We carried out an unannounced inspection of Lumb Valley Care Home on 4 and 5 June 2018.

At the last inspection in January 2016, we rated the service as good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At this inspection, we found the service remained Good.

At the time of our inspection, the manager was not yet registered with the Care Quality Commission (CQC). However, following the inspection we were notified that the application to register the manager with CQC had been approved. 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.

Lumb Valley care home is registered to provide accommodation, personal care and support for 22 people. Lumb Valley care home is located in the area of Lumb in Rossendale. The accommodation consists of communal areas and single and twin-bedded rooms on three floors with stair lift access; there is a separate unit for people living with dementia. There are accessible gardens and safe patio areas and a small car park for visitors and staff. At time of the inspection there were 16 people accommodated in the home.

People were happy with the care they received and made positive comments about the staff. They told us they felt safe and happy in the home and were comfortable in the company of staff. Staff understood how to protect people from abuse.

The information in people's care plans was sufficiently detailed to ensure they were at the centre of their care. People's care and support was kept under review and they were involved in decisions about their care. Risks to people's health and safety had been identified, assessed and managed safely. Relevant health and social care professionals provided advice and support when people's needs changed.

The home was a clean and comfortable place for people to live in. Appropriate aids and adaptations had been provided to help maintain people's safety, independence and comfort. Further improvements to the home were planned.

A safe recruitment procedure was followed and arrangements were in place to make sure staff were trained and competent. People considered there were enough staff to support them. People received their medicines when they needed them. Staff administering medicines had received training and supervision to do this safely.

People had 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. Staff respected people's diversity and promoted people's right to be free from discrimination. People's dignity and privacy was respected and upheld and staff encouraged people to be as independent as possible.

People had access to suitable activities. People were given a choice of meals and staff knew their likes and dislikes. People's nutritional needs were monitored and reviewed. People told us they were happy and knew how to raise their concerns and complaints; they were confident they would be listened to.

There were effective systems for assessing, monitoring and developing the quality of the service. People and their relatives were consulted around their care and support and their views were acted upon.

Further information is in the detailed findings below.

We carried out an unannounced inspection of Lumb Valley care home on the 21 and 22 January 2016.

Lumb Valley care home is registered to provide accommodation, personal care and support for 22 people. Lumb Valley care home is located in the area of Lumb in Rossendale. The accommodation consists of single and twin-bedded rooms. Communal lounges and dining room are located on the ground floor. There is also a small car park for visitors and staff. At the time of the inspection there were 19 people accommodated at the home.

The service was last inspected in October 2013 and was found compliant in all areas inspected. At the time of this inspection there was a registered manager employed. 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.

The service had recently been awarded fifth place in the top 20 recommended care homes in North West England by the Care Home Awards 2015. The Top 20 Care Home Awards 2015 highlight the most recommended care homes in each region of the UK. The Awards are based on over 45,000 reviews received from residents, family and friends of residents during 2014.

Throughout this inspection we received positive feedback from people who used the service, visitors and community professionals. People expressed satisfaction with the service provided and spoke very highly of the staff that supported them. Comments included, “They are very caring here, staff get very passionate about the people they care for” and “I have nothing to complain about. I really like living here”.

We noted the service had robust processes and procedures in place to maintain a safe environment for people accessing the service and for staff and visitors. The service had detailed and up to date health and safety checks which covered areas such as electrical safety, use of stairs, use of bathrooms, workplace safety, gas supply and appliances.

We noted audits on equipment and furnishings were done on a monthly basis. These audits included bedrooms, lounge, stairs, garden area, stair lift and hoists. We saw the service had a robust fire procedure and each person living at the service had a personal evacuation plan. We noted the service was compliant in a recent fire safety audit carried out by the local fire service. However, we noted that bedroom doors were not numbered. Therefore, this could have an impact on the identification of people by the emergency services should they be called to the service at any time.

People using the service told us they felt safe living at the home. Visitors were also confident that their relatives were in a safe place. We noted robust safeguarding procedures were in place and staff showed a good understanding around recognising the signs of abuse. Staff had also undertaken safeguarding training.

At the time of inspection we found the service had adequate staffing levels. Staff told us they had adequate time to undertake the caring role effectively. People told us their needs were met appropriately and staff had time to sit with them. We observed a good level of staff interaction to support this.

We found the service had a good recruitment system in place. However we noted the service needed to make provisions for dates of employment to be documented throughout the application form. We found the service required all new staff to undertake a thorough twelve week induction process.

The service had processes in place for the appropriate administration of medication. Staff were adequately trained in medication administration. Medication was stored safely and in line with current guidance.

