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We are carrying out a review of quality at Lowena. We will publish a report when our review is complete. Find out more about our inspection reports.

Inspection Summary


Overall summary & rating

Requires improvement

Updated 6 February 2020

About the service

Lowena is a short break service run by Cornwall Council for adults with learning disabilities. The service provides single room accommodation for up to 25 adults with a learning disability, physical disability and people living on the autistic spectrum, who need assistance with personal care.

The service is a large, bigger than most domestic style properties and larger than current best practice guidance. However, the size of the service having a negative impact on people has been reduced by the provider's focus on ensuring that people receive person-centred support which promotes choice, inclusion, control and independence. The service has been developed 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.

The service was a purpose-built single storey building in its own grounds. Occupancy levels vary on a day to day basis due to it being a respite service.

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

The service’s governance systems had generally improved and supported people using the service. The manager had only recently been registered with the commission. They were working hard to bring about the improvements required at Lowena. They were open, visible and committed to further improving the service. They were supported by a senior management team. However, governance systems were not always responding to required changes in a timely way. We have made a breach of regulation about this requiring the provider to take action. This is a continuing breach of regulation 17, At the previous inspection the service was in breach of this regulation because auditing system were not effective.

People took part in a range of activities which they enjoyed and were supported to maintain the relationships that were important to them. There were limitations in accessing community facilities since the providers transport was no longer available since September 2019. People were being supported to access the community, but this was limited due to the need for taxies or public transport. Staff were supporting people to use these forms of transport but told us it had significantly reduced choice in the community. This meant not everyone had an equal opportunity to use the community based on mobility needs.

People's needs were assessed before they used the respite service for short breaks. Support plans were not always updated in a timely way. This had been recognised by the management team and was being addressed. Some support plans, risk assessments had been reviewed and updated and this was ongoing. However, there was no evidence that it was being written in a format which could be understood by people with limited capacity. Staff were aware of the details of people's care plans and supported them accordingly. We have made a breach of regulation about this requiring the provider to take action.

The services environment continued to improve. Improvements found at the July 2019 inspection had been sustained and developed. All rooms were furnished in a domestic nature. Wall art and wall mounted televisions enhanced the homely environment. Further work was being undertaken to add shower facilities.

People were unable to provide us with verbal feedback because they had complex needs. Two of them however, nodded and smiled when we asked them if they were happy in the home. Three relatives and a care professional informed us that staff treated people with respect and dignity and people were safe using Lowena. We observed that staff interacted well with people and were attentive towards them. Staff made effort to ensure that people's individual needs and preferences were responded to.

People were cared for by st

Inspection areas

Safe

Good

Updated 6 February 2020

The service was safe.

Details are in our safe findings below.

Effective

Good

Updated 6 February 2020

The service was not always effective.

Details are in our effective findings below.

Caring

Good

Updated 6 February 2020

The service was caring.

Details are in our caring findings below.

Responsive

Requires improvement

Updated 6 February 2020

The service was not always responsive.

Details are in our responsive findings below.

Well-led

Requires improvement

Updated 6 February 2020

The service was not always well-led.

Details are in our well-Led findings below.