Villette Lodge Assessment and Re-enablement Service

We found the following examples of good practice:

• People were provided with easy read guidance around the coronavirus, infection control and how to wear PPE appropriately. People worked with staff to keep the service clean and tidy. Staff had designated processes in place for regular cleaning to reduce the risk of infection.

• There was signage around the home clearly showing how many people could access each room to allow for social distancing rules to be followed and to keep people safe. The registered manager had implemented changes to how staff worked so that there were designated areas for applying/removing PPE, processes in place to dispose of clinical waste following national time scales, zoning areas when people required to be isolated and changing where items were stored to remove the potential risk of infection.

• The provider had an adequate supply of PPE which the service could access at any time. Risk assessments were in place for the service, staff and people. Staff and people were following testing and isolation guidelines if they were required.

• People had just begun to have regular visits with relatives, and these were carried out in the garden area so that social distancing rules could still be maintained.

• Visitors to the service had their temperature checked, provided with information around safe hygiene techniques, provided with PPE if it was required, asked to use a designated hand sanitising station and completed a COVID-19 assessment before being allowed to access the service.

Villette Lodge has been developed and designed in line with the values that underpin Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning and physical disabilities using the service can live as ordinary a life as any citizen.

The home had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

At our last inspection we rated the service 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.

People who lived at the service felt safe. Relatives we spoken with also told us that they felt their loved ones were safe.

Staff had received training in safeguarding procedures and knew how to identify forms of abuse. The provider had a robust recruitment process and pre-employments checks in place, for any new members of staff. Peoples’ medicines were managed safely including the receipt, storage administration and disposal of medicines. Staff had been suitably trained and were confident in handling medicines. Regular premises and equipment checks were carried out.

Staff received regular training to support them with the necessary skills to care for people. Staff confirmed they received regular supervision sessions with their line manager.

People were supported to have a healthy and balanced diet. They told us that they enjoyed their meals and were involved with menu planning and could if they wished, have a choice of meals.

People had access to various healthcare professionals including visits to their GP, dentist and opticians. In addition, people were also supported to attend any hospital or specialist appointments.

People and their relatives were involved in the creation of care plans. Care plans were detailed and included information that supported staff to care for people in the way they wished to be cared for.

Activities were meaningful, not only in terms of social activities, but life-skills activities as well. People were encouraged to enhance these life skill activities both inside and outside of the service.

Staff told us that they enjoyed working at the service and they felt supported by the registered manager. Relatives we spoke with were complimentary about the home, the staff and the level of care their loved ones received.

The registered manager continually reviewed the quality of service provided and this included via quality assurance audits and obtaining feedback via questionnaires.

Further information is in the detailed findings below.

Villette Lodge Assessment and Re-enablement Service provide care and support for up to seven people who have learning disabilities or autistic spectrum disorders. At the time of our visit five people were using the service.

The home had a registered manager. 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.

Relatives made positive comments about the service and said people were doing well at the home. They described the service as being safe for their family member. One relative told us, “It’s very safe there for [family member], with good staff they are helping [family member] to be more independent.” One person told us, “They help me with my washing, they give me the help I need.”

One social care professional who worked closely with the home to support one person told us, “They have a good approach and work with people to keep them safe.”

Staff had a clear understanding of safeguarding and whistleblowing. They were confident any concerns would be listened to and investigated to make sure people were protected. Staff understood the process of raising a safeguarding alert and the importance of timely recording. Records were maintained of all safeguarding alerts which showed appropriate action had been taken.

Recruitment practices at the service were thorough, appropriate and safe so only suitable people were employed. Staff had received regular supervisions. However, we found some staff appraisals were out of date. The registered manager had already put plans in place to address this over the next few months, with appraisals now being undertaken.

We viewed historical and current staffing rotas. Enough staff were employed to make sure people were supported taking into account people’s one to one support. The home had a stable staff team and many were long standing members of staff. One social care professional told us, “There is always a member of staff available for me when I visit, they always have the information I need.”

Staff understood the Mental Capacity Act 2005 (MCA) regarding people who lacked capacity to make a decision. They also understood the Deprivation of Liberty Safeguards (DoLS) to make sure people are not restricted unnecessarily.

People’s choices were acknowledged. Each person had a range of social and leisure activities they could take part in. One person was attending a day service for woodworking skills. People’s dietary needs were respected and were used to develop a weekly menu which met the preferences, choices and needs of each person. People were supported to be as independent as possible, shopping for and preparing their own meals as part of the assessment and re-enablement process.

People’s healthcare needs were monitored and assessed; contact was made with other health care professionals when necessary. Staff helped people to lead a healthy lifestyle and supported them to health care appointments.

Relatives felt involved in their family member’s care and were able to speak with staff. For example one relative commented, “They have carried out the assessments they needed to, we have talked about [family member] moving on.”

People’s care records and risk assessments showed people were involved in their care. The service also followed the commissioner’s plans for assessment.

The service had systems in place to ensure medicines were managed in a safe way. Medicine Administration Records (MAR) were up to date with no gaps or inaccuracies.

Systems were in place for recording and managing safeguarding concerns, complaints, accidents and incidents. Relatives and people we spoke to knew how to make a complaint. Information was available in pictorial form on how to make a complaint. At the time of the inspection the service had not received any formal complaints.

Relatives, staff and people told us the organisation was well run and the home was well managed. Staff told us they felt the management was open, honest and approachable and the service promoted a positive culture for staff and for the people they supported. One relative told us, “I have never needed to complain but if I did I would go to the manager.”

People had accommodation which allowed privacy with lockable doors; rooms were comfortably furnished in accordance with people’s choices and preferences. The home was clean and airy with communal areas for people to sit and relax. A fully functional kitchen was available along with laundry facilities.

We saw that staff provided care in a way that demonstrated they had a good knowledge of each individual person. Where appropriate, we saw staff providing support and encouragement to the people to do things as independently as possible.

We checked care records for three people and found that they received the care and support that had been assessed, planned and agreed. We spoke with two staff members who told us that they were really well supported by their manager.

We found that staff were aware of their responsibilities to protect vulnerable adults.

The provider had an effective system to regularly assess and monitor the quality of service that people received. They also had an effective system in place to identify, assess and manage risks to the health, safety and welfare of people who used the service.

We observed how the people using the service were being supported and cared for and saw that they were happy, relaxed and comfortable as they went about the home. We saw that there were good relationships between them and the care workers who gave them practical and emotional support.

There were sufficient staff on duty to support people with their care needs. We looked at how the service recruited staff by checking five staff files. They showed that the appropriate checks and procedures were being followed.

We saw that staff provided care in a way that demonstrated they had a good knowledge of each individual person. Where appropriate, we saw staff providing support and encouragement to the people to do things as independently as possible.

Comments from a person using the service included "I go out to the pub and enjoy myself", "I get out to the shops and get what I want", "It's alright here".