Liversage Court Residential Home

The last ratings assessment of Liversage Court Residential Home was published 16 April 2019; the overall rating was Good. At this assessment the overall rating for Liversage Court Residential Home is Requires Improvement. This is based upon the findings at this assessment.

This assessment was carried out due to the length of time since the last rating.

Risks to people’s safety were not always effectively managed. Infection prevention and control practices were not sufficiently robust; medicines were not always managed safely, and environmental risks had not been fully identified or mitigated. Staffing deployment did not always support safe care, and some risks, including falls, were not consistently managed. Not all staff had completed all relevant training. These issues resulted in a breach of regulations relating to people’s safe care and staffing.

The environment and infection control arrangements did not always support people to remain safe. We identified a number of environmental risks, including unsafe access to some areas, maintenance issues and equipment that was not always functioning or appropriately set to meet people’s needs. Infection prevention and control systems were not effective, with concerns identified in relation to cleanliness, equipment and storage practices, despite people and relatives describing the home as generally clean. The provider took action to address concerns when raised; however, governance systems had not identified these issues.

Governance systems were not sufficiently effective to ensure the quality and safety of the service were consistently monitored and improved. Although audits and monitoring processes were in place, these did not reliably identify or address concerns identified during the assessment, including infection control, medicines management and care planning. In addition, required notifications had not always been submitted. These issues demonstrated a lack of effective oversight and resulted in a breach of regulation relating to governance.

People told us they felt safe and were generally supported to access healthcare services and maintain their health. Staff sought people’s consent and worked with external professionals appropriately. However, care was not always planned or delivered in line with best practice. Care records were not consistently accurate or detailed, people were not always involved in regular reviews and some clinical risks, including diabetes management and fluid monitoring, were not fully robust. Best interests’ decision-making was not always fully evidenced. These issues resulted in a breach of regulations relating to consent and person-centred care.

Privacy was not always respected. Information was not always kept confidential. This resulted in a breach of regulation relating to dignity and respect.

Although leadership was described as approachable and there was a generally positive culture, systems to drive improvement and learning were not always effective.