St Anne's Community Services - Jenkin Lodge

St Anne's Community Services – Jenkin Lodge is a residential care home for 5 people with a learning disability. People in care homes receive accommodation and personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The service provides residential and personal care in a purpose built bungalow. There were five people living at the service at the time of our inspection.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

A registered manager was 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 our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

People were cared for safely by staff who were trained and knowledgeable about their needs. There were systems and processes in place to protect people from the risk of harm. Staff were able to tell us about different types of abuse and were confident that the registered manager would address any concerns. Staff received regular supervision meetings and appraisals and staffing levels were sufficient to meet people's needs. There were safe recruitment and selection procedures in place and appropriate checks had been undertaken before staff began work.

Medicines were administered safely by staff who were trained and assessed as being competent to do this. People were provided with sufficient food and drink to maintain their health and wellbeing and staff supported people to access healthcare professionals and services.

People’s needs were assessed and reviewed and care records contained information about people's needs, preferences, likes and dislikes. Staff understood people were individuals and would not tolerate discrimination. People received person centred care, their independence was promoted and they had access to a wide range of activities

There were positive interactions between people and staff. Staff knew people well and promoted their independence. Care was person-centred and people were provided with choice. Staff were kind and treated people with dignity and respect. 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 supported this practice.

The premises were well maintained to keep people safe and the provider had a system in place for responding to people's concerns and complaints.

There were positive working relationships with other professionals which promoted people’s well-being. The registered manager and provider monitored the quality of service provided to ensure that people received safe and effective support which met their needs.

Further information is in the detailed findings below.

St Anne’s Community Services – Jenkin Lodge is a purpose built service which provides residential and personal care. The service is registered to support people with a learning disability. It does not provide nursing care. There were 5 people living there at the time of this inspection.

The service had a registered manager who had been in post since 2009 and had been registered in 2013. 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.

Staff had been trained to recognise and respond to any safeguarding issues. Staff knowledge and understanding of safeguarding was good. The service acted appropriately in reporting such issues to the local safeguarding adults unit. Relatives told us they felt their family members were safe when their support workers were providing them with support.

Risks to people were assessed, and risk assessments gave detailed information to ensure that people could be supported safely by staff. These had been reviewed consistently. Plans were in place to keep people safe in the event of an emergency. Accidents and incidents were fully recorded and were discussed at meetings to consider ways to ensure there was no reoccurrence.

There were a small amount of vacant staffing hours but there was a regular and consistent staff team. Staff files showed that recruitment was professional and robust to ensure suitable applicants were employed.

Medicine administration was managed and carried out appropriately and all staff had received training. Medicine storage was safe and appropriate. People were well supported with their nutritional needs and with their general health needs.

Staff had received training to enable them to meet people’s needs. Staff had supervision and annual appraisal and this was completed in line with the providers own policy. Records of supervision demonstrated two way conversations between staff and the registered manager. Relatives told us they felt staff had the skills they needed.

People were asked to give their consent to their care. Where people were not able to give informed consent, their rights under the Mental Capacity Act 2005 were monitored. Staff knowledge of mental capacity and deprivation of liberty was good.

Families we spoke with gave us very positive feedback about the service and were very happy with the care and support their relatives received. We observed and relatives told us that staff were caring and knew people well. Relatives felt that their family members were cared for very well and were happy with all aspects of their care. Staff showed a good understanding of the importance of dignity, privacy and respect.

Care plans were clear and detailed, and reflected people’s preferences. They were extremely personalised and demonstrated input from relevant others. Reviews and updates were recorded clearly. There were a good range of personalised activities and interventions offered to people on a daily basis.

The environment was in good condition with only one minor repair required. Infection control was well managed and staff demonstrated an understanding of ways to minimise the risk of infection.

There was regular engagement with families for both individual input to the person’s support as well as development of the service. There was very positive staff morale across the staff team and a real sense of teamwork was evident throughout the inspection and in the conversations we had with staff. Staff felt the registered manager was extremely effective.

The registered manager was open to improvements to the service. There were systems in place to monitor the performance of the service and these were being used effectively to make improvements across all areas of the service provided. People told us they felt they were listened to.

We considered all the evidence we had gathered under the outcomes we inspected.

This is a summary of what we found. The summary describes what we observed, the records we looked at and what people using the service, their relatives and the staff told us.

If you want to see the evidence that supports our summary please read the full report.

Is the service safe?

