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Inspection carried out on 7 July 2017

During a routine inspection

Garden Lodge provides accommodation and personal care for up to eight people who may have a learning or physical disability. At the time of our visit there were eight people using the service.

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

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. At the time of our inspection there was a registered manager in post.

Relatives told us the registered manager was exceptionally caring and was approachable and easy to talk to.

Without exception people and relatives we spoke with told us that staff were extremely caring. We were given lots of examples of when staff had gone the “extra mile” to show excellence in caring. All interactions we observed between staff and people were caring and respectful, with staff being patient, kind and compassionate. Feedback from relatives was exceptional, with comments like, “I have never seen a more caring group of people."

Staff demonstrated a good understanding of safeguarding and the provider’s whistle blowing procedure. This included knowing how to report concerns.

Medicines were managed safely. Records showed people received their medicines when they were due. Only trained and competent staff administered people’s medicines.

Health and safety checks were completed regularly to help keep the building safe. Up to date procedures were in place to ensure people continued to be supported in emergency situations.

The provider was meeting the requirements of the Mental Capacity Act 2008 and the Deprivation of Liberty Safeguards.

Staff told us they were well supported and trained appropriately.

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.

We saw the provider had in place comprehensive person centred plans for each person which gave staff detailed guidance on how to support people.

People had opportunities to participate in their preferred activities.

The provider carried out a range of internal and external quality assurance audits to monitor the quality of people’s care.

Inspection carried out on 2 February and 20 March 2015

During a routine inspection

This inspection took place 12 February 2015 and 20 March 2015 and was unannounced. This meant the provider did not know we were carrying on the inspection on that day.

We carried out our last inspection in October 2013. The provider during that inspection met our regulatory requirements.

Garden Lodge provides accommodation and personal care for up to eight people. The home is a purpose built house with eight bedrooms, a lounge, kitchen dining room and recently built conservatory and terrace. The home is set in its own gardens in a residential area, near to public transport routes and local shops.

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. At the time of our inspection we found the service had a registered manager in post.

The provider was meeting the requirements of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards.

People who were employed by the service had been checked by the provider to ensure they were safe to work with vulnerable adults.

We saw the staff had been trained to work with people in a positive way which protected their human rights.

The provider had put into place checks on the building to make sure people were safe.

We found staff received support from the provider using supervision, appraisal and training.

People had specialist assessments in place which recommended actions to be carried out by staff. We observed staff carrying out the required actions.

Staff promoted the well-being of people living in the home and had helped them achieve their goals.

Every member of staff that we observed showed a very caring and compassionate approach to the people who used the service. Staff spoke with great passion about their desire to deliver high quality support for people and were extremely understanding of peoples’ needs.

Using pictures and photographs staff engaged people to help them express their wishes, likes and dislikes and the activities they wanted to do. We found people were engaged in their care and the running of the home.

We saw the provider had in place comprehensive person centred plans for each person which gave staff detailed guidance on how to care for people.

Staff were able to recognise and intervene when people’s mood changed to prevent the situation from escalating and having a negative impact on them and those around them.

We saw each person had their own individual timetable of activities and people received personalised care.

Relatives told us the registered manager was approachable and easy to talk to.

The registered manager carried out a comprehensive set of audits to monitor the quality of the service. Where they found areas could be improved they were proactive in ensuring improvements were made.

We saw all records were kept secure, up to date and in good order, and maintained and used in accordance with the Data Protection Act.

Inspection carried out on 7 October 2013

During a routine inspection

We used a number of different methods, for example observing how people were supported to make decisions about their care, to help us understand the experiences of people using the service. This was because some people were unable to give us their comments directly about the care they received.

During our visit we found people were asked for their consent before they received any care or treatment and the provider acted in accordance with their wishes.

We found care and treatment was planned and delivered in a way which ensured peoples’ safety and welfare. We spoke with people about how they felt about the home. They said things like “happy here,” “very, very good,” and “home form home.” One person told us he was “happy working with (staff name) and happy at Garden Lodge.”

The provider had made suitable arrangements to protect vulnerable people and responded appropriately to any allegation of abuse. One staff said, “People who live here are very aware of how they should be treated so we have to make sure what we say and do are very clear so they cannot be interpreted as being abusive.”

The provider had taken steps to make sure people at the home were protected from staff who were unsuitable to work with vulnerable people. This was because they had carried out thorough background checks.

We found people who used the service, their representatives and staff were asked for their views about their care and treatment and they were acted on. In feedback from a survey the provider had carried out with relatives. They told us all staff were “excellent” at communicating with them and they “couldn’t agree more strongly that staff are excellent.” Other comments included. “It’s a warm feeling as you enter the building” and “Staff have a good sense of humour which I think is important.”

Inspection carried out on 12, 13 June 2012

During a routine inspection

We used a number of different methods for example observing how people were cared for to help us understand the experiences of people using the service. This was because we were not always able to get people’s direct comments about the care they received.

The assistant manager told us that most people who lived at this home could find it difficult to express their overall views about the service directly. To overcome this they had carried out surveys (in a format that people could understand) with the people who lived at the home and their relatives and / or advocates.

The most recent survey found that,

Everyone said that they were happy at Garden Lodge, they said that the staff team helped them take part in activities they liked. They liked the food, they were warm and they liked their home.

Relatives said that the homes strengths were training, dedicated staff and management, staff team work, well maintained premises, good staff ratio, good activities and holidays, and good healthcare and diets

People were happy with the support they received with their care and welfare.

During our visit we saw that staff respected people’s privacy and dignity. They were friendly and very polite and they knocked on bedroom doors before entering.

One person who lived at the home told us, “I’m going horse riding now.”

Another said, “Yes I’m fine here.”

Relatives said that staff and the manager had a really good understanding of their relative’s likes and dislikes and the home supported people to have good healthcare.

One relative said, “(Persons name) is fed better than I could ever provide at home.”

Other relatives had made comments about staff. They said things like,

“Staff have a sense of humour, I think it’s important.”

“Staff acted on (my request) immediately”

Another relative said, “The key worker is the most conscientious and caring person I know.”

Inspection carried out on 3 March 2011

During a routine inspection

The manager told us that most people who lived at this home could find it difficult to express their overall views about the service directly. To overcome this she had carried out surveys with the people who lived at the home and their relatives and / or advocates.

The most recent survey carried out by the manager in 2010 found that:-

Everyone said that they were happy at Garden Lodge, they liked the food, they were warm and they liked their home. They said that the staff team helped them and some said what activities they liked.

Relatives said that the homes strengths were training, dedicated staff and management, staff team work, well maintained premises, good staff ratio, good activities and holidays, and good healthcare and diets

Reports under our old system of regulation (including those from before CQC was created)