We carried out a review of the data available to us about Elmwood 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 Elmwood Lodge, you can give feedback on this service.
We found the following examples of good practice.
Visitors, including health and social care professionals were screened for symptoms of acute respiratory infection before being allowed to enter the service. The service followed national guidance when admitting people to the service to reduce infection risks. Staff ensured they and the people they supported were socially distanced where possible within the service. Staff had access to personal protective equipment (PPE) to support people safely whilst minimising the risk of the spread of infection. Staff understood how to put on and take off PPE safely and appropriately in line with national guidance.
Arrangements were in place for friends and relatives to visit people living at the service. Staff followed national guidance to ensure people could maintain contact with friends and family in a safe way. People were also supported to maintain regular contact with their friends and family members using a computer media-based programme that used video and audio connections. This enabled people with communication difficulties to not only hear but to see the people that were important to them.
There were appropriate arrangements in place to ensure people and staff were routinely tested for COVID-19 in line with government guidance on testing. Staff received infection control, COVID 19 and PPE training and followed safe hygiene practices within the service. The provider had infection prevention and control policies and procedures in place which were up to date and reflective of national government guidance. During our inspection we observed the home was clean and hygienic and staff worked with health and social care professionals to ensure good outcomes for people using the service.
Elmwood Lodge provides accommodation and personal care support for people who have enduring mental ill-health needs. Some of whom may also have learning disabilities. The accommodation is a spacious ten-bedded home situated in Sidcup Kent. At the time of our inspection ten people were living at the service.
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.
The service was a large home, bigger than most domestic style properties. It was registered for the support of up to 10 people. Ten people were using the service. This is larger than current best practice guidance. However, the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area and the other large domestic homes of a similar size. There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.
People’s experience of using this service and what we found
People spoke positively about the care and support they received. Throughout our inspection we observed staff interacted well with people and had built good relationship’s and rapport with individuals.
The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.
The service had safeguarding and whistleblowing policies and procedures in place and staff had a clear understanding of these procedures and how to keep people safe. People's needs, and preferences were assessed, and plans were in place to manage risks safely in the least restrictive way possible.
There were safe arrangements in place to manage medicines and staff followed appropriate infection control practices to prevent the spread of infections.
Appropriate recruitment checks took place before staff started work. There were sufficient staff available to meet people's needs. Staff had the skills, knowledge and experience to support people appropriately. Staff were appropriately supported through induction, training and regular supervision.
People were supported to maintain a healthy balanced diet. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice.
People were involved and consulted about their care and support needs. People had access to health and social care professionals as required. People were supported to access community service and to participate in activities of their choosing that met their needs.
Staff worked with people to promote their rights and understood the Equality Act 2010; supporting people appropriately addressing any protected characteristics.
There were systems in place to assess and monitor the quality of the service. The service worked in partnership with health and social care professionals and other organisations to plan and deliver an effective service.
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 on 25 November 2016).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Elmwood lodge provides accommodation and personal care support for up to ten people. People who use the service have mental health support needs. At the time of our inspection the home was providing support to ten people. The home 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.
At this inspection we found the provider was compliant with the requirements of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
Risks to the health and safety of people using the service were assessed and reviewed in line with the provider's policy. Medicines were managed, administered and stored safely. There were arrangements in place to deal with foreseeable emergencies. There were safeguarding adult’s policies and procedures in place. Accidents and incidents were recorded and acted on appropriately. There were safe staff recruitment practices in place and appropriate numbers of staff were deployed throughout the home to meet people’s needs.
There were processes in place to ensure staff new to the home were inducted into the service appropriately. Staff received training, supervision and appraisals that enabled them to fulfil their roles effectively. There were systems in place which ensured the service complied with the Mental Capacity Act 2005 (MCA 2005). This provides protection for people who do not have capacity to make decisions for themselves. People’s nutritional needs and preferences were met and people had access to health and social care professionals when required.
People were treated with respect and were consulted about their care and support needs. Staff respected people’s dignity and privacy. People’s support needs and risks were identified, assessed and documented within their care plan. People were provided with information on how to make a complaint. The service worked with health and social care professionals to ensure people’s needs were met.
