This inspection took place on 21 July 2015 and was unannounced. At the last inspection on 13 February 2014 we found the service was meeting the regulations we checked.
Haydon Park Lodge is a small family run care home which provides personal care, support and accommodation for a maximum of thirteen adults. People using the service have learning disabilities and/or sensory impairment. There were twelve people living at the home at the time of our inspection.
The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have a legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.
During this inspection we found the provider in breach of their legal requirement to ensure that people’s medicines were managed properly and safely. We identified concerns with how some prescribed medicines had been administered and the way information was recorded. There was no guidance for staff on people’s records as to how, when and why some medicines should be administered. We also found medicines were not properly disposed of and a controlled drug was not stored safely.
We also found them in breach of their legal requirement to ensure appropriate checks had been undertaken for new members of staff at the service to ensure they were suitable and fit to work at the home.
And, we found them in breach of their legal requirement to operate an effective system to assess and monitor the quality and safety of the service and maintain up to date, accurate records relating to people, staff and to the management of the service.
Despite the issues we identified, people and their relatives told us people were safe at Haydon Park Lodge. Staff knew how to protect people if they suspected they were at risk of abuse or harm. They had received training in safeguarding adults at risk and knew how, when and to whom they must report their concerns to if they suspected someone was at risk of abuse or harm.
Staff knew how to minimise identified risks in order to keep people safe from injury or harm in the home and community. The provider ensured maintenance and service checks were carried out at the home to ensure the environment and equipment were safe. Staff kept the home free of obstacles so that people could move freely and safely around.
There were enough staff to care for and support people. Staffing levels had been planned to ensure there were enough staff to meet the needs of people using the service. Staff received relevant training to help them in their roles and they felt well supported by the provider and registered manager.
People and relatives’ feedback about the service praised the care and kindness shown by staff. Staff had a good understanding and awareness of people’s specific needs and how these should be met. They knew people well and were able to anticipate what people wanted or needed. The way staff supported people during the inspection was kind, thoughtful and caring.
Staff knew how to ensure that people received care and support in a dignified way and which maintained their privacy at all times. They treated people with respect and ensured communication with people was done in a way that people could understand. Staff supported people to retain as much control and independence as possible when carrying out activities and tasks.
People were supported to keep healthy and well. Staff ensured people were able to access other healthcare services when this was needed. They worked proactively with healthcare professionals to ensure people got the care and support they needed. They also encouraged people to drink and eat sufficient amounts to reduce the risks to them of malnutrition and dehydration.
People had been involved in making decisions about their care and support needs. Support plans had been developed for each person using the service which reflected their specific needs and preferences for how they were cared for and supported. These gave guidance and instructions to staff on how people’s needs should be met. However we found people’s support plans had not been reviewed and updated regularly.
Staff demonstrated a good understanding and awareness of how to ensure people were able to consent to the care and support they received and what to do if they felt people may lack capacity to make decisions. The registered manager had sufficient training in the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS) to understand when an application should be made and in how to submit one. 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.
People and relatives told us the home was always open and welcoming. People were encouraged to maintain relationships that were important to them. People were also supported to undertake activities and outings of their choosing. Relatives said they would feel comfortable raising any issues or concerns directly with staff. There were arrangements in place to deal with people's complaints however the procedure for dealing with these was out of date and contained inaccurate information for people.
People, their relatives and staff spoke positively about the management of the home. People said they were approachable and supportive. The provider and registered manager sought the views of people, relatives, and other healthcare professionals about how the care and support people received could be improved. The registered manager worked proactively with healthcare professionals to continuously improve the service’s knowledge, learning and understanding of how to care for and support people.
You can see what action we told the provider to take at the back of the full version of the report.