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Inspection carried out on 31 January 2019

During a routine inspection

About the service: Allswell Lodge is a care home that provides personal care and accommodation for up to five adults. People living at the service have range of complex needs including learning disabilities. At the time of this inspection five people were using the service.

People’s experience of using this service:

¿ The service had safeguarding policy and procedures in place and staff had a clear understanding of these procedures.

¿ Appropriate recruitment checks took place before staff started work and there was enough staff available to meet people’s care and support needs.

¿ Risks to people had been assessed and reviewed regularly to ensure people’s needs were safely met.

¿ People were receiving their medicines as prescribed by health care professionals.

¿ The home had procedures in place to reduce the risk of the spread of infections.

¿ Assessments of people’s care and support needs were carried out before they started using the service.

¿ Staff had received training and support relevant to people’s needs.

¿People were supported to maintain a balanced diet.

¿ People are 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 support this practice.

¿ Staff treated people in a caring and respectful manner.

¿ People and their relatives [where required] had been consulted about their care and support needs.

¿ People were supported to participate in activities that met their needs.

¿No one living at the home required support with end of life care, however there were procedures in place to make sure people had access to this type of care if it was required.

¿ The home had a complaints procedure in place.

¿ The registered manager had effective systems in place to assess and monitor the quality of the service.

¿ They had worked in partnership with health and social care providers to plan and deliver an effective service.

¿ The service took people, their relatives, staff and health and social care professionals views into account through satisfaction surveys and feedback from the surveys was used to improve on the service.

¿ Staff enjoyed working at the home and said they received good support from the registered manager. Management support was always available for staff when they needed it.

Rating at last inspection: Good (Report was published on 7 July 2016).

Why we inspected: This was a planned inspection based on the last inspection rating.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit in line with our re-inspection programme. If any concerning information is received we may inspect the service sooner.

Inspection carried out on 7 June 2016

During a routine inspection

This announced inspection took place on 7 June 2016. We last inspected this service in April 2014. At that inspection we found the service was meeting all of the regulations we assessed.

Allswell Lodge provides accommodation for up to five people who require personal care and support on a daily basis in a care home setting. The home specialises in caring for adults with a learning disability. At the time of our visit, there were three people using the service full time and two people using the service for respite care at the weekends.

The home had a registered manager at the time of the inspection.. 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.

People were safe at the home. The provider took appropriate steps to protect people from abuse, neglect or harm. Training records showed staff had received training in safeguarding adults at risk of harm. Staff understood what constituted abuse and the action they would take to protect people if they had a concern.

Risks were managed so that people were protected and supported in a non-restrictive way. We saw that risk assessments and support plans were appropriate to meet people’s needs. Where risks were identified, risk management plans were in place. We saw that regular checks of maintenance and service records were conducted. This helped to keep people and the environment safe.

We observed there were sufficient numbers of qualified staff to support people and to meet their individual needs. We saw that the provider’s recruitment process helped to ensure that staff were suitable to work with people using the service.

People were supported by staff to take their medicines when they needed them and records were kept of medicines taken. Medicines were stored securely and staff received annual medicines training to ensure that medicines administration was managed safely.

Staff had the skills, experiences and a good understanding of how to meet people’s needs. Staff spoke about the training they had received and how it had helped them to understand the needs of people they cared for.

The service had taken appropriate action to ensure the requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) were followed. DoLS authorisations were in place to protect people where they did not have capacity to make decisions and where it was deemed necessary to restrict their freedom in some way, to protect themselves or others. We saw that each person’s mental capacity in respect of this decision had been assessed and the provider had applied to the local authority to verify their findings. Each person had a time specific DoLS authorisation and this was clearly displayed in the person’s care plan.

Detailed records of the support people received were kept. People had access to healthcare professionals when they needed them. People were supported to eat and drink appropriate amounts to meet their needs.

People were supported by caring staff and we observed people were relaxed with staff who knew and supported them. We saw that people had the privacy they needed and they were treated with dignity and respect at all times.

The provider had arrangements in place to respond appropriately to people’s concerns and complaints.

