Saxon Lodge

About the service

Saxon Lodge is a residential care home providing the regulated activity personal care to up to 9 people. The service provides support to people with a learning disability and/or autistic people. At the time of our inspection there were 9 people using the service. The service accommodates people in 1 purpose-built building across 2 floors. It is located in a residential area.

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

Right Support:

The environment was clean, large and spacious which included a variety of communal areas. Ongoing maintenance kept the service to a good standard. Adaptations were in place to support people to be independent. The environment reflected the people who lived there with photographs, artwork and personalised decorative accessories on display in bedrooms and communal areas.

Relatives spoke very highly of staff who were extremely skilled in supporting people to live fulfilled lives. People had choice in all aspects of their lives and were supported to do all they wanted to do. Staff had a flexible approach and accommodated people’s wishes. They regularly went out in their community and further afield. Where there were shared interests, people went out together.

People were supported to access healthcare and staff championed their rights to make sure they received timely care and support. They received their medicines and staff worked in-line with recommendations from health professionals. Staff supported people to make decisions following best practice in decision-making. Staff communicated with people in ways that met their 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.

Right Care:

Staff promoted equality and diversity in their support for people. They understood people’s cultural needs and provided culturally appropriate care.

There were always enough staff on duty to provide safe care to people. Staff completed regular training and were very skilled in their care of people. They acted quickly when needed to keep people safe. They maintained dialogue with relatives and health professionals who had confidence in them to ensure people received timely person-centred care.

Staff knew people really well, referring to people as ‘family.’ They communicated with people in the way they preferred and consistently understood individual communication needs. People had their own way of communicating, which included sounds, gestures, body language, pictures and symbols.

The care people received reflected their range of needs, wishes and preferences. The approach taken by staff supported people’s well-being and enhanced and enriched their lives. Relatives said they were involved in their loved one’s care. One relative said, “I’m invited to [develop] plans, reviews and meetings. I’m listened to, definitely. [Staff] always ask my advice and are looking to improve things. They go out of their way to identify what [person] likes and they are willing to explore different things.”

Right Culture:

People led inclusive and empowered lives because of the ethos, values, attitudes and behaviours of the management and staff. People received the best care from staff who had the right skills, experience and training. They empowered people to do all that they wanted to do. An advocate said the service had, “Genuinely caring staff who go above and beyond to make sure people get what they need. “It’s individualised care; it’s warm and welcoming and everybody gets involved. People are really well cared for and loved.”

People were supported by staff who understood best practice in relation to the wide range of strengths, impairments or sensitivities people with a learning disability and/or autistic people may have. This meant people received compassionate and empowering care that was tailored to their needs.

Staff placed people at the centre of their care. They were responsive to whatever people wanted to do and achieve. Staff spoke highly of people and went ‘above and beyond’ for them to live the best lives possible.

The service was committed to a culture of improvement and regularly sought feedback to this. The service enabled people and those important to them to work with staff to develop the service. Staff valued and acted upon people’s views. People’s quality of life was enhanced by the service’s culture of improvement and inclusivity.

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

Rating at last inspection

The last rating for this service was good (published 18 December 2019).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

We found the following examples of good practice.

• The service was clean, tidy and odour free.

• Staff were observed wearing personal protective equipment (PPE) appropriately. Staff were knowledgeable about when to change their PPE and disposed of it in clinical waste bins.

• The service was booking visitors in at a time that suited people and was spaced out to avoid potential infection transmission with other visitors. Visits were currently limited to reduce the risk of infection transmission; this was in line with national guidance and visitors had been informed.

• The staff team had worked together to cover increased staff sickness during an outbreak to minimise the use of agency staff and potential to increase transmission of infection.

• Staff conducted larger meetings, remotely, using technology, when appropriate to reduce the amount of people entering the service.

• Information on infection control procedures and the use of PPE was available to people in accessible formats.

Saxon Lodge is a residential care home providing personal care and support for up to nine younger adults with complex needs such as learning and physical disabilities. Accommodation was provided over two floors. Bedrooms had ensuite facilities and, if required, specialist moving and handling equipment.

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 large home, bigger than most domestic style properties. It was registered for the support of up to nine people. At the time of the inspection nine people were using the service. This is larger than current best practice guidance. However, the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area. 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

People who used the service could not talk to us about their experience of living at the service and being cared for by staff. However, we spent time with them observing how staff supported them. We noted that relationships and interactions between staff and people living in the home were positive and relaxed.

There were enough skilled staff on duty to meet people's needs. Safe recruitment procedures were followed to ensure the right people were employed at the home. Risks were well managed, and people received the medication and treatment they needed to keep them safe.

