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Inspection carried out on 17 February 2020

During a routine inspection

About the service

Talbot Woods Lodge is registered to accommodate up to 15 people and provides care and support for people with learning disabilities. The service is split over three floors which were accessible by stairs. There were 14 people using the service at time of inspection.

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 registered to provide support to up to 15 people and there were 14 people using the service at the time of our inspection. The service is larger than recommended by best practice guidance. However, we have rated this service good because 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

The service met the requirements of the Mental Capacity Act (MCA). MCA assessments had been carried out for people in relation to their care needs. However, the paperwork was not clear about the specific decision being made.

We have made a recommendation about the MCA in practice.

People told us they were happy and felt safe. Relatives said staff had a good understanding of people’s needs and preferences. Risks had been identified and measures put in place to keep people safe from harm. Medicines were managed safely and administered by trained staff.

Staff listened to what people wanted and acted quickly to support them to achieve their goals and outcomes. Staff offered people solutions to aid their independence and develop their skills.

Staff were well trained and skilled. The emphasis of support was towards inclusion and enabling people to learn essential life skills. Equality, diversity and human rights were promoted and understood by staff.

People and relatives described the staff as caring, kind and friendly and the atmosphere of the home as relaxed and engaging. People were supported to have maximum choice and control of their lives.

People received pre-admission assessments and effective person-centred support. The service was responsive to people’s current and changing needs. Regular reviews took place which ensured people were at the centre of their support.

People, relatives and staff spoke highly about the management and staff had a clear understanding of their roles and responsibilities. The team worked together in a positive way to support people to achieve their own goals and to be safe.

Checks of safety and quality were made to ensure people were protected. Work to continuously improve the service was noted and the registered manager was keen to make changes that would impact positively on people's lives.

The service applied 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 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.

For more deta

Inspection carried out on 13 July 2017

During a routine inspection

The inspection was unannounced on 13 and 14 July 2017.

Talbot Woods Lodge is a care home for people with learning disabilities. The home is registered to provide personal care for 15 people. At the time of the inspection there were 14 people living at Talbot Woods Lodge. One of the bedrooms was used for short stays.

At the last inspection in February 2015, the service was rated Good. At this inspection we found the service remained Good. There were improvements in how safe the service was and the ‘Is the service safe’ question is now rated Good.

Is the service Safe?

People’s medicines were managed safely and there was an improvement in how people’s PRN ‘As needed’ medicines were managed. Any risks to people were identified and managed in order to keep people safe.

There was a stable staff team who knew people well. Staff were recruited safely and agency staff were not used at the home.

Is the service Effective?

Staff received an induction, core training and specialist training so they had the skills and knowledge to meet people’s needs. Staff felt very well supported by managers.

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 place supported this practice.

Is the service Caring?

People and staff had good relationships. Care was provided with kindness and compassion by staff who treated people with respect and dignity.

Is the service Responsive?

People received care and support in a personalised way that was responsive to their changing needs. Staff knew people well and understood their needs and the way they communicated. We found that people received the health, personal and social care support they needed.

There was an accessible complaints procedure in place and people knew who to talk to if they were worried or concerned. There had been no complaints received since the last inspection.

Is the service Well-led

The culture within the home was personalised and open. People and staff benefitted from the family atmosphere. There was a clear management structure and staff and people felt comfortable talking to the managers about any issues and were sure that any concerns would be addressed. There were systems in place to monitor the safety and quality of the service provided.

Further information is in the detailed findings below

Inspection carried out on 25 February and 2 March 2015

During a routine inspection

The inspection was unannounced and took place on 25 February and 2 March 2015.

Talbot Woods Lodge is a care home for people with learning disabilities. The home is registered to provide personal care for 15 people. At the time of the inspection there were 15 people living at Talbot Woods Lodge.

There was a registered manager who was also one of the registered providers. 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.

We inspected the home in December 2013 and identified a breach in the regulations. This was because the registered person did not have suitable arrangements in place to protect people against the risk of restraint being unlawful. There were no records of mental capacity assessments or best interest decisions in line with the Mental Capacity Act 2005 to support the use of physical interventions. At this inspection improvements had been made and the shortfall was met. This was because decisions that were made in people’s best interests were recorded to ensure that people’s rights to make decisions about their care and support was respected.

Some of the people had complex needs and were not able to tell us their experiences. We saw that those people and the people we spoke with were smiling, happy and relaxed in the home.

