flats offering sheltered accommodation. Communal areas in the main house included a large lounge area, a dining room, a room where people could follow their interests and hobbies and a small ‘quiet room’.

We last inspected the home in November 2013. After that inspection we asked the provider to take action to make improvements to ensure people were protected against the risk of receiving care that was inappropriate or unsafe. We also asked them to improve the staffing levels and to make improvements in how the quality of the service was monitored. The provider sent us an action plan to tell us the improvements they were going to make, which they would complete by 18 April 2014. At this inspection we found improvements had been made in all areas reviewed. This meant the provider met their legal requirements. 

The home is required to have 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 and associated Regulations about how the service is run. At the time of this inspection, this service did not have a registered manager in post. A new manager had been appointed in September 2014 and was in the process of applying to the Care Quality Commission to become the registered manager of the service.

People we spoke with told us they felt safe living in the home. Staff demonstrated a good awareness of the importance of keeping people safe. They understood their responsibilities for reporting any concerns regarding potential abuse.

Staff were aware of people’s individual risks and how those risks were to be managed. There were a system of checks in place to manage any environmental risks.

Medication was managed appropriately and people received their medicines as prescribed.

Staff told us they received training, supervision and encouragement to gain further qualifications which supported them in meeting people’s needs effectively.

The manager understood their responsibilities under the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. They had identified a person who was at risk of having some of their movements restricted and was making the appropriate application to the local authority.

We saw meals were a sociable occasion and people clearly enjoyed their food. People told us they were offered drinks and snacks throughout the day.

Staff were friendly and supported people’s needs well. People told us that when staff delivered personal care, they treated them with dignity and respect and supported their independence to do as much as they could for themselves.

We saw care plans supported people’s individual preferences and needs. Some people’s information had not been updated consistently so it was not always clear what the most current assessment of their needs was.

People told us they were supported to pursue their interests and hobbies which kept them occupied and stimulated. During our visit we saw a great deal of laughter as some people enjoyed singing and dancing in front of a karaoke machine.

People who lived in the home and staff told us they were happy with the new manager and confident they would respond to any concerns. Staff told us the manager had made a positive impact on the home in the short time they had been in post.

The manager had established systems to obtain people’s views about the service provided and engaged with external organisations to improve the quality of care provided. The home had good links with the local church and schools and the manager was keen to develop those community links further.             

We visited the main house and the courtyard residential flats on the same site. We observed how people were being cared for at each stage of their treatment and care and how their health and well-being was safeguarded from abuse. We looked at how medication was managed and we examined how the service measured the quality of care provided to people who used the service. We spoke to staff and people who used the service.

We observed staff interacting with people with kindness. The main home had 11 en-suite flats. In addition there were a further eighteen flats separated from the main house by a courtyard. Above the residential flats were a further sixteen flats used as sheltered accommodation. We had concerns about some people’s safety when walking across the cobbled flagstones which paved the perimeter of the courtyard.

One person who used the service told us, “ It’s nice here, it’s my home, I’m happy”.

We reviewed the care of four people with varying levels of need. We saw medication was stored and administered safely.

We saw there had been a significant number of falls within the service. We had concerns there were insufficient staff to meet the needs of people living in both the main house and the flats. We examined care records and saw people’s needs were not always reflected in their risk assessments and care plans.

We noted the service made appropriate referrals to outside specialists on behalf of people who lived there.

We inspected The Foundation of Lady Katherine Leveson in July 2012 and found the provider was not complying with the regulations relating to the management of records. This meant we could not be confident that risks associated with people’s care were being identified and managed appropriately.

We told the provider they must make improvements. We inspected the service again in November 2012. Insufficient improvements had been made so we issued a warning notice to the provider and manager. This required them to become compliant with Regulation 20 (1) (a) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 by 18 December 2012.

We carried out an unannounced inspection to The Foundation of Lady Katherine Leveson on 2 January 2013 to check sufficient actions had been taken to comply with the warning notice. We also reviewed people’s care to check that their needs were being met.

We found that sufficient improvements had been made for the service to be compliant with the warning notice. Care records had been reviewed so that they contained accurate information about people’s needs and risks associated with their care. They also contained information about what support they needed from staff to ensure their needs were met.

People we spoke with were positive about the care they received. We were told: “On the whole they do pretty well really”. “They are very good.”

We carried out this visit to review improvements in relation to medication management and record keeping. We found that sufficient improvements had been made in relation to medicine management for the service to be compliant.

We found that further improvements were needed in relation to record keeping. We did not speak with people about their care records but we found that some care records were not up-to-date, sufficiently detailed or accurate. This meant there was a risk that people may not always receive appropriate care.

We carried out this visit to review improvements in relation to medication, record keeping and staffing following our last inspection of the home. We found that although some action had been taken to address specific concerns, further improvements were needed.

People told us that they were receiving their medicines but we could not be sure from viewing records and medicines available that medicines were always being managed as they should. Medicine records did not always clearly show that medicines prescribed had been given or were available.

People were complimentary of the care staff supporting them although they acknowledged sometimes staff were busy. People told us: “They are all nice, I have got no complaints at all, they are all very kind.” “Yesterday my breakfast came at 9.00am, I usually prefer it earlier.” Staff told us they could not always deliver care to people to a standard they were happy with.

We did not speak with people about their care records but we found that some care records were not up-to-date or accurate. This meant there was a risk that people may not always receive appropriate care.