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Inspection Summary


Overall summary & rating

Good

Updated 15 January 2016

We inspected Ann Charlton Lodge on 18 November 2015. This was an unannounced inspection which meant that the staff and provider did not know that we would be visiting.

Ann Charlton Lodge provides care and accommodation to people who have multiple sclerosis or related conditions of the nervous system. At the time of the inspection 24 people were using the service.

It is a detached, single storey; purpose built facility, which is situated in a residential area of Redcar. There are wheelchair accessible gardens surrounding the building.

The home 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.

There were systems and processes in place to protect people from the risk of harm. Staff were able to tell us about different types of abuse and were aware of action they should take if abuse was suspected. Staff we spoke with were able to describe how they ensured the welfare of vulnerable people was protected through the organisation’s whistle blowing and safeguarding procedures.

Appropriate checks of the building and maintenance systems were undertaken to ensure health and safety.

Risks to people’s safety had been assessed by staff and records of these assessments had been reviewed. Risk assessments had been personalised to each individual and covered areas such as moving and handling, choking, falls and behaviour that challenged. This enabled staff to have the guidance they needed to help people to remain safe.

We saw that staff had received supervisions and appraisals. Supervision is a process, usually a meeting, by which an organisation provides guidance and support to staff. The registered manager said that they were increasing staff supervision to six times yearly (currently four times yearly) in line with the requirements of the local authority.

Staff had been trained and had the skills and knowledge to provide support to the people they cared for. People told us that there were enough staff on duty to meet people’s needs.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that as far as possible people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible.

People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. The application procedures for this in care homes and hospitals are called the Deprivation of Liberty Safeguards (DoLS).

General capacity assessments were available for inspection. However, these were not decision specific, for example in relation to finance, health or medication amongst others. The registered manager was aware of the need to develop such decision specific capacity assessments. At the time of the inspection the registered manager had assessed two people as being deprived of their liberty and was to make applications to the local authority in respect of this.

We found that safe recruitment procedures were in place and appropriate checks had been undertaken before staff began work. This included obtaining references from previous employers to show staff employed were safe to work with vulnerable people.

Appropriate systems were in place for the management of medicines so that people received their medicines safely.

There were positive interactions between people and staff. We saw that staff treated people with dignity and respect. Staff were attentive, respectful, patient and interacted well with people. Observation of the staff showed that they knew the people very well and could anticipate their needs. People told us that they were happy and felt very well cared for.

We saw that people were provided with a choice of healthy food and drinks which helped to ensure that their nutritional needs were met. People were weighed on a regular basis and nutritional screening had taken place.

People were supported to maintain good health and had access to healthcare professionals and services. People were supported and encouraged to have regular health checks and were accompanied by staff to hospital appointments.

We saw people’s care plans were very person centred and described their care and support needs. These were regularly evaluated, reviewed and updated. We saw evidence to demonstrate that people were involved in all aspects of their care plans.

People’s independence was encouraged and their hobbies and leisure interests were individually assessed. We saw that there was a plentiful supply of activities and outings. Staff encouraged and supported people to access activities within the community.

The registered provider had a system in place for responding to people’s concerns and complaints. People were regularly asked for their views. People said that they would talk to the registered manager or staff if they were unhappy or had any concerns.

There were systems in place to monitor and improve the quality of the service provided. We saw there were a range of audits carried by the registered manager. Where issues had been identified action plans with agreed timescales were followed to address them promptly. We also saw the views of the people using the service were regularly sought and used to make changes.

Inspection areas

Safe

Good

Updated 15 January 2016

The service was safe.

Staff we spoke with could explain indicators of abuse and the action they would take to ensure people’s safety was maintained. This meant there were systems in place to protect people from the risk of harm and abuse.

Records showed recruitment checks were carried out to help ensure suitable staff were recruited to work with people who lived at the service.

There were arrangements in place to ensure people received medication in a safe way.

Effective

Good

Updated 15 January 2016

The service was effective.

Staff received training and development, supervision and support from their registered manager. This helped to ensure people were cared for by knowledgeable and competent staff.

People were supported to make choices in relation to their food and drink. Nutritional assessments were in place and people were regularly monitored for any weight loss.

People were supported to maintain good health and had access to healthcare professionals and services.

Caring

Good

Updated 15 January 2016

The service was caring.

People were supported by caring staff who respected their privacy and dignity.

Staff were able to describe the likes, dislikes and preferences of people who used the service and care and support was individualised to meet people’s needs

Responsive

Good

Updated 15 January 2016

The service was responsive.

People who used the service and relatives were involved in decisions about their care and support needs.

People also had opportunities to take part in activities of their choice inside and outside the service. People were supported and encouraged with their hobbies and interests.

Any concerns or complaints were taken seriously.  People told us they felt comfortable in speaking with any staff or the registered manager if they had cause to make a complaint.

Well-led

Good

Updated 15 January 2016

The service was well led.

The service had a registered manager who understood the responsibilities of their role. Staff we spoke with told us the registered manager was approachable and they felt supported in their role.

People were regularly asked for their views and their suggestions were acted upon. Quality assurance systems were in place to ensure the quality of care was maintained.