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Inspection carried out on 3 April 2019

During a routine inspection

About the service:

Court Lodge is a residential care home that provides personal care for up to six people with mental health and learning disabilities. At the time of our inspection there were five people living there.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

People’s experience of using this service:

¿ Some aspects of the service were in need of repair, and despite being reported by management, the provider had not taken timely action to resolve them.

¿ People and their relatives had positive feedback about the service. People told us they decided how they spent their time, and the activities they took part in. Staff used information from people’s histories and background to review different interests and hobbies they could revisit.

¿ Staff used technology to enhance people’s care, by supporting them to access the internet to view film trailers or search for equipment.

¿ People were supported to take positive risks, accessing the community regularly, and being involved with food preparation. Risks has been assessed and there was clear guidance for staff to follow.

¿ People told us there were enough staff to keep them safe, support them to follow their interests and take part in activities.

¿ People were supported to maintain a balanced diet. Some people had healthcare conditions that effected their eating or drinking and were supported to manage these independently.

¿ People, their relatives and staff were positive about the culture of the service, and felt it was well-led.

¿ 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 received planned and co-ordinated person-centred support that is appropriate and inclusive for them.

Rating at last inspection:

At the last inspection the service was rated Good. (5 October 2016)

Why we inspected:

This was a planned inspection based on the rating at the last inspection.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as

per our re-inspection programme. If any concerning information is received, we may inspect sooner.

Inspection carried out on 5 October 2016

During a routine inspection

We inspected Court Lodge on 5 October 2016.

The service provides accommodation and support for up to six people with mental health and learning disabilities. There were six people living at the service at the time of our inspection.

The service has 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.

People were cared for by staff that had been recruited and employed after appropriate checks were completed. There were enough staff available to support people.

Records were regularly updated and staff were provided with the information they needed to meet people’s needs. People's care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare.

Staff and the manager were able to explain to us what they would do to keep people safe and how they would protect their rights. Staff had been provided with training in safeguarding adults from abuse, Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS).

People were relaxed in the company of staff. Staff were able to demonstrate they knew people well. Staff were attentive to people's needs and treated people with dignity and respect.

People who used the service were provided with the opportunity to participate in activities which interested them; these activities were diverse to meet people’s social needs.

The service worked well with other professionals to ensure that people's health needs were met. Where appropriate, support and guidance was sought from health care professionals, including people’s GPs and other health professionals.

People knew how to raise a concern or make a complaint; any complaints were resolved efficiently and quickly.

The manager had a number of ways of gathering views on the service including holding meetings with people, staff and talking with relatives.

The manager carried out a number of quality monitoring audits to ensure the service was running effectively. These included audits on medication management and the environment.

Inspection carried out on 13 May 2014

During a routine inspection

A single inspector carried out this inspection. The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well-led?

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

If you'd like to see the evidence that supports our summary you can read the full report.

This is a summary of what we found:

Is the service safe?

We found that members of staff had a good awareness of systems and procedures used to protect people. Advice was sought from members of the wider multidisciplinary health care team in planning safe and effective care for people. Effective recruitment procedures ensured that people were cared for and supported by competent staff. One person told us, "They help me when I need it".

Is the service effective?

People were encouraged and supported to take part in meaningful activities. We saw evidence that a good quality of life was being achieved for people living at Court Lodge. Evidence included photographs of people engaging in a range of activities and person centred care planning which described in detail what mattered to people. One relative we spoke with told us, "They (the staff) often take (their relative) out for a picnic". One person we spoke with told us, "I like going to knit and stitch".

Is the service caring?

We saw that staff treated people with respect and dignity. People were involved in planning and reviewing their care and support. We saw evidence that people's wishes were balanced with ensuring their safety. One person told us, "I like all the staff. I have one-to-ones with (my keyworker)". One relative told us, "Every one of them (the staff) has treated (their relative) with kindness". One member of staff told us, "Staff always respect people's space, wishes and preferences".

Is the service responsive?

There was a person centred approach to planning care and support. People's views regarding their care were sought on a regular basis and this was documented in their plans. People had signed to indicate that they agreed with their plan of care. People's individual needs were dealt with in a prompt and efficient manner. People were encouraged to make choices regarding their care and support. One person told us, "I want (a particular member of staff) to come with me (to a hospital appointment)".

Is the service well led?

Although there was no annual survey available for us to see at the time of our visit we saw evidence that people's views regarding their care had been sought. Relatives we spoke with told us the manager was very approachable and we saw that people were provided with information needed to make a complaint. Contact details of agencies overseeing care were provided in a format they could understand. Incidents were dealt with in an appropriate manner and there was evidence that learning from incidents had taken place and revised procedures had been put in place. One person we spoke with told us, "I love it here. I've been here seven years now".

Inspection carried out on 2 May 2013

During a routine inspection

People told us they liked living at the service. One person told us “There wouldn’t be anywhere else as nice as this one.”

People received care that met their needs and promoted their rights. People participated in activities they enjoyed. People’s care was reviewed regularly and service delivery was amended accordingly. Advice and guidance was sought from health and social care professionals to be able to meet people’s needs effectively and promote their welfare and safety

People were supported to consent to their care and treatment and there was guidance available to staff around the process to follow should it be in one person’s best interests to undergo specific dental treatment. There was written guidance available to staff around the Mental Capacity Act 2005 and staff had undertaken training in the subject.

The environmental concerns identified at our previous inspection on 29 October 2012 had been addressed. There was new carpet in the communal areas, providing a homely and hygienic environment in which to live.

There were enough staff on duty to be able to meet people’s needs effectively. Staffing levels were adjusted to reflect people’s needs. There were systems in place to support staff to be able to undertake their role safely and effectively. A staff member told us “[the manager] is brilliant, they have changed so much”.

There were systems in place to monitor and review service delivery and to regularly maintain the safety of the premises.

Inspection carried out on 29 October 2012

During a routine inspection

At the time of inspection five people lived at the service and the manager had been in post for three weeks. Prior to the inspection we had received information of concern about the environment, repetitive menus and a lack of support being given to staff. During the inspection we saw that some of these areas had been addressed however the kitchen worktops were damaged and therefore unhygienic and there were areas of damp in the bathrooms. The manager had reported these matters to the provider to be addressed.

We looked at care records and saw that overall people’s needs were being met, but decisions effecting people’s care and support were not always recorded or reviewed. The manager told us they were reviewing people’s care plans to ensure they reflected people’s needs and documented decisions.

A person told us they got on well with everyone and they would talk to any of the staff if they had a problem. They liked to stay indoors and listen to the radio. A relative told us “I am amazed at how well they are cared for”. They told us their relative felt very comfortable with the staff; their relative got on better with some staff than others. We were told that the staff monitored people’s health very carefully and kept the family informed. “We are very lucky”. Another relative told us “they are really good”. The staff managed to encourage their relative to be independent and kept them safe.

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