Archived: Hope Lodge Limited

The service provides accommodation and personal care to three people with a learning disability and autistic spectrum.

There was a registered manager in post at the time of our inspection. 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.

People were kept safe from the possible risk of harm. Risk assessments were completed to ensure that the environment was safe and that people were protected from any avoidable risk of harm. People’s behavioural needs had been identified and appropriate measures were in place to help staff to manage behaviour which might have a negative impact upon others.

All pre-employment checks were carried out by the provider who ensured that staff were recruited safely before commencing their role. The provider had a safe system for the management and administration of medicines.

Staff received training which was appropriate to their role and had a comprehensive induction when they commenced employment. Staff understood the mental capacity act and associated deprivation of liberty safeguards (DoLs) and sought consent from people before providing care. Staff received regular supervisions and performance reviews so that they were competent in their roles. People were involved in choosing their menus and were supported to eat a balanced and healthy diet. People’s healthcare needs were met. The service worked closely with other professionals to ensure that people had the correct support to maintain their health and welfare.

People were treated with dignity and respect and cared for by staff who knew and understood their needs. People and their relatives were involved in the decision about their care and support.

People had their care needs assessed, reviewed and delivered in a way that mattered to them. They were supported to pursue their social interests and hobbies and to participate in activities provided at the home. There was an effective complaints procedure in place.

People and their relatives had their views sought by the service and were involved in the planning of their care and subsequent reviews. The service held residents meetings, sent satisfaction surveys and worked closely with other agencies involved in people’s care to ensure that they were satisfied with the service received.

The inspection team was made up of one inspector. As part of this inspection we spoke with the manager, one member of staff and one person who used the service. We looked at the care records for all three people who lived at Hope Lodge. We found that shortfalls identified during our last inspection had been addressed.

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

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

Is the service safe?

We spoke with one person who lived at the home who told us that they, "...feel safe." One relative of a person who lived at the home stated in a satisfaction survey that their relative was, "...happy and safe in your home."

We found that care was planned in a way that was intended to ensure people's safety and welfare. The individual care plans we looked at were supported by detailed assessments that identified possible risks to people, such as when they were swimming, access to the kitchen, challenging behaviour, cooking sessions and sunburn. We saw that these assessments identified triggers where applicable and steps that care workers should take to calm a situation or reduce the associated risks to people.

However, the care was not always delivered in accordance with people's care plans. The care plans for weight monitoring and healthy eating stated that people's weight should be monitored on a monthly basis but this was not always done.

People who used the service were deprived of their liberty even though this had not been authorised by the Court of Protection, or by a Supervisory Body under the Deprivation of Liberty Safeguards (DoLS). During the course of our inspection we noted that the door to the home was kept locked and people could not go out freely. In addition the doors leading to the kitchen were locked and people could not go into the kitchen area or access the garden at the rear of the building on their own. We also noted that there was a gate on the stairs to prevent one person from accessing the first floor of the building. The manager explained that it was for people's safety. People could hurt themselves in the kitchen if unaccompanied and would present a risk to themselves and others if they were to leave the home without a care worker with them. However, they had made no application under DoLS in respect of any person who lived at the home.

Is the service effective?

The person we spoke with told us that they liked living at the home. They told us that they did many activities, including bowling, swimming and cookery classes. They told us that they often, "...go out for a drive in the car."

We saw that each person had their own activities schedule and were involved in a number of activities outside of the home. These included bowling, swimming, sensory sessions, trips to a preferred fast food outlet for meals, shopping trips and outings to a local park, as well as attendance at their day centres.

A relative stated in a satisfaction survey that their relative was, "...happy and more contented..." living at the home.

Is the service caring?

When asked about the staff members at the home the person we spoke with said, "They are alright." We observed staff members as they interacted with the second person in the home who was unable to communicate with us verbally. They did this in a caring, respectful manner and clearly understood the person's needs.

One relative stated in a survey that the home provided, "...excellent care..." for their relative.

Is the service responsive?

We noted that when people asked for a drink they were either assisted to make this or it was made for them on request.

We saw that the home had undergone a two day assessment by Luton Council in February 2014 following which they had received a 'good' rating for the service provided. The manager showed us the continuous improvement plan that had been produced following the outcome of this assessment. This showed evidence that the identified actions were being completed and the action plan was being monitored.

Staff were asked for their views about care and treatment and they were acted on. We saw minutes of staff meetings which took place every two months. The minutes of the staff meeting of 27 November 2013 showed that the staff were unhappy with the service provided by the pharmacy used at that time. The manager had subsequently changed the pharmacy service provider.

Is the service well-led?

We saw that the manager completed weekly and monthly quality audits of the home's vehicle, people's finances, medicines, people's activities, health and safety, general maintenance and risk assessments. There were also weekly audits completed of staff personal records, staff training records and people's files.

We saw that the provider had completed an external audit on 14 April 2014. Their report included information on areas such as first impressions, staffing, catering, infection control, health and safety, clinical, nutrition, medicines and record keeping. The provider had identified that the carpet in the hallway and on the stairs required cleaning.

We found that people, their families and professional were satisfied with the care provided by the home. People's rights were upheld and decisions about their care and treatment respected. One person who used the service said, 'Get to do what I want, I'm happy.'

We found the home had an effective system in place to reduce the risk and spread of infection. Equipment used was regularly maintained and records seen reflected this.

There was an effective complaints procedure in place and people were provided with information in a format that met their needs.

One person said, 'I haven't had to complaint, I would say it to ' if I was unhappy, she would listen to me.'