Archived: Dalkeith Lodge

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.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, their relatives, the staff supporting them and from looking at records.

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

Is the service safe?

The service was safe. People were treated with respect and dignity by the staff. People told us that they felt safe. Safeguarding procedures were robust and staff understood how to safeguard the people they supported.

We inspected medication management and found that there were suitable procedures in place to ensure that people received the right medicines at the right time, with the support of appropriately trained staff.

We saw that the provider had an effective recruitment and selection procedure in place.

We found that records required to be kept to protect people's safety and wellbeing were maintained, held securely and available when required.

Is the service effective?

The service was effective. People's health and care needs were assessed with them, and they were involved in writing their plans of care. Specialist dietary, mobility and equipment needs had been identified in care plans where required. We saw that where appropriate people had signed and confirmed that they had been involved in writing them and they reflected their current needs.

Is the service caring?

The service was caring. We saw that staff interacted well with people and knew how to relate to them and how to communicate with them. People living in the home made positive comments about the staff, with remarks such as 'The staff are good'.

Is the service responsive?

The service was responsive. We found that the staff listened to people, and took appropriate action to deal with any concerns.

Records showed that the service was responsive to people's changing needs. For example, when a person felt unwell their doctor was called.

Is the service well-led?

The service was well-led. The provider and deputy manager had systems in place to provide ongoing monitoring of the home. This included checks for the environment, health and safety, fire safety and staff training needs.

We found that the five people who used the service were supported make choices and that they were listened to by the provider and their staff. People were encouraged to participate in activities of daily living, such as preparing meals and completing household tasks and we saw that they were supported to do this safely.

We found that overall people had positive experiences. The staff supporting them knew what support they needed and they respected their wishes. Care and support was delivered in a person focused manner and we saw that staff created opportunities for people to make daily choices and decisions.