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Archived: Queens Lodge Good

Reports


Inspection carried out on 11 May 2015

During a routine inspection

The inspection took place on the 11 May 2015 and was unannounced. Queens Lodge provides care and accommodation for up to 6 persons who have a Learning Disability. There were a total of five people living at the service at the time of our inspection.

The service has a registered manager. 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.

Systems were in place which guided staff on how to manage risks and safeguard people who used the service. There were clear procedures in place to ensure peoples safety and there were checks undertaken on the environment as well as assessments on how to minimise risks. There were some issues about storage which presented some risks which had not been fully considered.

Staff could recognise signs of harm or potential abuse but we found some barriers to reporting which meant that people may not be as open as they could be.

Staff turnover was high but efforts were made to ensure consistency by using regular agency staff. Staffing levels were regularly reviewed in consultation with other professionals and adjusted to meet the needs of the people using the service. Recruitment processes ensured that the staff who were appointed were safe to work in this setting.

Medication systems were safe but the guidance directing staff on the use of “as required” medication was not clear. This means that medicines may not be given consistently and when needed.

Staff received induction and training which gave them the knowledge they needed to carry out their role. Staff were regularly supervised and their competency monitored to ensure that they could meet people’s needs effectively.

The service was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS). Appropriate mental capacity assessments and best interest decisions had been undertaken by relevant professionals. This ensured that the decision was taken in accordance with the Mental Capacity Act (MCA) 2005, DoLS and associated Codes of Practice. The Act, Safeguards and Codes of Practice are in place to protect the rights of adults by ensuring that if there is a need for restrictions on their freedom and liberty these are assessed and decided by appropriately trained professionals.

Staff were proactive in their contacts with healthcare agencies and acted on their guidance, in people’s best interests.

People were involved in the developing of the menu and in meal preparation. The quality of the meals we observed were good however the monitoring of food and fluid for individuals, identified as at risk would benefit from greater oversight.

Interactions between people using the service and staff were warm and friendly. Staff knew people they were caring for and what their care preferences were. Care plans were detailed and informative and reflected people’s needs. Where people’s needs changed, advice was sought and the plan evaluated. People were involved in planning their care and this endured that people were provided with care in a way that they wanted to be supported.

People were enabled to access person centred activities and were encouraged to maintain hobbies and interests. Staff supported people to maintain relationships which were important to them.

The registered manager demonstrated clear leadership and was described as approachable and helpful.

The provider had systems in place to assess and monitor the quality of the service, which included sampling of documentation and visits. Action plans were in place to address areas identified by the audit.

Inspection carried out on 22 October 2013

During a routine inspection

We met with three people who lived in the service, all of whom had learning disabilities, and some also had physical disabilities. We met with two members of staff and the manager for this service.

Each person had a plan of care with completed risk assessments. People were assisted in taking part in a range of activities both within and outside of the service, and were able to make requests as to how they wished to spend their time.

People�s health and welfare needs were maintained with the help of external health professionals. This meant that people�s health needs were constantly monitored.

Staff knew what could be classified as �abuse� and all had undergone safeguarding training. The provider needed to update relevant paperwork to demonstrate that all aspects of safeguarding were complete.

The staff received regular supervision and appraisals. Staff had access to training that ensured their professional development, so that they had the right skills to provide the required care to meet the needs of the people using the service.

We saw that the provider had systems in place to identify assess and manage risks to the health, safety and welfare of people using the service. The provider may find it useful to note that people�s emergency evacuation plans were not immediately accessible should these be required in an emergency.

Inspection carried out on 5 February 2013

During a routine inspection

During our visit on 5 February 2013, we observed the interactions between staff and the people living at the service. Some people had impairments which limited their communication but it was evident that staff were knowledgeable about their individual abilities. We found that people were treated respectfully and were making choices about their daily lives. Before care took place they were asked what their wishes were and choices were offered in a way that their consent could be indicated.

We looked at two of the four care plans for the people living at the service during our visit on 5 February 2013. The system in place was robust and assessments of people's needs had been made. Any associated risks had management plans in place to maintain people's safety.

We found that the provider had made arrangements for the management of medication and that staff were trained to administer medication so people's safety was protected.

We looked at the rota and noted that there were usually two people on each shift throughout the day. The people living at the service were able to access information about who was on shift each day from a picture board displayed in the lounge area.

The provider had a complaints policy in place for staff to follow. We saw evidence that people living at the service had monthly meetings where they were supported to raise any concerns and a further opportunity was given in the one to one sessions held each month with their key worker.

Reports under our old system of regulation (including those from before CQC was created)