Archived: Hamilton Lodge Trust

Updated 4 November 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The inspection took place on 4 May 2016 and was unannounced.

The inspection team consisted of three inspectors and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service. Our expert was a family carer for children with autistic spectrum disorder.

Before we carried out our inspection we reviewed the information we held on the service. This included statutory notifications that had been sent to us in the last year. A notification is information about important events which the service is required to send us.

We spoke with eight people who used the service, six relatives, nine care staff and the registered manager. We also gathered feedback from adult social care professionals connected to the service.

We reviewed nine care plans, eight medication records, five staff recruitment files and staffing rotas covering eight weeks. We also reviewed quality monitoring records and records relating to the maintenance of the service and equipment.

Updated 4 November 2016

The inspection took place on 4 May 2016 and was unannounced.

The service provides care and support for up to 40 people who have autistic conditions, learning disabilities and physical disabilities. At the time of our inspection there were 24 people using the service.

The service had a registered manager in place. 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.

Staff were trained in safeguarding people from abuse and systems were in place to protect people from abuse. Staff understood their responsibilities to report any safeguarding concerns they may have and were confident they had the skills to do this.

Risks to people and staff were assessed and action taken to minimise these risks. People were encouraged to remain as independent as possible and any specific risks related to this were assessed.

Staffing levels meant that people were safe but levels were in need of review as staff could not ensure that people’s social needs would be met promptly. Staffing in one particular bungalow was not enough to support everyone effectively when one person’s distressed behaviour occupied a lot of staff time. This was having a negative impact on others. Staffing levels had begun to be reviewed across the service as there was an acknowledgement that they did not always allow for people’s need to be met promptly.

Recruitment procedures were designed to ensure that staff were suitable for this type of work and checks were carried out before people started work to make sure they were safe to work in this setting. New staff were able to shadow more experienced staff to help them gain confidence. The high level of vacancies at the service meant that agency staff were often used and support and guidance for these staff could be improved.

Training was provided for staff to help them carry out their roles and increase their knowledge of the healthcare conditions of the people they were supporting and caring for. Some training refreshers were overdue. Staff were supported by the managers through supervision and appraisal.

People gave their consent before care and treatment was provided. Staff had been provided with training in the Mental Capacity Act (MCA) 2015 and Deprivation of Liberty Safeguards (DoLS). The MCA and DoLS ensure that, where people lack capacity to make decisions for themselves, decisions are made in their best interests according to a structured process. Where people’s liberty needs to be restricted for their own safety, this must done in accordance with legal requirements. People’s capacity to give consent had been assessed and decisions had been taken in line with their best interests. There was a good understanding of processes related to DoLS.

People were supported with their eating and drinking needs and people were fully involved in shopping and cooking. Staff helped people to maintain good health by supporting them with their day to day physical and mental healthcare needs.

Staff were caring and treated people respectfully making sure their dignity was maintained. Staff were positive about the job they did and enjoyed the relationships they had built with the people they were supporting and caring for.

People, and their relatives, were involved in planning and reviewing their care and were encouraged to provide feedback on the service. Care was individualised and subject to on-going review and care plans identified people’s particular preferences and choices. People were supported to play an active part in their local community and follow their own interests and hobbies.

Formal complaints were well managed and had been investigated and resolved satisfactorily. An overall complaints log was being put into place.

Staff understood their roles and were well supported by the management of the service. The service had an open culture and people felt comfortable giving feedback and helping to direct the way the service was run. Staff were positive about their work and the manager, who had been in post a few months only, had worked hard to create a positive and inclusive staff team.

Quality assurance systems were in place and audits were carried out regularly to monitor the delivery of the service. Improvements were evident and the manager had a clear idea of the priorities for the service.