We carried out a review of the data available to us about Queens 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 Queens Lodge, you can give feedback on this service.
Queen’s Lodge is a respite service and residential home providing personal care to people with autism, mental health issues and/or learning disabilities. The service can support up to 22 people and at the time of the inspection there were 20 people living there. The service consists of two houses which share a garden, Queens Lodge is the respite home, with rooms for 12 people, while Southview is a ten bedded home for people staying longer term. People have their own rooms but share communal kitchens, bathrooms, and lounge areas.
The service consisted of two large homes, bigger than most domestic style properties. This is larger than current best practice guidance. Despite this, the service was run 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.
People’s experience of using this service and what we found
People were kept safe from harm, and from the risk of abuse, by trained staff who cared about them. People’s personal risks were assessed and continuously updated in their support plans so that staff could look after them safely. The home was safe and the registered manager ensured it was kept well maintained. The home was clean and fresh and people and staff took pride in keeping the home tidy. Staff supported people to take their medicines safely. The service learned from things that went wrong.
People had support plans in place that were started before they arrived at the service. The registered manager and other staff organised tea visits for prospective new residents and worked hard to make people feel at home. Staff followed clear support plans for people including positive risks. Staff had specific training in people’s particular needs. Staff had infection control training and food hygiene training. People and staff cooked together and made healthy food with a varied menu. People were able to make their own decisions about their hobbies and the way they spent their days. People at the respite care home left the site during the day to attend day centres and education facilities. Some people at the residential home also had hobbies or jobs outside of the service and staff supported people to go out into the community.
Staff were very caring and friendly. We saw staff and people joking and laughing together as they prepared food at the home. Staff took time to communicate with people in ways that works for them, using clear speech, hand gestures and facial expressions. People were treated with dignity and respect by staff who encouraged them to be as independent as possible. A person told us, “I like it here, at the last place no one said hello.” And another person said, “I can talk to people here.”
People’s care was personalised. The registered manager got to know people and their families before they came to stay at the home and continued to update support plans as staff grew to know people well. People were encouraged to fulfil their potential and staff took pride in seeing people get jobs and flourish in the community. Policies for the home were available for people in easy read formats. The staff focussed on how to enable people to live full lives and make friends. The registered manager acted on complaints and when necessary changed procedures to ensure incidents were not repeated.
The registered manager was a positive, proactive person who supported staff well. Staff were proud to work at the home and enjoyed spending time with people. One staff member told us, “The teamwork is very good. The managers are really good, it's flexible. The flexibility is good, and you meet different people every day, it's challenging but interesting.” And another said, “I call this place my home. I love my job.” A relative told us, “Beyond all expectation, the registered manager and the team work with us collaboratively all the time to encourage [person] to grow skills and build confidence in carrying out tasks in a safe environment where he is comfortable. They are knowledgeable and empowering, offering great advice and creative solutions.”
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
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 details, please see the full report which is on the CQC website at www.cqc.org.uk
The last rating for this service was Good (published 5 August 2017).
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.
At the last inspection of March 2015, the service was rated Good. We carried out this unannounced inspection of the service on 23 June 2017. At this inspection, we found that the service had maintained its ‘Good’ rating.
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.
People were protected from the risk of harm because staff knew how to recognise and report abuse. Staff understood the safeguarding procedures in place about how to keep people safe. Staff were able to raise concerns about abuse and poor practice internally and to external agencies if necessary to protect people.
Appropriate recruitment procedures were followed to ensure suitable staff were employed at the service. Sufficient numbers of suitably skilled staff were deployed to meet the needs of people safely.
People’s care was provided by staff who were supported in their role. Staff received regular supervision and an annual review of their performance to ensure that care provided was effective.
People were supported to take their medicines safely by staff trained and assessed as competent to do so. Staff followed the provider’s procedures and good practice to manage medicines safely.
People received enough food and drink to meet their dietary and hydration needs. People had access to healthcare services when needed and were supported to maintain their health.
Staff provided care and support in line with the requirements of the Mental Capacity Act 2005. People who lacked capacity were supported appropriately as decisions about their care were made in their best interests.
People were supported by staff who were kind and compassionate. Staff had developed positive working relationships with people and treated them with respect. Staff respected people’s privacy and maintained their dignity in all aspects of their care.
People received personalised care that met their individual needs. Staff assessed people’s needs and had guidance on how to deliver effective and safe care. People enjoyed taking part in a wide range of activities for stimulation and social interaction.
People benefitted from a service that had an open and transparent culture. People using the service and staff were happy with how the service was managed.
Regular checks and audits of the service were carried out to ensure the service continued to improve in their standards and practices. The registered manager and provider took action to address any concerns identified.
The inspection took place on 10 and 11 March 2015 and was unannounced.
The provider’s registration covers short breaks and respite services supplied by Queen’s Lodge and for permanent accommodation for people at Southview. The buildings that comprise these services are adjacent to each other. Entry to both services is through the main building at Queen’s Lodge.