There were robust systems and processes in place to monitor and evaluate the service provided. People’s views about the service were sought and considered through service user meetings and satisfaction surveys.
This inspection took place on 24 and 25 November 2015 and was unannounced. At our last inspection on 12 November 2013 we found the provider was meeting the regulations in relation to the outcomes we inspected.
Elmwood lodge provides accommodation and personal care support for up to 10 people. People who use the service have mental health support needs. At the time of our inspection the home was providing support to nine people.
The home 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.
At this inspection we found breaches of legal requirements of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have told the provider to take at the back of the full version of the report. We have also made a recommendation to the provider where improvements to the service should be made.
The provider failed to ensure that effective systems were in place to provide staff with annual appraisals of their practice and performance. Care plans and records were not always reviewed on a regular basis and in line with the provider’s policy to ensure people’s needs were appropriately documented and met. Medicines were not always managed and recorded appropriately. We have made a recommendation to the provider where improvements to the management of medicines should be made.
The home had a policy in place for safeguarding adults from abuse and staff demonstrated a clear understanding of the actions they would take to ensure people were kept safe. There were safe and robust recruitment procedures in place that ensured staff were suitable to work with people using the service. Assessments were completed to assess levels of risk to people’s physical and mental health, and care plans contained guidance for staff that helped protect people from harm by minimising identified risks. There were arrangements in place to deal with foreseeable emergencies and staff knew what to do in the event of a fire. Accidents and incidents involving the safety of people using the service were recorded and acted on appropriately.
Staff were supported through regular supervisions and by attending appropriate training. New staff members completed an induction programme which included mandatory training. People were supported to maintain good health and had access to a range of health and social care professionals when required. People told us they were involved in the decisions about their care and were able to voice their wishes and preferences. Care plans contained mental capacity assessments where appropriate, and applications for Deprivation of Liberty Safeguards (DoLS) were made in accordance with the Mental Capacity Act 2005 (MCA). The MCA protects people who may lack capacity to make decisions in relation to consent or refusal of care and treatment. DoLS protects people when they are being cared for, or treated in ways that deprives them of their liberty for their own safety. People were supported to eat and drink sufficient amounts to meet their needs and maintain a balanced diet.
People were provided with information about the service and attended regular meetings in order to share their views on the running of the service. People told us they had been consulted about their care and support needs and were allocated a named key worker to co-ordinate their care. People’s privacy and dignity was respected and staff were knowledgeable about their needs in relation to disability, race, religion, sexual orientation and gender.
People’s physical and mental health needs were assessed before they moved into the home. They were provided with information about how to make a complaint and this information was displayed throughout the home for reference. They were also supported to engage in local activities and events, and to maintain social support networks, such as visiting friends and relatives.
Staff told us the registered manager was approachable and supportive. There were procedures and systems in place to evaluate and monitor the quality of the service provided although these had not identified the issues that we found on inspection. The home encouraged involvement from health and social care professionals in assessing the quality of the service provided to people through the use of surveys and by seeking feedback. The provider also took account of people’s views about the quality of the service provided through resident’s satisfaction surveys and through the homes comments and suggestions box.
We found that people had risk assessments and care plans. People had a staff member allocated as their key worker who would regularly review their care.Staff told us that people were supported to make their own decisions and that they wanted to get the best for them. People told us that they were supported in making choices on activities they attend in the community.
We found that staff had been trained on the control of infection and appropriate arrangements were in place for the cleaning of the home environment. We found that there were sufficient staff on duty to meet people's needs and staffing had increased on occasions to meet people's planned appointments. People told us that the staff were helpful and nice.The provider had plans in place to recruit to two vacant posts.
The provider regularly assessed the quality of the service and we found they had implemented changes to the service following audits, for example we found that a monitoring system for staff training had been put in place following recommendations from a recent audit.
People told us they knew who their key worker was and that they had good meetings with their key worker where they could chat about things. People said they were well cared for.
People also told us everything was in good working order at the home and that they felt comfortable there.