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Inspection carried out on 26 September 2019

During a routine inspection

About the service

The Lodge is a residential care home providing personal and nursing care to 2 people with learning disabilities and autism at the time of the inspection. The service can support up to 4 people in one adapted building.

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

The service was a small home. There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.

People’s experience of using this service and what we found

Audits were not always effective to check the quality of the service. Some audit checks did not identify inconsistencies in documentation.

Systems in place ensured people were kept safe. Staff understood how to protect people from abuse. Risks were assessed and reviewed effectively and staff understood how to manage risk to people. People were supported by a sufficient number of safely recruited staff who were flexible to meet people’s needs. Medicines were stored and administered safely and as required medicines were used appropriately as a last resort. People lived in a clean and tidy environment and staff understood how to promote infection control. Lessons were learned when things went wrong and action was taken to reduce the risk of reoccurrence.

People’s needs and choices were holistically assessed and considered people’s needs related to equality and diversity. Care was delivered in line with people’s needs and choices. People were supported by staff who were appropriately trained and had the skills to meet their needs. People were supported to eat in line with their care plans and dietician advice. People were referred to healthcare professionals in a timely manner when needed. People lived in an environment that had been adapted to meet their personalised needs.

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.

People were supported by kind and caring staff who treated them with empathy. People were supported to make decisions for themselves where possible. People were supported by staff who respected their privacy and dignity. People were encouraged to be independent.

People were involved in care planning and reviewing their needs to ensure they had as much control as possible over their care. People were supported by staff who knew how to meet their personalised needs. People were supported by staff who understood their communication needs and systems were in place to ensure compliance with the Accessible Information Standard. People were encouraged to engage in personalised activities of their choice and staff promoted family relationships. A complaints policy was in place and relatives were encouraged to use this when needed. People’s end of life wishes were considered.

The registered manager was aware of their statutory responsibilities and submitted notifications to CQC where required. A person centred approach to care was encouraged and staff followed this to promote good outcomes for people. Staff and relatives found the registered manager to be approachable and were confident they would address any concerns. The provider encouraged an open environment in line with the duty of candour. Staff and

Inspection carried out on 13 April 2017

During a routine inspection

This inspection was unannounced and took place on 13 April 2017.

The Lodge provides accommodation and personal care for up to four people. On the day of our inspection two people were living in the home.

The home had a registered manager who was present for the inspection. 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 protected from the risk of potential abuse because staff knew how to recognise the signs and what action to take to safeguard them. People’s risk was managed in a way that promoted their independence. People were cared for by sufficient numbers of staff who were recruited safely. People received their medicines as prescribed by staff who were appropriately trained.

People’s care needs were met by skilled staff who were supported in their role to provide effective care and support.. People’s human rights were protected because staff had applied the principles of the Mental Capacity Act and the Deprivation of Liberty Safeguards in their care practices. People had access to a choice of meals and were encouraged to eat and drink sufficient amounts. People were assisted by staff to access relevant healthcare services when needed.

People were cared for by staff who were kind and sympathetic to their needs. People were supported to be involved in making decisions about their care needs. People's right to privacy and dignity was respected by staff.

People were encouraged to be involved in their care assessment and had access to an advocate to represent them. The service provided was person centred to meet people’s specific needs. Staff were able to recognise when people were unhappy and this was explored and resolved where possible. The provider had systems in place to record and monitor complaints.

People were supported to have a say in how the home was run. The home was run by a registered manager who was supported in their role by the performance and compliance manager. Staff felt supported in their role by the registered manager. The provider had effective systems in place to assess and monitor the quality of the service provided to people.

Inspection carried out on 13 February 2015

During a routine inspection

We inspected this service on 13 February 2015. This was an unannounced inspection. Our last inspection took place in January 2013 and at that time we found the home was meeting the regulations we looked at.

The service was registered to provide accommodation and personal care for up to four people. People who use the service have a learning disability and/or mental health needs.

At the time of our inspection two people were using the service.

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 and associated Regulations about how the service is run.

People’s safety risks were identified, managed and reviewed and the staff understood how to keep people safe. People’s medicines were managed safely, which meant people received the medicines they needed when they needed them.

There were sufficient numbers of suitable staff to promote people’s safety and people were happy and relaxed around the staff.

Staff had completed training to enable them to meet people’s needs effectively and the development needs of the staff were monitored by the registered manager.

People who used the service were unable to make certain decisions about their care. In these circumstances the legal requirements of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS) were followed. People had access to advocates to help them make decisions about their care.

People could access suitable amounts of food and drink of their choice and specialist diets such as a high calorific diet were catered for.

People’s health and wellbeing needs were monitored and people were supported to attend health appointments as required.

Staff treated people with respect, kindness and compassion and people’s dignity and privacy was promoted.

People were enabled and encouraged to make choices about their care and the staff respected the choices people made. The staff understood people’s communication styles and behaviours, and they knew how to respond to these behaviours to improve people’s care experiences.

The care was led by the people who used the service and plans were based upon people’s individual preferences and likes. People’s plans of care were flexible and the staff adjusted plans to meet people’s changing needs.

People were involved in the assessment and review of their care and staff supported and encouraged people to access their local community.

People’s spiritual needs were met. This included the need to develop and maintain their friendships and faith.

Staff analysed people’s responses and behaviours to identify if they were happy with their care. If people showed they were unhappy with their care, the staff took action to make improvements to the care.

There was a positive atmosphere within the home and the registered manager and provider regularly assessed and monitored the quality of care to ensure standards were met and maintained. The registered manager understood the requirements of their registration with us and they and the provider kept up to date with changes in health and social care regulation.

Inspection carried out on 8 January 2013

During a routine inspection

There were three people living in the home at the time of our inspection. We spent time speaking with staff and all the people who lived there

The atmosphere at the home was relaxed and homely. We observed positive and respectful interactions between people and staff throughout our inspection. One person we spoke with said they enjoyed going on visits.

Staff used pictures and photographs to assist people to make choices and share their views. The views of people were used to improve the quality of services delivered. We observed that staff treated people with respect, communicating in a way that maximised people's involvement in their care.

There were three staff on duty including the registered manager. We found they were knowledgeable and experienced.

The provider had a system in place for dealing with complaints and people knew how to use it.

Inspection carried out on 21 December 2011

During an inspection looking at part of the service

We completed this inspection visit because we had not visited for sometime and we did not have any recent information about the service. We needed to assess whether the service was meeting the essential standards of quality and safety.

Four people live in this bungalow that provides single floor access with good facilities. Two people had their own bedroom and two others shared a large bedroom. The home was very comfortable and homely with particular appeal as all people using the service had been involved in decorating their home for Christmas.

When we arrived at 9am we were told it was a special day, everyone was going out for lunch and onto the pantomime at the local theatre later in the day. People were very excited about this and told us that they had been planning and looking forward to this day.

Two people were able to verbalise this quite positively. Two were not, but told us by means of communication with staff and other non-verbal means that they were very excited about the planned trip. We were able to observe interactions about the planned event and people showed their enthusiasm and pleasure by their reactions and smiles.

We later spoke with two relatives who visit regularly and they told us that they were very satisfied with the care provided at The Lodge. One said their relative was �Very happy, enjoys life and is treated well by brilliant staff.