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Mount Lodge Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 19 December 2018

This inspection took place on the 25 and 29 October 2018 and the first day was unannounced.

Mount Lodge is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

The home was registered to provide personal care and accommodation for up to 15 young adults with mental health and emotional needs. At the time of the inspection there were 13 people living there.

At the time of this inspection the registered manager had applied to de-register. The trainee service manager told us they would be applying to register with CQC as the registered manager and was in the process of completing their application. They were at the home for the inspection and were responsible for the day to day management of the home. A registered manager is a person who has registered with 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.

During the inspection there was considerable discussion about how the staff saw their role in supporting people to be independent and work towards moving from a care environment to living with support or independently in the community. Since the last inspection there has been more involvement of mental health professionals within the organisation. A psychotherapist was employed in the last year and the provider plans to employ a psychiatrist to work as part of the staff team, to offer people additional support. As part of the changes there have been ongoing discussions with CQC about the regulated activities that Mount Lodge is registered to provide. Staff spoke about moving away from support with personal care and some staff explained as recovery practitioners they were not trained to provide this. We found the focus was moving towards a supported living service rather than a residential care home and staff agreed they were moving away from 'care' towards independence. However, Mount Lodge is currently registered to provide the regulated activity 'accommodation for person who require nursing or personal care'. The expectation was they would offer this to people living in the home and the service has been inspected as a residential care home.

Consequently the rating of Good from the last inspection has changed to an overall rating of Requires Improvement as improvements were needed in some areas with regard to the services current registration.

The quality assurance and monitoring system was not effective. Although audits looked at all areas of the services provided they had not identified the concerns we found during this inspection. For example, the home was not well maintained, staff had not followed the fire risk assessment and there were not enough staff consistently working at the home, with the skills to offer support when people needed it. For example, agency staff.

From August 2016 all organisations that provide NHS care or adult social care are legally required to follow the Accessible Information Standard. The standard aims to make sure that people who have a disability, impairment or sensory loss are provided with information that they can easily read or understand so that they can communicate effectively. Staff said people could communicate their needs and were aware that people’s changing behaviour was a form of communication.

We recommend appropriate training is provided to enable staff to have a clear understanding of AIS.

Staff had attended training in the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards and were aware of current guidance to ensure people were protected. DoLS applications had been requested when needed to ensure people were safe. People were protected f

Inspection areas

Safe

Requires improvement

Updated 19 December 2018

The service was not consistently safe.

The premises were not well maintained and the provider had not ensured equipment was safe to use.

There were not enough staff working in the home that understood people�s needs enough to provide appropriate support when needed.

Medicines were administered safely and administration records were up to date. Staff had attended safeguarding training and demonstrated an understanding of abuse and how to protect people.

Risk to people had been assessed and there was guidance for staff to follow to ensure people�s safety.

Recruitment practices were robust and only suitable staff were employed.

Effective

Good

Updated 19 December 2018

The service was effective.

Staff had attended training for Mental Capacity Act 2005 and Deprivation of Liberty and were aware of current guidelines and their responsibilities.

Relevant training was provided to ensure staff had a good understanding of people�s needs and the support they wanted.

People decided with staff what shopping was needed and they were assisted to cook healthy meals.

People were supported to see health and social care professionals when they needed to.

Caring

Good

Updated 19 December 2018

The service was caring.

Staff provided the support people wanted and treated people with respect.

People made decisions about all aspects of their day to day lives and chose where and how to spend their time.

People maintained relationships with relatives and friends and, with people�s permission, they were involved in discussions about the services provided.

Responsive

Good

Updated 19 December 2018

The service was responsive.

People received support that was based on their wishes and preferences.

People made decisions about all aspects of the support they received.

A complaints procedure was in place and people knew how to raise concerns.

Well-led

Requires improvement

Updated 19 December 2018

The service was not consistently well-led.

The quality assurance and monitoring system was not effective.

Feedback was sought from people and staff through regular meetings.

The provider informed CQC of incidents that affected people in line with current legislation.