We carried out a review of the data available to us about Harold Lodge on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Harold Lodge, you can give feedback on this service.
Harold Lodge is a care home providing care for 4 people. At the time of our inspection there were 4 people using the service. The home is on 2 floors, bedrooms are on the ground floor and the 1st floor. Other facilities such as the kitchen and lounge area are on the ground floor.
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
People's experience of using this service and what we found
Right Support:
The service supported people to have the maximum possible choice, control and independence be independent and they had control over their own lives. Staff supported them in the least restrictive way possible and in their best interest; the policies and systems in the service supported this. Staff focused on people’s strengths and promoted what they could do, so people had a fulfilling and meaningful everyday life. The service gave people care and support in a safe, clean, well equipped, well-furnished and well-maintained environment that met their sensory and physical needs. Staff enabled people to access specialist health and social care support in the community.
Right Care:
People could communicate with staff and understand information given to them because staff supported them consistently and understood their individual communication needs.
People’s care, treatment and support plans reflected their range of needs and this promoted their wellbeing and enjoyment of life.
People could take part in activities and pursue interests that were tailored to them. The service gave people opportunities to try new activities that enhanced and enriched their lives.
Right Culture:
People received good quality care, support and treatment because trained staff and specialists could meet their needs and wishes.
The service enabled people and those important to them to work with staff to develop the service. Staff valued and acted upon people’s views.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 10 February 2020) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
At our last inspection we made 2 recommendations, for the provider to seek guidance on reviewing care plans and good governance, the provider had made improvements in these areas.
Why we inspected
This inspection was prompted by a review of the information we held about this service.
We carried out an unannounced comprehensive inspection of this service on the 28 November 2019 and the 02 December 2019. A breach of legal requirements was found. The provider completed an action plan after the last inspection to show what they would do and by when to improve practices around the area of consent.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions, Effective, Responsive and Well-led which contain those requirements.
You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Harold Lodge on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
Harold Lodge is a residential care home providing personal care to people with needs related to learning disabilities and autism in a residential terrace house. The service can support up to four people. At the time of the inspection there were four people living at the service. The provider operated a second care home from the adjoining residential house.
The care home is an adapted period property with four bedrooms with a communal lounge and kitchen and medium sized garden.
The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
People’s experience of using this service and what we found
People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.
The service did not always apply the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.
The manager had been in post for three months and had applied to the Care Quality Commission to become the registered manager. The manager worked across three services and there was no deputy manager in place. The manager had begun to make improvements at the service and was aware of areas that needed further development work.
Care records were not always updated following changes in people’s needs and personal circumstances. However, they were personalised and reflected people’s preferences. Staff demonstrated they knew people well and respected their dignity and diversity.
Medicines were well managed and people received their medicines as prescribed. People had access to nutrition and hydration and health care.
The service was open and inclusive and people’s relatives and staff spoke highly of the management team. People’s relatives told us they felt their relative was safe living at the service. The provider had assessed the risks people faced and had developed plans to keep them safe from harm.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 21 June 2017).
Why we inspected
This was a planned inspection based on the previous rating and to check the safety and quality of care people received.
We have found evidence that the provider needs to make improvements. Please see the effective and responsive sections of the full report.
Enforcement
We have identified one breach of the Regulations in relation to the safe care and treatment. We have made two recommendations in relation to good governance and person centred care.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
The service is registered to provide accommodation and support with personal care to a maximum of four adults with learning disabilities. At the time of inspection three people were using the service.
The previous registered manager left the service in March 2017 and a new manager had been appointed. They told us they were in the process of applying for registration with the Care Quality Commission. 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.
There were enough staff working at the service to meet people’s needs and robust staff recruitment procedures were in place. Appropriate safeguarding procedures were in place. Risk assessments provided information about how to support people in a safe manner. Medicines were managed in a safe way
People were able to make choices for themselves and the service operated within the spirit of the Mental Capacity Act 2005. People told us they enjoyed the food. People were supported to access relevant health care professionals.
People told us they were treated with respect and that staff were caring. Staff had a good understanding of how to promote people’s privacy, independence and dignity.
Care plans were in place which set out how to meet people’s individual needs. Care plans were subject to regular review. People were supported to engage in various activities. The service had a complaints procedure in place and people knew how to make a complaint.
Staff and people spoke positively about the senior staff at the service. Systems were in place to seek the views of people on the running of the service.
This inspection took place on 18 February 2015 and was announced. At the last inspection of this service in October 2013 we found they were meeting all the standards we looked at. The service provides support with personal care and accommodation for up to four adults with a learning disability some of whom are on the autistic spectrum. Four people were using the service at the time of our inspection.
The service had 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.
Staff did not receive all training they required to meet the needs of people in a safe manner. You can see what action we told the provider to take at the back of the full version of the report.
The service had taken steps to promote people’s safety. Staff were aware of how to respond to allegations of abuse. Risk assessments were in place and these covered how to support people who exhibited behaviours that challenged others. There were enough staff to meet people’s needs and medicines were managed safely.
Staff received regular one to one supervision. People had access to health care professionals and the service sought to promote people’s health. People were supported to make their own decisions where they had capacity. Where people lacked capacity proper procedures were followed in line with the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. People were supported to eat sufficient amounts although they were not always provided with a varied diet.
Staff interacted with people in a caring and friendly manner. People’s dignity was promoted through choice, privacy and independence.
Care plans were in place which set out the needs of individuals and we saw these been followed. People had access to leisure and education opportunities. The service had appropriate complaints procedures in place.
The service had clear lines of accountability and staff told us the registered manager was accessible and approachable. Various quality assurance and monitoring systems were in place. Some of these included seeking the views of people that used the service.
We spoke to one persons' relative, who commented "so far I am quite happy with everything." Another persons'relative commented "overall we are pleased, X always seems clean and well looked after."
We found that the provider assessed people's needs on a regular basis and recorded changes in their care plans. One person's relative said "they let me know everything."
The home was clean and tidy on the day of our visit. Staff told us they carried out cleaning duties throughout their shift. This was dictated by the shift plan, which we saw a copy of.
We found there were adequate numbers of staff working within the home and they were suitably qualified to meet people's needs.
We saw copies of various meetings held within the home. These showed that staff discussed what improvements were needed within the service.
People who use the service attended regular weekly activities such as going to day centres three times a week. Some users also have one to one sessions provided by a community outreach service, where they are taken out daily to the park, to local cafes or shopping.
Care plans were person centred and clearly documented the care and welfare needs of each person.
The provider had clear policies and procedures in place that addressed safeguarding. Pictorial poster were displayed on the notice board showing various forms of abuse and what people who use the service should do if they were concerned about abuse.
We saw evidence that regular staff training was provided by the organisation through internet based 'e learning' and in house training. Topics covered included mental capacity, moving and handling, food hygiene, safeguarding, supporting people with learning disabilities and health and safety.
Questionnaires were sent to relatives annually and one relative told us they always completed the questionnaire as the home had plenty of activities and staff needs to know they were doing a good job.