Archived: Beulah Lodge

At the last inspection in 2015, the service was rated "Good". At this inspection we found the service remained "Good".

People living in the home were protected from abuse and foreseeable harm. They felt safe. There was a sufficient number of staff to support people safely, meet their needs and support them to go out into the community. The provider ensured staff had the necessary training, skills and experience to support people effectively.

Staff obtained people's consent before providing care or support. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice. People received care which met their individual needs from a consistent staff team who knew them well and were kind and caring.

People were satisfied with the quality of their meals and told us they had a sufficient amount to eat and drink. Staff supported people to maintain good physical and mental health and liaised well with outside social and health care professionals. There were appropriate arrangements in place to ensure medicines were stored, administered and disposed of safely. People were supported to take their medicines as prescribed.

People were supported to be as independent as they could be. People were enabled to participate in a variety of activities inside and outside of the home. They were also encouraged and assisted to keep in contact with their family and friends which helped to ensure they did not become socially isolated.

People were given opportunities to feedback on the care they received. They felt able to complain if the need arose. The registered manager listened to and used feedback to improve the quality of care people received. There were appropriate systems in place to assess and monitor the quality of care people received. The home was well organised and managed.

Further information is in the detailed findings below.

During the inspection we spoke with four people using the service, two of their relatives, two members of staff, the manager and provider. We also reviewed records, policies and procedures. We looked at four people's care plans and five staff files.

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

Is the service safe?

People using the service told us they felt safe. There was information in communal areas throughout the home for people using the service, their visitors and staff on how to make a complaint. The service had appropriate safeguarding policies and procedures in place which staff were familiar with and understood. The majority of staff had received training in safeguarding vulnerable adults. Staff we spoke with had good knowledge about the types and signs of abuse and what to do if they had concerns about the safety of people using the service.

Staff had received training in the Mental Capacity Act 2005. The home had appropriate policies and procedures in relation to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS) to guide and support staff. There were no people using the service at the time of our visit who required a review of their needs under the DoLS procedures.

However, we were concerned that not all the people using the service had up to date risk assessments. We also found people's risk assessments were not personalised and did not state how obvious risks should be managed. There was a risk of people receiving care or treatment which was inappropriate or unsafe.

We have asked the provider to improve the way they assess people's needs and plan and deliver care to ensure people's welfare and safety.

Is the service effective?

The care plans we reviewed reflected people's preferences and hobbies as well as health, dietary, mobility and equipment requirements. The records we reviewed demonstrated people's care was delivered in accordance with their care plan. People using the service were satisfied with the quality of care they received. Comments we received included, 'I'm comfortable here. I want to stay here until the end of my life", 'I really like it here because I feel happy" and 'I love the people here, I can please myself with what I do." Relatives told us, 'They (the staff) are wonderful" and 'I'm very happy with the way X is looked after."

People's rooms were decorated and furnished to suit their personal taste, and reflected their social interests. A range of activities were available to people inside and outside the home. People were supported to gain access to the community. People told us, 'I went on holiday in May and I enjoyed it." 'I don't go out much but if I wanted to I'd ask the staff" and 'I enjoy the activity room. I like bingo and karaoke."

Is the service caring?

We observed people being treated with dignity and respect by staff. Staff were attentive and patient throughout our inspection visit. People using the service told us the staff were always like that. People using the service commented, 'The staff are nice, they are very caring.' 'the staff care about me and look after me well." Relatives told us, 'They (staff) do far more than they need to" and 'the staff are very caring."

People's care was organised so as to ensure a continuity of care. The service worked well with other healthcare professionals and social groups to ensure people's health and social needs were met.

Is the service responsive?

People using the service and their relatives were involved in their care planning. The service was sufficiently flexible to respond to people's unplanned for needs. Relatives told us the manager was in regular contact with them to discuss issues concerning people using the service and to get their views.

We saw that the views of people using the service, their relatives and staff were regularly sought by the manager in a variety of ways. People were aware of how to make a complaint if they were unhappy with their care and were confident that staff would respond to their requests. There were systems in place to ensure that staff were able to learn from incidents and complaints.

Is the service well-led?

The manager had effective systems in place to monitor the quality of care people received. There were effective recruitment and selection processes in place and appropriate checks were carried out on staff before they began to work with people using the service.

However, we were concerned that staff were not appropriately supported in relation to their responsibilities by receiving appropriate training relevant to the work they perform. We have asked the provider to improve the way they support their staff.

They told us they could talk to staff about their concerns and they were confident staff would take their concerns seriously and would do something about them.

People were observed to be treated with respect by staff and to have their privacy and dignity respected.

People were supported in promoting their independence and community involvement. People told us they were given opportunities to express their choices and to make decisions in their daily lives.