People's needs were assessed and care and treatment was planned and delivered in line with their individual care plan. Care plans were well organised and the information was clear.

There were risk assessments in place which identified the risks for the individual and how these could be reduced or managed. We saw risk assessments relating to accessing the local community and managing behaviours that could be challenging.

We saw there were robust systems in place to assess and check appropriate and safe care was being delivered. These included daily and monthly internal audits. These audits included environmental safety and fire safety.

The provider had appropriate security arrangements in place to protect people who lived at the service. We found that the entrance door was secure and visitors could only enter the building with the knowledge of the staff.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. Whilst no applications have needed to be submitted, proper policies and procedures were in place. Relevant staff have been trained to understand when an application should be made, and how to submit one.

We saw that medicines were handled appropriately by staff who had been adequately trained and who had access to regular updates. We found that the documentation associated with the giving of medicines showed that people received medication they needed when they needed it.

Is the service effective?

People were in varying degrees unable to communicate verbally and did not have the mental capacity to use key pads. We were however able to gain an indication from people that their needs were effectively met. Care plans demonstrated that family members had been involved in the care planning and review process to ensure care needs were up-to-date and relevant to current care needs.

Staff we spoke with were clear about the needs of the people they supported and what they told us was reflected in people's care plans.

We spoke with staff who told us they felt well supported by the manager who ensured access to regular training and development.

Is the service caring?

We saw staff treated people with dignity and respect and maintained their privacy and dignity. We heard care staff speaking courteously and kindly with people, asking permission before helping to support them and explaining what was happening. We observed care staff supporting people where needed in a calm and unhurried manner.

We observed how staff interacted with people whilst medicines were administered. Staff were respectful when they spoke with people and enabled people to take their medicines in an unhurried manner.

The atmosphere throughout the home was relaxed and we saw that staff took time to talk to people. They made time to speak with people respectfully, giving good eye contact and the opportunity to respond. Activities were centred on the individual and what the person preferred to do. We saw that people were relaxed and appeared happy.

Is the service responsive?

Care and support was provided in accordance with people's preferences, interests and diverse needs. Records we looked at, discussion with staff and observations showed that people's wishes were respected and acted upon.

The care plans identified any health issues and people were referred to health professionals according to their individual needs. We saw evidence of input from district nursing services, doctors and opticians. We were told that the service and the local GP practice had recently instituted an annual health check for all people at the home. This demonstrated the provider was working cooperatively with other healthcare professionals to maximise health benefits for people who lived at the home.

People had access to activities and we saw staff actively engaging in conversation with people. This meant the home was organised so that it met people's social and emotional care needs, in addition to their physical care needs.

Is the service well-led?

We found the service had an effective quality assurance system in place and any identified actions had led to improvements in the service that people received.

Decisions about care and treatment were made by the appropriate staff at the appropriate level. Staff said they felt the service was well-managed and the registered manager was approachable and enthusiastic. They said they had confidence that any issues brought to their attention were always dealt with properly and thoroughly.

We found that the provider was delivering the frequency of staff supervision and appraisals as set out in its own policy.

Staff told us they were clear about their roles and responsibilities. Staff told us the leadership at the service was inclusive and their views were taken into consideration.

We found that people were involved in making decisions about their care wherever possible. Where people did not have capacity or needed additional support to make decisions appropriate arrangements had been put in place. This was important to make sure people's rights were protected.

We saw that the people were cared for in a clean, hygienic environment. There were good cleaning routines in place and staff were aware of how to minimise the spread of infection in the home. This was important to help make sure that people were protected from the risk of infection, or other illnesses.

We found that staff were trained and well supported to do their jobs. This included consistent up to date training, regular supervision and staff meetings. We also saw that there were good systems in place to monitor the quality of the service provided.

In this report the name of the registered manager Sean Martin does not appear. This is due to an omission on our register. This is presently being rectified.

We found that people had been supported to be involved in making decisions about their care wherever possible. Where people did not have capacity and needed support to make decisions appropriate arrangements had been put in place. Suitable arrangements for planning and reviewing the care people needed were also in place.

We also looked at people's care records. We found records were accurate, up to date and regularly reviewed. We also saw how people were supported with their communication and included in decision making throughout their treatment and support.

We found that staff were trained and supported to do their jobs well. This included specialised training, regular supervision and staff meetings. Staff also had regular opportunities to air their opinions and had team meetings.

We saw that regular checks were carried out by senior management, to monitor the quality of the service and that the service annually reviewed people's 'satisfaction' of the service.