About the service:

The Lawns Residential Care is a residential home which was providing accommodation and personal care for 36 people aged 65 and over at the time of the inspection. Some people were living with dementia.

People’s experience of using this service:

People told us they felt safe and staff were kind and caring. Staff understood how to safeguard people from abuse and report any concerns. There were sufficient numbers of staff deployed to meet people's needs and ensure their safety. Appropriate recruitment procedures ensured prospective staff were suitable to work in the home. People received their medicines when they needed them from staff who had been trained and had their competency checked. Risk assessments were carried out to enable people to retain their independence and receive care with minimum risk to themselves or others. People were protected from the risks associated with the spread of infection.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. The manager assured us the principles of the Mental Capacity Act would be further embedded in the assessment and care planning processes. People’s needs were assessed prior to them using the service. Arrangements were in place for new staff to receive induction training.

There was ongoing training for all staff. Staff were supported with regular supervisions and were given the opportunity to attend regular meetings to ensure they could deliver care effectively. People were supported to eat a nutritionally balanced diet and to maintain their health.

Staff treated people with kindness, dignity and respect and spent time getting to know them and their specific needs and wishes. Care plans reflected people's likes and dislikes, and staff spoke with people in a friendly manner. Our observations during inspection, were of positive and warm interactions between staff and people. People spoken with could not recall discussing their care needs, however, the manager assured us he had plans to develop the care planning process to ensure people had more involvement.

People were provided with varied activities in accordance with their needs and preferences. People were aware of how they could raise a complaint or concern if they needed to and had access to a complaints procedure.

The manager provided leadership and took into account the views of people, their relatives, staff and visiting professional staff about the quality of care provided. The manager used the feedback to make improvements to the service and had established a quality assurance system.

Rating at last inspection:

Outstanding (21 April 2016)

Why we inspected:

This inspection was part of our scheduled plan of visiting services to check the safety and quality of care people received.

Follow–up:

We will continue to monitor the service to ensure that people receive safe and high- quality care and re-inspect in line with the rating for the service. We may inspect sooner if we receive information of concern.

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

This inspection took place on 13 and 14 January 2016 and was unannounced.

The provider of The Lawns is registered for accommodation and personal care for up to 40 people some of whom may be living with dementia. At the time of our inspection 32 people lived at the home.

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.

There was a very positive atmosphere within the home and people were very much at the heart of the service. People and their relatives were enabled to be involved in the care and staff were highly motivated in ensuring people were treated as individuals and had an enjoyable life. People were able to see their friends and families when they wanted. There were no restrictions on when people could visit and they were made welcome by staff.

Staff had developed positive, respectful relationships with people and were extremely kind and caring in their approach. People’s privacy and dignity were respected by staff who worked to a set of values around providing care centred on each person. People were supported and encouraged to be as independent as possible in all aspects of their lives. Extensive work had been undertaken to make the home environment both interesting and stimulating with helpful pictorial clues to support people with dementia.

People told us that staff concentrated on what was most important to them and made sure they received the care they needed and preferred. People were supported to take part in planned and spontaneous activities which they found fulfilling. People told us that they valued how staff had thought of ways to make sure they could continue with daily routines they liked. Staff anticipated people’s care needs and responded to people swiftly, respectfully and with warmth.

People, who lived at the home, and or their representatives, were involved in making decisions about their care and support. Staff were aware of people’s individual communication needs and used these to support people to give their own consent to their care and make everyday choices about the care provided where possible.

People had been helped to eat and drink enough to stay well. We saw people were provided with their meals in serving dishes to actively support people in making their own choices and promote people’s dining experiences. When necessary, people were given extra help to make sure that they had enough to eat and drink.

People were supported by sufficient numbers of staff with the right skills to meet their needs and reduce risks to their safety. Staff knew people well and used every opportunity to continue to enhance their skills and knowledge in order to effectively meet people’s needs. People had access to a range of healthcare professionals when they required specialist help.

Staff practices around the administration and management of people’s medicines reduced the risks of people not receiving their medicines as prescribed to meet their health needs. This included making sure all people’s ‘as required’ medicines was consistently available to them should they choose to have these.

Staff knew how to protect people and reduce accidents and incidents from happening by ensuring people’s needs were met in a safe way. Staff knew how to recognise and report any concerns so people were kept safe from harm and abuse. Recruitment checks had been completed before new staff were appointed to make sure they were suitable to work with people who lived at the home.

Staff supported people who lived at the home and their relatives to raise any complaints they had. The registered provider had a complaints procedure which included investigating and taking action when complaints were re

The purpose of this inspection was to look at how the care and support was provided to people with dementia. On the day of our inspection 18 of the 37 people who lived at the home had a diagnosis of dementia.

During the day we were able to speak with six people and we received two comment cards where people gave their views about the care and treatment that people received. One family member commented: ‘I feel this home, ‘The Lawns’, gives excellent care to my mother who has dementia. She feels safe and secure here and is almost always in good spirits when I visit, basically she feels at home here.’

People told us that they were happy at The Lawns. One person told us: “I quite enjoy living here and the staff are very good at looking after me.” Another person said: “I’m very fortunate to be able to live here” and described the home has: “Very comfortable, warm and clean.”

Before people came to live at the home their needs were assessed in their own homes, hospitals and other community services. This was often done by a multidisciplinary team of health and social care professionals alongside a member of the management team from The Lawns. This ensured that people with dementia had care tailored to meet their individual needs when they came to live at the home.

We found that care records showed that staff knew the likes and dislikes of people with dementia, and that people's wishes were respected. We saw that staff spent individual time with people and provided care and support in a gentle way when people’s behaviour needed to be supported. This showed that staff had developed positive practices when they supported people with dementia with their emotional and psychological needs.

We found that arrangements were in place that made sure that the service people with dementia received was responsive to their needs and improvements were made.

When we carried out this inspection 37 people were using the service. We spoke with four people in detail as well as other people in less detail during the course of the inspection. We also spoke with four relatives who were visiting. We spoke with the registered manager, the head of care and two other members of staff.

People we spoke with told us that they were happy with the service they received and the staff working there. One person told us that the staff were: “Very helpful” and that they found the home to be: “Very nice”. Another person said: “We have fun here; we dress up at Christmas and Easter and have a walk around the grounds. All the flowers are coming up now”.

Staff knew about the needs of the people they were caring for. We saw that people’s needs were reviewed regularly to make sure staff had up to date information about people.

We found that people’s medicines were managed appropriately to make sure they received medication as prescribed.

Staff had been recruited in an appropriate way and checks had been undertaken to make sure that they were suitable to care for vulnerable people.

People were asked about their views of the service so that they felt involved in their care and treatment. A system of audit was in place to ensure that people were not placed at risk of receiving inappropriate care.