Archived: Dalkeith Lodge

Updated 9 August 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 5 July 2016 and was announced. The provider was given 24 hours’ notice because the service was a small care home for adults with learning disabilities. People are often out during the day and we needed to be sure that someone would be in.

The provider had not had the opportunity to complete a Provider Information Return (PIR) as they had not received this document prior to the inspection. This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We looked at previous inspection reports and notifications received by the Care Quality Commission. A notification is information about important events, which the provider is required to tell us about by law.

We spoke with the provider and the deputy manager. We looked at three people’s care plans and the associated risk assessments and guidance. We spoke with two people who lived at the service. We observed how people were supported and the activities they were engaged in. We looked at a range of other records including two staff recruitment files, the staff induction records, training and supervision schedules, staff rotas, medicines records and quality assurance surveys and audits.

After the inspection we spoke with one relative via telephone to gain their feedback.

We last inspected Dalkeith Lodge on 3 July 2014 where no concerns were identified.

Updated 9 August 2016

This inspection was carried out on the 5 July 2016 and was announced.

Dalkeith Lodge is registered to provide accommodation and personal care for up to eight people. People living at the service had a range of learning disabilities. Some people had physical and sensory disabilities and occasionally required support with behaviours which challenged.

Downstairs there was a lounge, conservatory, kitchen and dining room. There was also one bedroom which was currently vacant. There were five further bedrooms on two additional floors and a bathroom and wet room. At the time of the inspection there were three people living at the service.

The provider was in charge of the day to day running of the service. The provider is a ‘registered person’. 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 provider had run the service for over 20 years. They told us the aim of the service was to promote independence and respect people’s privacy and dignity, whilst supporting them to stay safe. People and their relatives were regularly asked for feedback on the service, but other stakeholders such as healthcare professionals were not. There was no summary or publication to people, staff and stakeholders of the results, to show continuous improvement and the action the provider was taking. This was an area for improvement

The provider regularly worked alongside staff to mentor and provide guidance and assistance. The Care Quality Commission (CQC) was informed of important events within the service, in line with current legislation. The provider ensured that the quality of care was high and carried out regular audits.

There was not a written business continuity plan in place. The provider had thought about what to do in an emergency, but this had not been written down and shared with the staff team. This was an area for improvement.

Risks relating to people’s health and well being had been assessed and action was taken to minimise them. Regular health and safety checks were undertaken to ensure the environment was safe and equipment worked as required. Regular fire drills were undertaken.

Staff knew how to recognise and respond to abuse. The provider told us there had been no safeguarding issues and the local authority safeguarding team confirmed this was the case. They understood their responsibilities and who to report concerns to.

There was enough staff to meet people’s needs. People were able to do the activities they wanted and attend all of their appointments. Before staff started working at the service all the necessary checks were carried out to ensure staff were suitable to work with people.

Medicines were stored appropriately. People received their medicines when they needed it and were encouraged to be as independent as possible when taking their medicines.

Staff had received induction, training, support and supervision to support people effectively. The Care Quality Commission is required by law to monitor the operation of the Deprivation of Liberty Safeguards. Staff had up to date knowledge on the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). They supported people to make their own choices. People signed their care plans, giving consent to their care. People were able to come and go as they pleased. People were supported to eat healthily. They were involved in planning and preparing meals. Staff had sought advice and guidance from a variety of healthcare professionals to ensure people received the best care possible.

People were given the information they needed, in a format they understood so they could make day to day decisions. People completed a pictorial weather chart to help them decide what to wear. People were provided with information about advocacy services. People had been living at the service for many years and there was a small, stable staff team who knew people well.

People were treated with dignity and respect. They were supported to be as independent as possible, helping to maintain the garden and with household chores. Friends and relatives could visit the service whenever they wished.

People were involved in writing their care plans and risk assessments. They received the care they needed, in line with their wishes. People were actively involved in the local community and regularly attended church and various local clubs. People took part in a variety of activities in the home and showed us pictures of parties and BBQs that had been held.

There had been no recent complaints. People and their relatives told us they were in regular contact with staff and felt they could raise any issues if they arose.