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Inspection Summary


Overall summary & rating

Good

Updated 12 December 2018

Shrub End Lodge provides accommodation and personal care for up to six people. It is a service for people who have a learning disability and/or autistic spectrum disorder. At the time of our inspection five people were using the service. The service is a single story building with communal areas and six bedrooms. The service is set in a residential area with easy access to the local community.

People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission regulates both the premises and the care provided, and both were looked at during this inspection.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.” Registering the Right Support CQC policy

The service had a Registered Manager in post. 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.

Staff knew people well and had some training to provide appropriate care and support to people in most situations. However, they had limited understanding and training in the mental capacity act and deprivation of liberty safeguards. Consequently, people were not always supported to have maximum choice and control of their lives in the least restrictive way possible. In addition some specific care need training had not been provided to staff supporting people with specific needs, such as Dysphasia Training, where a person is at risk of choking. Consequently we have made a recommendation around these learning needs.

Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. Risks to people were identified, assessed and where appropriate reduced or discussed with people. People were cared for safely by staff who had been recruited and employed after appropriate checks had been completed. People’s needs were met by sufficient numbers of staff. The management of medicines was safe and medication was administered by staff who were competent to do so.

People were supported to develop food choices, had their nutritional and hydration needs met and had a positive dining experience . Referrals were made to health professionals when required and health needs were being met on a day to day basis.

Staff cared for people in an empathetic and kind manner. Staff had a good understanding of people’s preferences of care that met their needs.

People and their relatives were involved in the planning of their care. Care plans were sufficiently detailed about a person’s care and support needs, and reviewed on a regular basis. People were supported to follow interests and participate in social activities of their choice and preference.

The service had quality assurance systems in place to monitor and support good care and these were reviewed on a regular basis. The registered manager had processes in place to deal with complaints

Further information is in the detailed findings below

Inspection areas

Safe

Good

Updated 12 December 2018

The service remains Good

Effective

Requires improvement

Updated 12 December 2018

The service has deteriorated to Requires Improvement.

Not all staff had received MCA and DoLS training and some staff lacked understanding of the Mental Capacity Act 2005.

Staff received some training relevant to their role, although staff would benefit from some refresher training to ensure that they had up to date knowledge.

Staff felt supported and had regular supervision.

People received healthcare support and where required referrals were made to other professionals.

Caring

Good

Updated 12 December 2018

The service remains Good

Responsive

Good

Updated 12 December 2018

The service remains Good

Well-led

Good

Updated 12 December 2018

The service remains Good