We saw clear evidence of a person-centred approach that was taken towards a person’s individual needs. Records showed and we saw that people’s complex needs and behaviours were managed through staff having a thorough knowledge and understanding of that person.

Staff were flexible about the activities people were involved in according to their preferences. Records showed activities were risk assessed to ensure the person and others

Inspection carried out on 7 May 2014

During a routine inspection

A single inspector carried out this inspection. The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well-led? The summary describes what staff told us, what we observed and the records we looked at. We looked at the care records of four people and spoke with three members of staff. People who used the service had complex needs and were not able to verbally communicate their needs through speech, but we saw that staff took their time to understand what people were communicating and responded appropriately to any requests made.

Below is a summary of what we found.

Is the service safe?

Assessments carried out by the staff ensured that people's needs were identified and met. Risks were assessed and reviewed regularly to ensure people's individual needs were being met safely. We reviewed the care plans of four people who used the service and saw these were person centred and represented the needs of the person. People were supported to take their medicines in a safe way. This meant that people were cared for and safe. Policies and procedures were in place to assess and monitor that the service was prioritising people's safety. Staff had undertaken training on the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards and understood how this could impact on the people they cared for.

Is the service effective?

People received effective care from staff that were trained and supported by the manager. We saw that clear information was available to people which helped them understand the care and treatment that was being delivered to them. As far as it was possible people and their families were involved in assessments of their health and care needs. Where people did not have the capacity to understand the process then professionals that supported people were asked for their guidance and advice.

Is the service caring?

The service was good and caring. This was confirmed by our observations of the interaction between staff and people. Staff respected peoples' privacy, dignity and their right to be involved in decisions and make choices about their care and treatment. Care plans we viewed detailed people's individual preferences, so that staff knew people's individual wishes. We asked one person who used the service if they liked the staff and they smiled, indicating that they did.

Is the service responsive?

People's needs were reassessed on a regular basis and we saw the service responded to any changing needs. People had access to other services and to professionals who worked with the provider and staff for the benefit of people who used the service.

Is the service well-led

The home had a registered manager who was experienced and knew their staff and people well. People who used the service did not have the ability to be involved in a formal survey and most did not have families who could be asked for their opinion about the care their relative received. This meant that the provider could not conduct the usual type of written questionnaire with people. Instead senior staff conducted a ‘Dignity and Care’ observation survey over a one month period. They looked at how staff and people worked together, the environment, meals times, personal care delivery, respecting people and communication. The findings were discussed as a team and an action plan with time scales written. This meant that people through observation could give their opinion as to the care they received. Staff had access to training and felt supported to deliver their duties and to raise any concerns that might occur.

Inspection carried out on 18 June 2013

During a routine inspection

At the time that we visited there were three people living at Allswell Lodge on a permanent basis and one person regularly using the respite service. We used a number of different methods to help us understand the experiences of people using the service because most of the people who lived at Allswell Lodge had complex needs, which meant they were not always able to communicate with us.

Through the use of Short Observational Framework for Inspections (SOFI) we were able to observe that people's experience of the service was a positive one. During our inspection we saw staff always treated people with respect and dignity and people were supported to make informed decisions about how they lived their lives. We also gathered evidence of people's experiences of the service by speaking to the registered manager and other staff who worked in the home and reviewing various records the provider was required to keep.

We saw that policies and procedures had been put in place to ensure the safety and well-being of people using the service and we saw evidence of a quality assurance system regularly monitored by the provider.

Inspection carried out on 4 October 2012

During a routine inspection

At the time that we visited there were three people living at Allswell Lodge on a permanent basis and one person regularly using the homes respite service. We used a number of different methods to help us understand the experiences of people using the service because most of the people who lived at this care home had complex needs, which meant they were not always able to verbally communicate with us in a meaningful way.

Through the use of Short Observational Framework for Inspections (SOFI) we were able to observe that people's experience of the service was a positive one. We also gathered evidence of people’s experiences of the service by speaking to the services owner/manager and other staff that worked in the home and reviewing various records the provider is required to keep.

It was evident from the practices we observed during our review that the people using the service were well supported by the staff that worked there and treated with respect.