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Inspection carried out on 26 February 2018

During a routine inspection

Care service description

Carlile Lodge is a service for up to ten people with learning disabilities and /or autistic spectrum disorder who may also have behaviours that can be challenging. People lived in their own flats and shared communal areas such as a kitchen, lounge, dining room and laundry room. There were eight people living at the service when we inspected.

Carlile Lodge is a ‘care home’. People in care homes receive accommodation and nursing or 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 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.

Rating at last inspection

At our last inspection we rated the service good.

Rating at this inspection

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.

Why the service is rated Good

People were supported to recognise when they were vulnerable and how to keep themselves safe. People were involved in identifying risks and in planning with staff, how these could be minimised. People were involved in managing their own medicines and in minimising the risk of infection.

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. When incidents or accidents occurred people and staff worked together to minimise the risk of them happening again.

People worked with staff to develop their own care plans and design their own support. People were supported to prepare their own meals. People chose what they ate and could eat in their own flats or with others in the communal dining area. People were supported to understand any health conditions and how to manage them well. People took part in a range of activities they enjoyed and were encouraged to try new things. Staff knew people well and responded quickly to any signs of anxiety or distress. Interactions between people and staff were relaxed and included lots of humour. People were supported to respect each other and appropriately challenge each other’s behaviour. People used a range of tools to express themselves and information was given to them in ways they understood. People had been supported to develop end of life care plans when appropriate.

There were enough competent, trained staff to meet people’s needs and they were recruited safely. Staff told us they felt well supported by the registered manager and could put forward suggestions for improvements at any time. Staff used effective systems to communicate with each other to ensure people’s needs were met. The registered manager received updates on good practice and changes in legislation from the provider and shared these with the staff team. Staff worked in partnership with other professionals to support people and understand their support needs.

Regular audits of the service were completed and used to drive improvement. People, relatives and professionals were encouraged to give feedback on the quality of the service. Feedback was generally positive and any concerns had been addressed. People were encouraged to raise any concerns or complaints and these were resolved in line with the provider’s policy and to people’s satisfaction. The environment had been designed to meet people’s needs including adaptations to people’s bathrooms when re

Inspection carried out on 24 and 25 September 2015

During a routine inspection

The unannounced inspection took place on the 24 and 25 September 2015. Carlile lodge provides accommodation and support for up to ten people who may have mental health needs or a learning disability. The service was last inspected in July 2013 and had met our standards of compliance.

At the time of the inspection ten people were living at the service. All people lived in their own personal flat either on the ground floor, female only floor or male only floor. All flats had an en-suite with shower or bath facilities. One person lived in a self-contained annex which was external to the main part of the home. All people had access to a large communal lounge/dining area, kitchen, shared bathrooms and laundry room. There is a small courtyard garden area that people could access when they wished.

The service is run by a registered manager, who was present on both days of the inspection visit. 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 and associated Regulations about how the service is run.

There were enough staff with the right skills and knowledge to support people. Staff felt confident that they received enough training and could ask for more if they felt they would benefit from it. They had good support and supervision to fulfil their role effectively and felt confident in approaching the registered manager, deputy manager or senior if they needed extra guidance.

Staff were trained in safeguarding and understood the processes for reporting abuse or suspected abuse. They were aware of the procedures for whistle blowing and felt confident that the management of the service would respond appropriately to any incidents of abuse.

Staff sought consent from people when providing support, promoted independence and encouraged freedom of choice. People’s wishes were respected, even if decisions may be seen to be unwise. Staff had a clear understanding of the principles of the Mental Capacity Act 2005 (MCA). Where people were being assessed for capacity they were offered advocacy and the service had taken the appropriate steps to meet the requirements of the legislation.

Staff knew the people who lived at the service well, they understood what was important to help them meet their full potential. Each person had their own individual needs assessed and these were regularly reviewed and support plans were updated. People were fully involved in their support plans as much as they wished to be. This was clearly observed within the recorded documentation.

People received their medicine in a safe way. Robust processes ensured that medicine was safely stored, administered and recorded. Regular audits of medicines were conducted and records showed that previous errors had been investigated. People received their medicine in an individual way to meet their preferred needs.

People were offered choice regarding their food. People could choose when and where to have their meals. People were encouraged to take ownership over the preparation of meals and devised rotas together to share out tasks such as the cooking and washing up. People had their dietary preferences met and were supported to manage restrictions to their food due to medical conditions.

We observed throughout our inspection numerous examples of people being shown care and understanding. People were encouraged to follow their own time table of educational and recreational activities and new activities and special days out were arranged with the involvement of the people living at the service. People were supported to have regular resident meetings which they were in charge of. They were given the opportunity to provide feedback to the service about things they wanted to improve or what they thought was going well.

The registered manager and staff took an approach to the service that encouraged independence, freedom and personal ownership. People were supported to live their own individual lives, and people were treated with dignity and as equals. There was a relaxed rapport between staff and people.

People knew how to complain and clear policies were evident. People were given information in an appropriate format that would help them understand what they should expect. Where complaints had been made the service had been responsive and sought solutions. Complaints were used as an opportunity to learn and improve outcomes for people.

People were encouraged to be fully involved in the management of the service. They were asked to be involved in the recruitment of new staff and would be part of the interviewing process.

Good leadership was clearly visible in the service. The registered manager had the right skills, experience and knowledge to lead the rest of the staff team to provide support in a way which improved people’s lives. Good processes were in place for monitoring quality and making improvements.

Inspection carried out on 8 July 2013

During a routine inspection

People that used the service spoke very positively of the staff and their lives at Carlile Lodge. People told us they were involved in planning their care and had control of their own lives. They were involved in the running of the service including cooking, shopping, planning social events and the recruitment of staff. People received the support they needed and were encouraged to be as independent as possible, whilst still remaining safe. People were treated with respect and their rights were maintained.

People were supported to maintain their health and to access health services when they needed to. They were given the help they needed to safely manage their medicines.

People were supported to be involved in their local community through the use of community facilities, such as shops, banks, pubs and restaurants. They were asked about the activities they enjoyed and given support to do these. People�s personal relationships were respected and they were supported to maintain relationships with their family and friends.

There were enough skilled and qualified staff employed to meet people�s needs.

The service was checked regularly by the manager and the registered provider to ensure people were receiving safe and effective care. This included asking people who used the service for their feedback. People told us that they did not feel that there was anything that needed changing with the service.

Inspection carried out on 16 November 2012

During a routine inspection

There were eight people living at the service at the time of inspection. People told us that the staff and manager were nice. A person said the service was �homely�. Another person told us the staff looked after them well. A person told us they got on well with the other people at the service, referring to them as their �friends�.

We spoke with relatives who all spoke positively about the service with a relative describing the service as �superb�. Another relative told us how the service got the best out of their relative adding �we could not ask for better, they are very caring�. They told us that staff �bend over backwards� to enable their relative to participate in activities and their relative�s life was very full. They said the manager always contacted them about changes to their relative. Relatives noted that the staff treated people with respect and dignity and they were professional in their approach.

The manager had ensured the staff were trained to meet people�s needs. A relative told us that the manager gave them confidence that their relative was being well cared for. Their relative had become more independent since they had lived at the service and were always happy to return following a visit to their family. We saw that people were involved in making decisions about all areas of their lives and care. They had their needs met. The staff were supported in their roles. There were systems in place to monitor service delivery and the safety of the service.

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