Archived: Pelham Lodge

Below is the summary of what we found. The summary describes what we observed, the records we looked at and what people using the service and staff told us.

If you want to see the evidence that supports our summary please read the full report.

During our visit we spoke with five people who used the service and four members of staff including the person in charge. The registered manager was unavailable on the day of our visit.

Is the service safe?

Before people received any care or support they were asked for their consent and the provider acted in accordance with their wishes. We found staff gained consent verbally, and used Makaton sign language before they delivered care or gained access to a person's individual space. We also found written consent on the care files we looked at.

Makaton is a language programme that uses signs and symbols to help people to communicate.

We found each person who used the service had their own care plan, support plan, health plan and medication file, which contained relevant information to help staff support each individual accordingly.

We found staffing levels were sufficient to support people who used the service. The staff on duty during our visit matched the staff on the rota. We saw pictures and named staff were listed on a noticeboard outside the office, so people who used the service could identify the people who were supporting them that day. One staff member told us the level of staff had improved in the last few months. They said, 'New staff had been recruited and this ensured the service was staffed at the appropriate level to support each individual as required."

The provider told us they ensured all relevant appliances were safe and in good working order.

Is the service effective?

People told us they were able to make choices in what they wanted to do each day. One person said, 'I like to go out each day.' Another person said, 'I get up when I want.'

We found each plan of care was person centred. We saw it was recorded, where relevant, what care and treatment was required and how this should be delivered.

The person in charge told us they used an advocacy service to support people to have their say and get their views heard.

Is the service caring?

We observed staff encouraging people who used the service to complete tasks and activities at their own pace. One member of staff told us each person had their own activities programme and showed us an example of what this entailed.

Staff we spoke with told us they asked people's consent before they delivered care or came in close contact with them while care was delivered.

Is the service responsive?

We found people received their medication as prescribed by the doctor. We saw measures for making sure medicines were safely managed and staff had the information available to them to support the need to make sure medicines were handled safely. One person told us they always got their medicine on time.

During our visit one person became agitated and showed signs of a behaviour outburst. Staff responded to these signs and intervened appropriately and in a timely manner.

Is the service well-led?

We looked around the home and saw people who used the service had had their bedrooms redecorated. Each room had been personalised to the individual's personal taste. We saw new furniture had been purchased for the lounge and dining area.

We saw relevant checks were taking place to ensure the premises, equipment and vehicles were safe for people who used the service.

There were arrangements in place in case of emergencies. We saw a business continuity plan which gave staff step by step instructions of who to contact and when and where they should take refuge in the event of an emergency.

We found care was planned and delivered in a way which meant that people's individual needs were identified and met. This meant the staff were caring and responsive to people's needs. One person told us, "They help me when I need help."

The arrangements for making sure medicines were safely managed could be better and we found staff did not always have the information and knowledge they needed to make sure medication was handled safely and that people were protected from avoidable risks. People we spoke with told us they always got their medicines on time. One person commented, "I have lots of tablets, I get them on time; never miss."

We found the provider and manager had made improvements to the environment and had established new systems for checking the service was safe and that people received a good quality of service. People we spoke with liked living at the service.

There had been improvements in the standards of cleanliness and hygiene when we inspected this time, but the records did not provide evidence that cleaning was undertaken regularly. We saw that issues we had raised in our previous report had not been acted on. This meant the accommodation was not comfortable and pleasant for people living at the service.