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Inspection carried out on 23 October 2018

During a routine inspection

This comprehensive inspection took place on 23 October 2018 and was unannounced.

Carlton Gate consists of two ground floor properties providing accommodation and personal care for adults with learning disabilities. The two properties, Florey Lodge and Barnard Lodge are identical, each having three bedrooms, shared bathroom facilities, a communal lounge/dining area and a kitchen. People have access to several small courtyard gardens shared with other flats within the complex. The service provides accommodation and personal care for up to six adults with learning disabilities. At the time of our visit there were two people living at Barnard Lodge. Florey Lodge was closed awaiting refurbishments.

At our previous inspection of Carlton Gate on 8 March 2016 we rated the service ‘good’ overall. You can read the report from our last inspection, by selecting the 'all reports' link for Carlton Gate - Care Home Learning Disabilities on our website at www.cqc.org.uk. At this inspection we found people continued to receive good care and support. We rated the service good overall.

The manager in post had applied to become the registered manager of 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.

The provider had systems in place to assess and meet people's care needs in a way which suited them. Where appropriate, people, relatives and healthcare professionals contributed to the care planning process. Care plans were reviewed as people's needs changed.

Risks in relation to people’s safety were identified and managed through the implementation of a risk assessment process. Risk assessments were reviewed in line with the provider’s policies and procedures.

The provider had safeguarding policies and procedures in place. Staff demonstrated a good understanding and awareness of how to keep people safe from harm.

People using the service were being protected from improper treatment. The provider made sure that people's capacity was assessed when needed and that care was delivered in people's best interests.

Staff respected people’s choices and requested people’s consent before offering them support.

People were treated with dignity and respect. Staff supported people in a kind and compassionate manner.

Staff gathered information and took account of people's cultural needs and preferences to ensure staff supported people in an appropriate manner.

People's medicines were managed safely. Staff completed appropriate medicines training and competency assessments before carrying out medicines related tasks and were confident supporting people with their medicines.

People were supported to have sufficient amounts of nutritious food and drink to meet their needs. Mealtimes were organised in a way that promoted people’s choices and preferences.

People had access to healthcare professionals to monitor and maintain their health care needs. Staff supported people to attend medical appointments.

The service was complying with the Accessible Information Standard (AIS). The AIS applies to people using the service who have information and communication needs relating to a disability, impairment or sensory loss.

Staff were employed following a thorough recruitment process. Staff were receiving appropriate support and training to enable them to carry out the duties they were employed to perform.

Sufficient numbers of staff were deployed to the service in order to meet people's needs.

Audits were carried out to ensure the environment and people were safe. The home was clean and tidy and staff were following correct infection control procedures.

Staff told us that incidents, accidents, concerns and complaints were discussed at team meetings an

Inspection carried out on 8 March 2016

During a routine inspection

This inspection took place on 8 March 2016 and was unannounced. The service was meeting all of the regulations we checked the last time we visited in August 2013.

Carlton Gate consists of two modern ground floor properties providing accommodation and personal care for adults with learning disabilities. The two properties, Florey Lodge and Barnard Lodge are identical, each having three bedrooms and shared bathroom facilities. People also have access to a comfortable communal lounge/dining area and a kitchen. People have access to several small courtyard gardens shared with other flats within the complex. The service provides accommodation and personal care for up to six adults with learning disabilities. There were three people living at Barnard Lodge at the time of our visit. Florey Lodge was closed awaiting refurbishments.

The service had a registered manager in post. 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 using the service expressed positive views about the service and the staff.

The service received referrals from social workers. This information was used to inform and develop people’s care plans in consultation with people and their family members (where appropriate). This ensured people’s support needs could be identified and risk assessments completed before people moved into the service on a permanent basis.

People’s risk assessments covered a range of issues including environmental issues, falls and mobility, nutrition and personal care. Staff supported people to attend health appointments and there were protocols in place to respond to any medical emergencies or significant changes in a person’s well-being.

Medicines were stored safely. Where staff were responsible for prompting people’s medicines, staff had completed training in medicines administration.

