This unannounced inspection took place on the 27 January 2017. Laxton Hall provides accommodation for up to 29 people who require nursing or residential care for a range of personal care needs. There were 27 people in residence during this inspection.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

The strong cultural and compassionate ethos of the service provided at Laxton Hall was evident in all areas. Everyone living there received person centred and culturally specific care, which promoted all aspects of being Polish and created a positive healing environment.

The provider had created a community where people who had shared experiences in their early life (during World War II) could be together, talk to each other where little explanation was needed for an immediate understanding and deep cultural bond. People consistently told us this was very important to them.

The registered manager was a trusted and respected leader who involved people in creating their community by having their say in how the home was run.

The provider staffed the home with Polish Sisters of Mary Immaculate an order that was recognised for their humanity, compassion. The Sisters were sent from the Mother House in Poland, they were experienced in care for the elderly, particularly those who have been affected by events of World War II. The sisters provided supervision and guidance to all staff, who also had a deep understanding of Polish culture, traditions and language.

People experienced warm caring relationships with staff where conversation and sharing traditional Polish pastimes including story-telling and singing incorporated people’s need to feel at home and promoted close bonds. Staff helped people to explore their life paths, successes and difficulties through reminiscence and conversation during activities. People described how living at Laxton Hall had brought them comfort and a sense of home. People could choose to actively practice their religious faith in the on-site chapel, accessible to all, and the priest was also an integral part of their community.

People received care and support from staff that had a deep understanding of their physical and psychological needs. Staff took time to get to know people and build relationships. People’s healthcare needs were met by staff who were competent at closely monitoring people’s clinical observations which enabled them to identify any deterioration in health quickly and respond. Staff referred people to health professionals for assessment of their mental and physical health where necessary. People were assisted to attend health and dental appointments and request that staff provided translation for them in medical appointments if they chose.

People chose whether they stayed at Laxton Hall when their health deteriorated. Experienced staff facilitated people’s wishes and provided end of life care that met their individual needs with kindness, compassion and understanding.

People’s visitors were always made to feel welcome; staff helped to maintain family relationships that were important to people. There was a room where relatives who had travelled a long way to see their relatives could stay overnight.

People felt safe at Laxton Hall; all staff understood their responsibilities to safeguard people and knew how to raise any concerns with the right person if they suspected or witnessed ill treatment or poor practice.

People’s needs were regularly reviewed so that risks were identified and acted upon as their needs changed and people’s care plans provided instruction to staff on how to mitigate people’s risks to ensure people’s continued safety. Staff u

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service.

This inspection was unannounced, which meant the provider did not know we were coming.

Laxton Hall provides accommodation and personal care for up to 29 older Polish people. At the time of this inspection there were 29 people living at Laxton Hall. At our last inspection on 26 September 2013, the provider did not breach any of the regulations we assessed.

There was a registered manager in post at the time of this inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

The CQC is required by law to monitor the operation of the Mental capacity Act 2005 (MCA), Deprivation of Liberty Safeguards (DoLS) and to report on what we find. We saw that there were policies and procedures available in relation to the MCA and DoLS to ensure that people who could not make decisions for themselves were protected.

During this inspection people who live at Laxton Hall, visitors and a visiting healthcare professional were very complimentary about the care and support that people received.

People’s healthcare needs were assessed; the care was planned and delivered in a consistent way. From the three care plans we looked at, we found that the information and guidance provided to staff was detailed and clear. This enabled staff to provided appropriate and individual care and support. Any risks associated with peoples care needs were assessed and plans were in place to minimise the risk as far as is possible to keep people safe.

Our observations throughout the day showed us that staff clearly knew how to support people in a consistent, patient and caring way. The number of staff available allowed many people to have one to one support to support them in meeting their care needs and provide social interaction.

Staff had the knowledge and skills that they needed to support people. They received training and on-going support to enable them to understand people’s needs and provide appropriate and individualised support.

Staff respected peoples dignity and worked in ways that provided support to people and maintained their independence.

From the records and speaking to people demonstrated to us that a large number of varied social interests were provided to meet people’s choices and preferences.

Auditing systems were effective and ensured that were improvements were required; action was taken in a timely manner.

The staff at Laxton Hall were very dedicated in providing high quality of care and were well supported by the registered manager.

We were accompanied on this visit by someone called an expert by experience. An expert by experience has personal experience of managing, using or caring for someone who uses a health, mental health and/or social care service.

We take an expert by experience to inspections so they can talk to the people using the service to help us gain a good understanding of the experience people have in living there.

The expert by experience spoke with six people. They said that staff were friendly and were meeting their care needs. They said there was good access to medical services, staff encouraged independence and choice, there were lots of activities and Polish language and culture was respected. One person said: ‘’the carers are all very nice and they look after for us very well. They speak and treat us with respect’’.

The expert by experience also spoke with four relatives of people living in the home. They told her that the care that staff provided was very good. One relative said: ‘’ I think it’s lovely here… The dedication of the staff is excellent’’. We also spoke with a relative. She also confirmed that the care was excellent.

We also carried out an observation for one and a half hours. Staff were seen to be generally friendly and caring.

This was a positive inspection. People said that they were satisfied with the care they received. Relatives we spoke with said that care was very good. The essential standards we inspected were found to have been met.

As the purpose of our visit was to check whether staff were aware of how to fully protect people from abuse, we did not speak with people living in the service. They had previously told us they felt safe. We did meet with one relative on the day of the inspection, who told us that her relative was entirely safe living in the service.

We spoke with five people who lived in the service. As people spoke Polish as their first language, we took a Polish interpreter with us to help us talk with people.

The people we spoke with were generally very satisfied with staff and the care they received. Staff were seen to be generally very good at their jobs, friendly and respectful. One person said: ‘’It suits me here. I am able to do whatever I want. I don't have to go downstairs from meals. I can take them in my room’’. Another person said: ‘’Staff are very good. They help you when you ask them anything ‘’.

Two people we spoke with said that some staff could be ‘’moody‘’ on occasion. The manager said that this would be followed up and monitored.