People were supported to maintain good health and had contact with doctors and other healthcare

professionals when required. A varied and balanced diet was always provided for people. Staff were well trained and knowledgeable about how people needed to be supported to keep well and enjoy a good quality of life.

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.

The registered manager and staff ensured that people's individual care and support needs were met and records were reviewed regularly to reflect people’s current needs. People received the support they required to safely engage in activities of interest to them. Family relationships were actively supported by staff who arranged regular visits to families and also welcomed relatives into the home.

Relatives of people expressed confidence in the registered manager and staff, they said they were well informed and updated by the home about all aspects of the care provided. Relationships between the registered manager and staff were positive. Regular audits and checks were conducted by the provider to maintain and check on the quality of the service provided.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

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

Rating at last inspection

The last rating for this service was good (published 27 June 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Saxon Lodge provides accommodation for up to nine people with complex needs such as learning and physical disabilities. At the time of our inspection there were nine people using the service. Accommodation was provided over two floors. Bedrooms had ensuite facilities and if required specialist moving and handling equipment.

At the last inspection on 20 March 2015, the service was rated good. At this inspection we found the service remained good.

Medicines were stored and managed safely with people receiving their medicines as prescribed.

There were systems and processes in place to protect people from the risk of harm. Staff were aware of types of abuse and signs to look for. They also understood their responsibility to report anything they may be concerned about. The registered provider had a whistleblowing (telling someone) policy in place and staff had knowledge of this.

Risks to people’s safety had been assessed and risk assessments were personalised to each individual. Accidents and incidents were appropriately recorded and regularly analysed to minimise the risk of reoccurrence. Appropriate checks of the building and maintenance systems were undertaken to ensure health and safety.

There were appropriate staffing levels to meet the needs of the people using the service. We saw evidence of safe recruitment and selection procedures and appropriate checks were undertaken prior to staff starting work.

Staff had been trained and had the skills and knowledge to provide support to the people they cared for. Staff were given effective supervision and a yearly appraisal.

Staff understood the requirements of the Mental Capacity Act 2005 (MCA) and the Deprivations of Liberty Safeguards (DoLS) which meant they were working within the law to support people who may lack capacity to make their own decisions.

People were supported to maintain a healthy diet and to access healthcare appointments.

There was a lively and homely atmosphere in the service. Staff had a clear understanding of people’s needs and how they liked to be supported. People were supported by kind and attentive staff and we observed positive interactions between staff and people using the service. Relatives spoke positively about the care their loved ones received.

Support plans were individualised and person centred. They were well-written and contained a high level of detail about people’s needs and preferences.

People were supported to take part in activities within the service such as watching films and listening to music. Staff also encouraged and supported people to access activities within the community. These included days out walking in the countryside and visits to the theatre.

Relatives and staff described the registered manager as approachable and felt there was an open culture. Effective quality assurance was taking place to monitor the quality of the service and drive positive change.

At the inspection we went back to check the action staff had taken to ensure the records were being maintained appropriately. We looked at six of the eight sets of care records. We found that the care records contained evidence to confirm that the person and their relative had been involved in drawing up the plan of care and keeping it up to date. People were unable to communicate so staff told us how they involved people and their relatives in developing care plans and how they shared their ideas about care and support.

Where people were highlighted as being at risk, for example, with epilepsy, care plans had been developed. We found evidence of accurate nutritional screening. We found that care records contained up to date assessments, care plans and risk assessments. We found that care plans were reviewed monthly.

We found that people were protected from the risks of unsafe or inappropriate crae and treatment because records were maintained.

We observed staff providing support to people in a kind and caring manner. We found that people experienced care and support that met their needs.

We found that there were enough staff to meet people's needs and people were supported by suitably qualified, skilled and experienced staff.

Staff were up to date with training, however we found that although staff had previously received regular supervision sessions these were now overdue. We also found that appraisals were not up to date.

People were not protected from the risks of unsafe or inappropriate care and treatment because care records were not always completed properly.

We saw that people were well cared for and supported by a team of staff who were very knowledgeable about the care and support that people needed.

People's needs were assessed and their rights were respected by the staff. We saw that people were able to make decisions about how they wanted to spend their time and how they wanted to be supported and cared for.

People had support plans and risk assessments in place which helped staff to understand and meet people's needs and wishes. We observed staff helping people to maintain their independence and make choices for themselves, for example what activities they wanted to participate in during the day and what some people wanted for their lunch.

We saw that contact with families and friend is maintained and staff support people to do this. There was lots of involvement with local community groups and people had the opportunity with the support from staff to visit a variety places, attend social events and go on holidays.