Staff were familiar with the provider’s safeguarding policies and procedures and able to describe the actions they would take to keep people safe. We had received two safeguarding notifications from the provider since the last inspection took place in August 2013. We saw records demonstrating that these matters had been managed appropriately in conjunction with local authority safeguarding teams.

The service was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS). The Care Quality Commission (CQC) is required by law to monitor the operation of the Mental Capacity Act (2005) (MCA) and DoLS, and to report upon our findings. DoLS are in place to protect people where they do not have the capacity to make decisions and where it is regarded as necessary to restrict their freedom in some way, to protect themselves or others.

Staff understood when a DoLS application should be made and how to submit one. Applications had been made to the relevant agencies as people using the service were subject to restrictions relating to access in and out of the building.

People’s independence was promoted. People attended church services church, went shopping and ate out. People had also been on holiday and further trips were planned.

Staff were aware of people’s specific dietary needs and preferences and offered people choices at mealtimes. People selected their own meals and ate them in the lounge or in their rooms. People who required support to eat and drink were offered this assistance in a caring and patient manner.

There were arrangements in place to assess and monitor the quality and effectiveness of the service. This included resident surveys and weekly meetings, staff team meetings and internal audits.

Inspection carried out on 17/04/2014

During a routine inspection

Carlton Gate is a care home providing accommodation, personal care and support for up to six people with a learning disability. The service is divided into two units, each for three people. When we visited, six people were living in the home.

People told us they felt safe in the home, they liked the staff and enjoyed the activities provided. Their comments included “I like living here” and “I feel happy speaking to staff, I like the staff.”

The care staff we spoke with demonstrated a good knowledge of people’s care needs, significant people and events in their lives and their daily routines and preferences. They also understood the provider’s safeguarding procedures and could explain how they would protect people if they had any concerns.

The home had a registered manager in post. Staff told us the manager, senior staff and the provider provided strong leadership and promoted high standards of care.

We saw all communal parts of the home and some people’s bedrooms, with their permission. We saw the home was clean, hygienic and well maintained.

We found the provider to be meeting the requirements of the Deprivation of Liberty Safeguards.

Inspection carried out on 3 July 2013

During a routine inspection

We spoke with three people who used the service and looked at the provider’s 2012- 2013 feedback survey. This was a survey of all its services, including Carlton Gate. People were satisfied with the care and treatment they had received and were happy living in their accommodation.

People who use the service were asked for their involvement in developing their care plan and if the person refused, this was documented. All people's risk assessments and care plans were up to date. Care plans were person centred.

People were cared for in a clean, hygienic environment by staff that had been through a recruitment process and subjected to the appropriate pre-employment checks. People who use the service were involved in the interview process. Staff had received training on infection control and there was a policy and procedure in place on infection control.

There were systems in place to monitor the quality of service people received. People were asked for their feedback through surveys and monthly residents meetings.

Inspection carried out on 2 November 2012

During a routine inspection

People who use the service told us that they were happy to be living at Carlton Gate. One person told us that staff were kind to them and that they were supported to do what they wanted each day. People were asked for their opinions on the quality of the service and any concerns were acted upon.

People who used the service were assessed to ensure that the service could meet their health and well-being needs. Once at the service, risk assessments were undertaken to ensure a person's safety. There were arrangements in place to deal with foreseeable emergencies and all staff had received basic life support training.

Staff had received training in capacity and consent and understood the importance of getting a person's permission before delivering care. People who use the service were involved in developing their person-centred support plan. Staff used pictures to support people who found it difficult to verbalise their preferences. People we spoke with knew about their support plan and told us that they agreed with it.

People who use the service told us that they felt safe living at Carlton Gate. Staff had receiving safeguarding training and were aware of the procedure to follow should they have a concern.

There was a programme of mandatory training for all staff. We saw that staff were appraised annually and received monthly supervision. Staff we spoke with told us that they felt well supported by management.

Inspection carried out on 8 June 2011

During a routine inspection

People told us that they liked living in the home and felt involved in their care. They had their own key worker who they could talk to. They were able to choose what they would like to do and were supported to do this. This included going on short holidays and days out.

Reports under our old system of regulation (including those from before CQC was created)