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Beckford Lodge Requires improvement

We are carrying out a review of quality at Beckford Lodge. We will publish a report when our review is complete. Find out more about our inspection reports.

Reports


Inspection carried out on 5 June 2019

During a routine inspection

About the service

Beckford Lodge is registered to provide personal care to people in their homes. The service supports two people in shared accommodation. The accommodation was a domestic dwelling situated within the Warminster local community.

Registering the Right Support and other best practice guidance 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’s experience of using this service and what we found

The service didn’t consistently apply the full range of the principles and values of Registering the Right Support and other best practice guidance. People were not empowered to shape their lives. There was a perception that people’s care needs had not changed for many years. This meant that their delivery of care was not in line with changes in guidance or with legislation.

Staff supported people in the least restrictive way possible and in their best interests.

Risk assessments were not always completed for risks identified. The Registered Manager and chief executive officer (CEO) told us the expectation was that the commissioners of the placements completed these risk assessments. The CEO said it was their duty of care under the Care Act Assessment. We will be discussing with commissioners the assessments of risk that relate to fire.

Medicine systems were not safe. The staff removed medicines from the multi compartment system (MDS) and left them “potted” for one person to take at a later date. The medicine care plan did not list the prescribed medicines we saw in the MDS system. The registered manager said this will be followed up, in line with the policies and procedures.

Care plans were not person-centred for one person. The registered manager said that because it was documented staff had to ask the person, this meant they were person-centred care plans. The registered manager said that because the care plan was developed with the person this was person-centred.

People we spoke with said they felt safe in their home and when staff were present. The staff had attended safeguarding of people at risk and knew the procedures for raising concerns.

There were systems in place to assess and monitor staff performance. Staffing levels were in line with the local authority’s assessment of people's needs.

The person we spoke with said they liked the staff, they were caring and their rights were respected. The person we spoke with said they made their day to day decisions. This person told us they were able to prepare their meals and staff assisted them with shopping for food.

People had access to the GP and to community NHS facilities.

The person we spoke with said they would approach the staff with concerns. There were no complaints received

The staff said the registered manager was approachable. They said the team was stable, they worked well together and covered vacant hours between themselves.

Quality assurance systems were based on the support plans in place. There was a tick system in place used by the registered manager to indicate support plans were in place and had been reviewed.

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 at the inspection dated 17 October 2016 and published in 22 November 2016.

Why we inspected

This was a planned inspection based on the previous rating.

We have found evidence that the provider needs to make improvements. Please see Safe, Responsive and Well Led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Beckford Lodge on our website at www.cqc.org.uk.

Inspection carried out on 17 October 2016

During a routine inspection

Beckford Lodge, known as the Ordinary Life Project Association (OLPA), is a supported living service registered to provide personal care to people. Supported living services enable people to live in their own home and live their lives as independently as possible. The support offered by Beckford Lodge included personal care, shopping, budgeting and supporting people to access their community and take part in activities. The registered manager explained that the support hours provided varied depending on the person’s needs. At the time of our inspection one person was using the service under the regulated activity of personal care.

The inspection took place on the 17 October 2016 and was announced, which meant the provider knew before the inspection we would be visiting. This was because the location provides supported living services. We wanted to make sure the registered manager would be available to support our inspection, or someone who could act on their behalf.

A registered manager was employed by the service. 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.

People were actively involved in developing their care and support plans. Care plans were personalised and detailed the daily routines specific to the person using the service. Where people required support with their personal care they were able to make choices and be as independent as possible.

People had a range of activities they could be involved in. People were able to choose what activities they took part in and suggest other activities they would like to complete. Staff provided support as required.

Risks to people’s safety had been assessed and plans were in place to minimise these risks. Staff received training to help them identify safeguarding concerns and understand their responsibilities on reporting any concerns identified.

We looked at the arrangements in place to manage complaints and concerns that were brought to the registered manager’s attention. The service had a complaints procedure in place setting out how complaints could be made and how they would be handled. There had not been any complaints since the service had registered.

People’s medicines were managed safely and people were able to self-administer their medicines with some support from staff. Where required people were supported to access healthcare services to maintain and support good health.

There were sufficient staff to meet people’s care needs. Safe recruitment procedures ensured people were supported by staff with the appropriate experience and character. People were supported by staff that had access to a range of training to develop the skills and knowledge needed to carry out their roles. New staff were supported to complete an induction programme before working on their own.

People were supported to have a meal of their choice. They were supported with planning their weekly menu and shopping for their chosen food. Staff encouraged people to drink sufficient fluids.

There was a registered manager in post. The registered manager carried out regular audits to monitor the quality of the service.

Inspection carried out on 26 February 2014

During a routine inspection

The provider offered a range of care and support services, including residential, supported living and an outreach service. At the time of the inspection, the service was providing personal care to one person.

People referred to the service were assessed initially by the registered manager. The 'needs assessment' considered communication, accommodation and living arrangements, relationships with, and views of others, diversity, social activities and support, caring responsibilities, finance, household management, health and emotional well being, with details of medications, dental and optical arrangements, nutritional needs, end of life choices and capacity.

The registered manager explained that the care and support visits were delivered with flexibility, to suit the needs and preferences of the people receiving the support.

People receiving the service acknowledged, in response to the annual survey, that they been involved in planning their care and support plan, they received the care that was agreed, and that the staff were respectful to them.

Staff confirmed that they had received supervision sessions on a monthly basis and that they were clear about what was expected from them, and they regularly received feedback on how they were progressing within their role. Positive comments were received about the provider, one member of staff said "they are fantastic and so supportive".

Inspection carried out on 31 January 2013

During a routine inspection

People using the service preferred not to be visited by us in their own home. We read from the most recent survey which was returned by people using the service that they received the support and care they wanted and had regular meetings to discuss any changes to their support.

The manager told us that people were encouraged to do a lot of things for themselves but had support from staff with tasks such as bathing, shopping and dealing with other agencies. We were told this sort of support helped people to be independent and “was driven by the person using the service.”

In the recent survey by the service, people said they appreciated their keyworker and wanted to keep the same one. People said they found staff were flexible and willing to change the ways they provided their support.

Staff told us they felt supported in their work, were encouraged to develop and had good opportunities for training.

The provider had set up systems for gaining feedback from the people who used the service and for monitoring the quality of service the people received.

Inspection carried out on 17 March 2011

During a routine inspection

We saw how people received different kinds of support to match their different needs. A person explained how they could choose to use less than their weekly allocation of support hours. This meant they could ‘bank’ hours to use for additional support another time, for example, for staff accompaniment to a short break away.

We saw that risk assessments were used, to help plan how people could be encouraged to become more independent.

A person we met valued support with menu planning and shopping. They and their support worker had worked out ways of safely managing how to have hot meals when at home without support.

A person chose to have their regular support worker with them in their annual reviews with a care manager. This helped the person contribute to and understand the review process.

A person told us they valued always having the same support worker, who had built up a good knowledge of their needs, likes and dislikes. They also had a close working relationship with a relief worker, who covered any absence of the main support worker.