Queen’s Lodge caters for people from the age of 18 years to retirement age. They have a range of needs, some more complex than others: learning disability, physical disability and autism. The majority of younger people live permanently at home with their family carers and stay at Queens Lodge for short breaks or respite care. Queen’s Lodge is registered to provide accommodation and personal care for up to ten people; two of these places are kept as emergency beds. People may spend between 14 and 150 nights a year staying at Queen’s Lodge, depending on their assessed needs. Occupancy levels at the service vary on a day to day basis, contingent on how many people have booked in for their short stay. Queen’s Lodge is a stepping stone service, as some people may then go on to move into more independent living when they leave their families, whilst others may need permanent accommodation in a residential care setting.
Southview provides long term accommodation for people aged over the age of 50 years, all of whom have a learning disability. It is registered for ten people and at the time of our inspection, there were nine people living at the service.
Information relating to both services is included within this inspection report. Where specific detail relates solely to Queen’s Lodge or to Southview, sub-headings have been used to provide clarity for the reader.
The service had 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.
People felt safe living at the service and their risks were assessed and managed safely by staff. Staff knew how to recognise potential signs of abuse and what action to take if they suspected abuse was occurring. They had been appropriately trained. The service followed safe recruitment practices and new staff had all necessary checks undertaken to make sure they were safe to work with adults at risk. Staffing levels were sufficient to meet people’s needs and were flexible across the services provided at Queen’s Lodge and Southview. People’s medicines were managed safely. People on a short break brought their medicines with them which were then managed by staff, whilst people at Southview had their medicines ordered, managed and administered by staff. All staff were trained in the administration of medicines.
People could choose what they wanted to eat and there was a wide variety of food available to meet people’s cultural needs. People helped to plan the menus on a weekly basis and menus used photos of food to make them easily accessible. People had access to a range of healthcare professionals. Each service had been adapted to cater for people’s needs. Consent to care and capacity to make decisions was sought in line with the requirements of the Mental Capacity Act (MCA) 2005 and associated legislation. No-one was subject to Deprivation of Liberty Safeguards (DoLS) and people could leave either service freely, although the majority of people required staff to support them and keep them safe. Staff underwent an induction programme and all essential training. They received regular supervisions and annual appraisals from their managers.
People were looked after by kind and caring staff in a warm, friendly environment. Staff would go into work even on their days off and were genuinely concerned for people’s welfare. The service had received an ‘Inspiring People Award’ from the service provider because they demonstrated the provider’s values and put these into practice. They had organised an event at which people planned their dreams and wishes for the future. People were involved in expressing their views and were treated with dignity and respect. They were encouraged to be independent and to follow hobbies that they enjoyed.
Before people embarked on a short break or respite stay at Queen’s Lodge, they were invited to stay for tea on two occasions, and then stay overnight. Assessments were undertaken for each person prior to their stay at Queen’s Lodge. Care plans provided detailed information for staff about the person and how they wished to be cared for; these were person-centred. Outings were organised in the community for people living at Southview and they could also go shopping, visit the pub or have holidays. A complaints procedure was in place that was in an easy read format. There had been no complaints received within the last year.
People were asked for their views at Queen’s Lodge and at Southview. At Queen’s Lodge, families were asked for their feedback at the end of each short break. At Southview, residents’ meetings were organised to enable people to share their views. The provider had a family charter in place which encouraged people and their families to be involved in all aspects of the service. There were robust quality assurance systems in place that enabled the provider to audit all aspects of the care provided at the service. These helped to identify areas which might require improvement. The registered manager worked collaboratively with health and social care professionals, the local authority and with local special schools.
We saw that people's consent was sought, wherever possible, before care and support was provided. We observed that the care given was safe and appropriate and based on effective care planning and risk assessments. This meant that people's individual needs were met and their preferences were taken into account.
People were protected from the risks associated with poor medication management. We saw that medicines were properly handled and administered in line with the provider's policy. We noted that there were sufficient numbers of experienced staff to provide good care. We also found that systems were in place for people and relatives to make a complaint about the service if necessary.
When we spoke with staff, they told us about the individual needs and preferences of people staying in the house and those that visited regularly for respite care. It was apparent that they knew the individuals and their families well.
Letters of thanks and cards showed that people were pleased with the care they, or their relative, received and the ongoing support provided by the home. We looked at some of the letters and saw that they commented specifically on how well the staff met the needs of people with complex needs or challenging behaviours.
We noticed that the home had been adapted to allow people as much freedom as possible whilst ensuring they remained safe. People were able to use local community facilities. Many of the people who used the respite care facility attended school or college. Other people were in protected employment in the provider's own workshops and horticultural centre.
The house for older people with learning disabilities was staffed and arranged separately to the respite care house. This allowed for the needs of the more aged population to be met and for the house to have the feel of a more permanent home.