We saw the service had created detailed individual risk assessments for all people using the service. These risk assessments include

People using the service told us that they liked living at Lumb Valley and were satisfied with the care and attention they received. One person said, “I’m really comfortable, the staff are very good and I’m well looked after.”

We found that suitable arrangements were in place for the safe keeping and handling of medicines.

We saw that the home was warm, well ventilated and generally well maintained. . One person said, “I’ve got a nice bedroom and it’s clean.”

We noted that recruitment procedures were thorough in order to protect people from the employment of unsuitable staff.

Complaints were taken seriously and investigated. People told us they felt confident to make a complaint should the need arise.

At the last inspection of 9 July 2012 we found that staffing levels at night were insufficient to meet the needs of people using the service and new members of staff were not receiving induction training. These were serious concerns and warning notices were issued. This inspection was carried out to check that action had been taken to achieve compliance with these issues.

We found that staffing levels had been increased throughout the night and during the day in order to ensure the needs of people using the service were met.

We saw that a thorough induction programme was in place for new employees. The care workers on duty told us they felt supported by the manager and the increased staffing levels meant she had time for regular one to one supervision meetings with them.

This inspection was carried out in response to information of concern we received about staffing levels and staff training.

We found that on several occasions at night people were at risk of receiving inappropriate and unsafe care because of inadequate staffing levels.

We noted that recently employed and inexperienced care workers had not been given any training for their role. This also put people at risk of receiving inappropriate and unsafe care.

Since the last inspection of December 2011 improvements have been made and the provider has complied with the warning notices issued in respect of staff training and monitoring the quality of the service.

All the people we asked told us they were satisfied with the care provided. One person said, “They really look after you, the care is excellent.” Another person said, “The staff are very good and I choose what to do, I get up at 6.30am.”

People using the service and their relatives were involved in planning their care in order to ensure people were cared for in the way they preferred.

We observed members of staff attending to people in a professional and courteous manner.

People using the service were consulted about the care and facilities provided at the home and were given the opportunity to express their views at monthly meetings. One person said, “We can air our views at the meetings.”

All members of staff have received the training they needed in order to provide safe and effective care for people using the service.

We asked several people for their views about the home. One person said they were happy living at Lumb valley. Another person told us members of staff were polite. One person told us that the staff needed to listen to the views of people living in the service more clearly.

We found that privacy and dignity for people in shared rooms was compromised. Independence was not always promoted for people because of the location of their bedrooms and an unsuitable lock on the bathroom door.

We have visited Lumb Valley on two occasions this year and have found only minimal improvements have been made to the premises since the last inspection. Most of the bedroom carpets were badly stained and the bath hoist seat was cracked and badly stained.

Our observations and findings indicated people were not always receiving appropriate support or person centred care. People’s weight could not be properly monitored because the scales were old and unsuitable for some people. Care records were not kept up to date which meant people were at risk of inconsistent and inappropriate care.

Training for members of staff was inadequate and meant that a care worker qualified to administer first aid was not always on duty. None of the staff had received training in infection control training and one of the cooks did not have a food hygiene certificate. Staff told us that they planned the menus, that food was home cooked and offered a choice of options. People living at Lumb Valley told us the food was generally good.

People told us that they liked living at the home. One person said,"The staff are very good, I don't have to wait when I need attention." Another person said, "The staff help me and I can choose when to get up and go to bed."

We asked several people what they did all day and were told there was nothing to do. One person said, "We used to play bingo but we don't do it now."

All the people we asked told us they had enjoyed their lunch and the meals were good.

One visitor said the staff were considerate and she was impressed with the care.

We spoke with three people who lived in the home about their medicines. One person that was looking after their own medicines said care workers supported them to do this safely and they gave the right amount of support. This person said care workers were really kind, helpful and fun and they always made sure they always got fresh supplies of medicines on time. They also said the care workers would do anything he asked of them including cooking food that they had bought for themselves.

The same person said staff always gave them their medicines on time including one of their tablets that needed to be given earlier so that it would work properly.

Another person that had severe pain problems said their medicines were always given to them properly and care workers always made sure the GP and nurses visited regularly to make sure they were getting the best treatment.

We spoke with a person that needed a special diet to help manage their diabetes and they said care workers helped them do this. They also said that staff helped them manage their medicines and blood tests and that this was done properly.

People living at the home told us that Lumb Valley was a comfortable place to live. One person said, "I like my bedroom it's grand and I have some of my own things." Another person said, "I like my bedroom it's smashing."

People told us the staff were very nice and they were looked after.