Medicines were managed safely and stored securely. People received their medicines as prescribed by their GP. Staff knew when they should administer PRN ‘as needed’ medicines. However, there were not any written plans in place. The deputy manager took immediate action to contact the prescribing health professionals for advice on writing these plans.

People told us they felt safe at the home. Staff knew how to recognise any signs of abuse.

The provider had a system in place to ensure staff understood their responsibilities in regard to the Deprivation of Liberty Safeguards (DoLS). The DoLS are part of the Mental Capacity Act 2005. They aim to make sure that people in care homes are looked after in a way that does not inappropriately restrict their freedom. The safeguards should ensure that a care home only deprives someone of their liberty in a safe and correct way, and that this is only done when it is in the best interests of the person and there is no other way to look after them. There were records that showed the provider had a system in place to ensure they recognised where an individual may require a DoLS application to ensure their rights were upheld. DoLS applications were correctly completed and submitted to the local authority.

The provider had a range of systems in place to protect people from risks to their safety. These included premises and maintenance checks, regular servicing and checks for equipment such as hoists, stair lifts and all electrical equipment and risk assessments for each person living in the home.

People received care and support in a personalised way. Staff knew people well and understood their needs. People received the health, personal and social care and support they needed.

Staff were caring and treated people with dignity and respect. People had access to the local community and had individual activities provided.

There was a stable staff team and agency staff were not used. Staff received an induction, core training and specialist training so they had the skills and knowledge to meet people’s needs.

People, staff, health professionals and a relative commented on the friendly and family atmosphere at the home. There was a clear management structure and staff, representatives and people felt comfortable talking to the managers about any concerns and ideas for improvements. There were systems in place to monitor and drive improvement in the quality of the service.

Inspection carried out on 2 December 2013

During an inspection in response to concerns

We visited Talbot Woods Lodge unannounced on 2 December 2013 in response to information of concern. At the time of the inspection there were 14 people living at the home. We spoke with the manager, the deputy manager and three support workers. On this occasion, we did not talk with people living at the home. This was because people may not have been able to understand fully the matters we were looking at and they may not have been fully able to tell us their experiences.

People who use the service were not consistently protected against the risk of unlawful control or restraint because the provider had not made suitable arrangements. Records did not contain evidence of mental capacity assessments or best interest decisions where physical interventions were used.

There were enough qualified, skilled and experienced staff to meet people�s needs.

Inspection carried out on 1, 6 November 2013

During a routine inspection

At the time of our unannounced inspection fourteen people lived at Talbot Woods Lodge and one was staying for a few days� respite. On our initial visit, three people were away on a holiday with the manager and deputy.

People living at the home had complex needs which meant they were not always able to tell us their experiences. Therefore, in addition to speaking with three individuals we observed the support people received, reviewed records and spoke with the manager and five staff. The people we spoke with told us they liked the home.

Before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes. Where people were unable to give valid consent, the provider acted in accordance with legal requirements.

People experienced care, treatment and support that met their needs and protected their rights. We observed that staff supported people in an attentive and dignified way.

People who use the service, staff and visitors were protected against the risks of unsafe or unsuitable premises. We saw that the home was clean and neatly decorated.

People were cared for by suitably qualified, skilled and experienced staff. Staff we spoke with said they enjoyed their work and received regular training. They confirmed that new staff worked under supervision.

The provider had an effective system in place to monitor the quality of the service and to manage risks to people�s health, safety and welfare.

Inspection carried out on 10 January 2013

During a routine inspection

People using the service had complex needs which meant they were not always able to tell us their experiences. Therefore, in addition to speaking with two individuals we gathered evidence by observing care, reviewing records and speaking to two relatives, the deputy manager and two care workers.

People's diversity, values and human rights were respected. We noted throughout the inspection that care workers were polite, respectful, patient and sensitive. The relatives we spoke with told us that care workers were also polite and respectful. A care worker we spoke to told us Talbot Woods Lodge was a �very homely home�.

We found that people's needs were assessed and care and treatment was planned and delivered in line with their individual care plan. A care worker we spoke with told us �the clients come first�.

We found people who use the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

People were cared for, or supported by, suitably qualified, skilled and experienced staff.

People who use the service, their representatives and staff were asked for their views about their care and they were acted on.

The provider had an effective system in place to identify, assess and manage risks to the health, safety and welfare of people who use the service and others.

An individual told us �it�s a nice place to live�.