Walton Lodge

At this inspection we checked if improvements had been made. We found that the registered provider had addressed all the concerns raised at our last inspection and the service was rated Good. You can read the report from our last inspections, by selecting the 'all reports' link for ‘Walton Lodge’ on our website at www.cqc.org.uk.

Walton Lodge is a care home for adults aged between 18-65 years old that have severe learning disabilities and autism. The home consists of a large converted bungalow which accommodates 14 people and a separate building (Fairways) which accommodates six people. Fairways supports people who are working to develop their independent living skills. There is plenty of accessible outside space which is secure and safe. The home is located on the outskirts of Doncaster.

The registered provider was working within 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.

At the time of our inspection 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.

The registered provider had systems in place to safeguard people from abuse. Staff knew what action to take if they suspected abuse.

Risks associated with people’s care were identified and managed appropriately and in a manner which did not unnecessarily restrict their freedoms. Risk assessments clearly demonstrated what actions were required to minimise risk.

People were supported by sufficient numbers of staff who were knowledgeable about their needs and knew how to support them.

Accidents and incidents were monitored to identify and address any patterns or trends. This ensured people were safe and action was taken to ensure repeated incidents were kept to a minimum.

The registered provider had systems in place to ensure people received their medicine as prescribed. However, one medicine store room required a thermometer to monitor the temperature. This was resolved by the registered manager on the evening of our inspection.

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 registered provider ensured staff received training appropriate for their role. Staff told us they felt supported and received one to one sessions with their manager to discuss work related issues.

People were supported to maintain a balanced diet which met their needs and took account of their preferences. People had access to healthcare professionals as required.

We observed staff interacting with people and found they were kind and caring. Staff knew people well and responded to their needs in an understanding way. Through our observations and by looking at care and support plans, we found that people received personalised care which was responsive to their needs.

The registered provider had a complaints procedure in place and people and relatives we spoke with felt at ease to raise concerns.

The registered manager completed a range of audits to ensure the service was running in line with the registered providers policies and procedures. People and their relatives were asked for feedback about the service and were kept up dated about any changes.

Further information is in the detailed findings below

Walton Lodge is a care home for adults aged between 18 - 65 years old that have severe learning disabilities and autism. The home consists of a converted large bungalow which accommodates 14 people and a separate building which accommodates six people who are working to develop their independent living skills. There is also a secure garden area. The home is located on the outskirts of Doncaster with access to public transport links.

At the time of our inspection there was a registered manager 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.

The provider did not have safe arrangements in place for managing medicines. We found the stock of medicines did not always tally with the records. It was difficult to see if medicine had been given as prescribed. The provider had no protocols in place for people who required medicines on an ‘as and when’ required basis.

The provider had a safeguarding procedure in place to protect people from abuse. Staff received training in this subject and this was repeated on an annual basis.

We found the registered provider employed enough staff to meet people’s needs. We observed staff interacting with people and found they were supported in a timely way.

Risks associated with people’s care had been identified and appropriate plans were in place to help minimise the risks from occurring.

The registered provider had a safe system in place for recruiting new staff. Staff received an induction when they commenced employment with the registered provider.

Training records and discussions with staff demonstrated that they possessed the right skills, knowledge and experience to meet people’s needs. Staff confirmed they received supervision sessions with their line manager. Supervision sessions were one to one meetings to discuss their role. However, staff did not receive an annual appraisal of their performance.

We looked at the support plans for three people who used the service and there was evidence that people were consulted about how they wanted to receive their care. However the service had Closed Circuit Television (CCTV) in communal areas and we were unable to access documents relating to people’s consent for this to be used.

We looked at care records and found people were able to access health care professionals in a timely way when required.

People were involved in meal preparation and took part in shopping for food they liked. We saw people were involved in preparing a weekly shopping list and buying food which was in keeping with their preferences.

We observed staff interacting with people and we found they knew people well and were caring and supportive. Staff found ways to communicate with people to assist them to be involved in conversations.

Care plans we looked at were informative and reflected people’s current needs. Staff knew people well and understood their needs and preferences.

People were involved in social activities and were able to choose what they wanted to do. Each person had an activity plan for the week and staff supported people to keep to it.

The service had a complaints procedure and this was displayed in the home. An easy to read version was also available.

The registered provider had an audit system in place but this did not always identify areas of concern. We identified some areas of development as part of this inspection which had not been addressed by the registered provider.

The registered provider had no formal system in place to capture the views and opinions of people who used the service and their relatives. Relatives and residents meetings were not provided, however people and relatives we spoke with were complimentary about the management team and happy with the service provided.

Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. There were risk assessments in place to keep people as safe as possible. Staff we spoke with had a good knowledge of the people they were supporting. They were able to give information about their care needs.

There were effective systems in place to reduce the risk and spread of infection. People were protected from the risk of infection because appropriate guidance had been followed.

People were cared for, or supported by, suitably qualified, skilled and experienced staff. Appropriate checks were undertaken before staff began work.

There were enough qualified, skilled and experienced staff to meet people's needs. There were systems in place to respond to unexpected circumstances, for example to cover sickness absence or emergencies. Staff felt they provided a good standard of care to people who used the service.

During our observations we found good interactions between staff and people who used the service. We found there was a relaxed atmosphere. Staff enabled people to make choices about their care and how they wanted to spend their time, even where their understanding and communication was limited. We observed staff effectively offering support, explanations and reassurance to people who used the service.

We found people who used 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. The staff we spoke with told us they had received training about safeguarding issues and this was reflected in the staff training records. From our discussions with staff, they had a good understanding of the safeguarding arrangements in place.

We found the provider had taken steps to provide care in an environment that was suitably designed and adequately maintained. We saw the lounge and dining areas had been decorated and furnishings replaced. We found people who used the service appeared comfortable in their surroundings and were able to participate in daily living skills or other activities, either individually or with others.

We found people were supported to eat and drink sufficient amounts to meet their needs. We saw people were being provided with sufficient drinks and food during the day. Two people we spoke with told us they were involved in choosing what food they enjoyed. We found there were sufficient amounts of food stored in the freezer and fridges.

Evidence showed people were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines. We observed a member of staff giving medicine. We found they carried out the task safely and spoke to people in a kind and respectful way. They patiently waited and stayed with the person to make sure that medicines were properly swallowed and correctly signed the medicine chart afterwards.

We looked around the premises and found people who used the service were not always protected against the risks of unsafe or unsuitable premises because of inadequate maintenance.