Archived: St Ann's Lodge

The service provides personal care and support for up to six people within a small care home setting. It specialises in providing care to people who have a learning disability. There were six people using the service at the time of our inspection. There is an adjoining small care home next door, St Ann's Lodge 2 run by the same provider. The registered managers of both services are both directors and work closely to run the two services together and people and staff can move between both services through an interconnecting door. We inspected both services on the same day. We have produced separate inspection reports as the two homes are registered separately and the similarities between the two are reflected in the two inspection reports.

There was a registered manager in place. 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.

Although the service operated some good medicines management practices the service was unable to account for all medicines which should have been in stock. This was because the service did not keep accurate records of medicines people took out and returned to the service when on social leave. This meant we could not always verify all people received their medicines as prescribed as we were unable to complete some medicines stock checks. The registered manager told us they would improve recording processes to rectify this issue immediately.

Staff understood how to recognise abuse and how to report any concerns they had relating to this. People had appropriate risk assessments in place with suitable risk management plans to manage the risks to them. The premises and equipment were maintained safely.

There were enough staff to meet people’s needs and the manager followed a robust recruitment process so that only suitable staff worked with people at the service.

The registered manager understood their requirements under the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS). DoLS provides a process to make sure that people are only deprived of their liberty in a safe and correct way, when it is in their best interests and there is no other way to look after them. The registered manager had assessed which people required DoLS and made the necessary applications as part of keeping them safe. However, although staff had received training in the MCA and DoLS they did not always understand their responsibilities in relation to these acts. When we raised this with the provider they told us they would put in place extra support for staff to help them achieve a better understanding.

People received a choice of food and drink and people received the right support in relation to their dietary needs. Staff also supported people to monitor and maintain their health and people had access to the healthcare professionals they needed.

Staff received a range of training, much of which was specific to the needs of the people with a learning disability they worked with, to help them to carry out their roles and understand people’s needs. The registered manager supported staff well through a programme of individual supervision and annual appraisal.

Staff understood the people they were working with including their needs and backgrounds and this information was recorded in care plans to guide staff in the best way to support people. Staff supported people to be as independent as they wanted to be and to take part in activities they were interested in. People were involved in making decisions about and reviewing their own care. Care plans contained accurate information about people's needs and the registered manager kept these under review. People, their relatives and staff were involved in the running of the care home. Healthcare professionals fedback to us that the service was particularly caring and well-led.

There was a suitable complaints system and relatives had confidence the manager would resolve any issues they rose with them. The manager and staff had a good understanding of their roles and responsibilities.

People we spoke with told us they were happy living in the home. One person told us "I love it here and I have a nice room". People's needs were assessed and care and support was planned and delivered in line with their individual care plan.

We saw that the provider had established good links with social services and health services, with regular contact with social workers, GPs, Dentists and pharmacists. We looked at a sample of medication administration record sheets and found these to be accurate and up to date, together with the signature of the person administering the medication.

The provider had a copy of the multi-agency guidance regarding safeguarding vulnerable adults. We saw records which confirmed that staff had completed training in safeguarding through the local authority. People who use the service told us that they felt safe living at the home.

Appropriate checks were undertaken before staff began work and there were effective recruitment and selection processes in place. People who use the service, their representatives and staff were asked for their views about their care and support and they were acted on.

People who use the service said they were "happy living at St Ann's Lodge", saying "it's nice here, I like it", "I have all I need in my room", "I can go out where I want", "my friends and family come to visit and I go to see them", I go out to the day centre" and "staff listen and give me the help I need". One person told us the best thing about being at the home was the holidays while another person thought the best thing was living with their friends and doing the things they wanted.

We saw staff speak with people appropriately, calling them by their name and knocking before they entered bedrooms. The owners and staff clearly knew people who lived at the home very well, knowing their needs and how best to meet them.