About the service:

Liversage Court Residential Home is a residential care home that provides personal care to 40 people aged 65 and over. At the time of the inspection there were 38 people living there. The service is run by a long-established charity in Derby which supports people who struggle to afford the cost of living by providing affordable housing and assisted living.

People’s experience of using this service:

People living at Liversage Court Residential Home received a good service. People told us how happy they were there, and how the service met their individual and diverse needs.

Staff were very positive about their work, and demonstrated the values of respect and dignity in care throughout the inspection. They understood how to keep people safe whilst promoting independence.

People were supported to lead the lives they wished, and were involved in decisions about all aspects of their care. They enjoyed a wide range of activities both in the service and out in their local community. Staff clearly respected each person as an individual, supporting them with kindness and good-humour.

The leadership of the service was good, and promoted a culture of high quality care and continuous improvements. The governance of the service was well organised, and all aspects of the service were checked regularly to ensure standards remained high.

More information is in our full report.

Rating at last inspection:

At our last inspection the service was rated Good. The inspection report was published on 17 May 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, compassionate, high quality care. Further inspections will be planned for future dates.

The last inspection of the home was carried out in November 2013. We asked the provider to make improvements in relation to the administration of ‘as required’ medicines and to deliver care in line with individual care plans. We found that these actions had been completed.

Liversage Court provides accommodation for up to a maximum of 40 people over two floors. It is situated near the centre of Derby City and is close to shops and local amenities. At the time of our inspection, there were 39 people living at Liversage Court Residential Home.

The service had a registered manager in place. 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.

People who used the service and relatives made positive comments about Liversage Court. They said the standard of care was good and the staff kind and considerate. They told us the staff, listened to their views, encouraged them to make choices, and treated them with dignity and respect.

There were enough staff on duty to meets people’s needs. People told us the staff were caring and always had time to talk and listen to them. Staff were trained and knowledgeable about the people who used the service and knew how best to support them.

Staff helped to ensure people’s health care needs were met, referring them to health care professionals where necessary. Medicines were safely managed at the service and given to people when they needed them.

People said they liked the food served and helped to choose the menus. They were encouraged to take part in a range of activities provided by the service. Regular residents meeting were held where people had the opportunity to share their views and make suggestions about the running of the service.

Records showed there were systems in place to assess and monitor the quality of the service and the focus was on continuous improvement. There was good leadership at the service from the registered manager and provider who promoted an open and inclusive culture.

We spoke with five people who used the service. One person told us “I get on well with most staff, we have a laugh and a joke.” Another person said “It’s alright, they look after you well.” Other people told us not all staff were polite and they felt rushed on occasions. Not everyone felt they were involved in their care or made decisions about their daily lives.

We saw that people were not always treated with dignity and respect when provided with support. Although detailed care plans and assessments were in place, staff did not always follow the instructions.

People were provided with a choice of suitable and nutritious food and drink. However, not everyone was positive about the meals provided, and people's dining experience depended on their level of independence and what support they required.

Although systems were in place to ensure medication was available and stored safely, people did not always receive their medication as prescribed.

People were provided with the opportunity to raise any issues in a variety of ways. These included discussions at the Residents Meetings, completion of the annual survey as well as the formal complaints procedure. We saw the provider listened to people's comments and complaints and acted upon these.

We spoke with three people who use the service they told us staff were friendly and approachable and spoke to them in a respectful way. They told us staff treated them with dignity and encouraged them to be as independent as possible.

All three people were happy with the care they received and felt involved in planning and reviewing their care.

People told us they felt safe at Liversage Court and thought enough staff are on duty to meet their needs. People felt they were able to complain if they needed to and that any issues would be dealt with promptly

We observed lunch and we saw that there were staff available to give assistance where needed. The meal looked nutritious and appetising and was served in a relaxed manner.

We spoke with people using the service about the care they received and we received comments such as, “I think they look after us OK, in terms of my health. I do see the doctor and nurse when I need to.”, “I know I have a care plan and have seen it.”

We spoke with fourteen people using the service and three relatives during our visit. Although we received positive comments with regards to how hard the staff worked, we received a high amount of comments about the staffing levels.

One person using the service told us, “The manager is very good. We can go and see her whenever we like. She deals with most things very efficiently.”

Another person said, “I have been to the meetings held for people using the service I feel able to speak up. We suggest things that we’d like and normally that’s taken on board.

We were concerned that there had been a high number of falls recorded in the last twelve months for people using the service. We looked at the accident records and we saw that one person using the service had fallen 20 times in the last 11 months. There was evidence that the falls had been discussed with the persons GP and some falls had been attributed to behaviour. There was also evidence that equipment to alert staff to any falls had been put put in place. However, there was no evidence that a referral had been made to the falls prevention team in order for assessments to be made to try and prevent further falls occurring or injury being sustained. We saw that two other people using the service had fallen several times in the last few months and referrals to the falls prevention team had not been made. This means equipment and other risk management procedures were not in place to minimise the risk of further falls. We have also addressed this in outcome 13 of this report.