This unannounced inspection of Afton Lodge Care Home took place on 12 October 2017. Located in a residential area of Bootle, Afton Lodge Care Home provides accommodation and care for a maximum of 27 people. Access for people who use wheelchairs is located to the front of the property. A passenger lift is available for access to the upper floors. Parking is available to the front of the property and a large garden to the rear. The home is located close to shops, local facilities and transport links.
There were two registered managers in post who shared the role. 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.
Everyone we spoke with told us they felt safe living at the home.
Records showed that people received their medications when they needed them, and medication was stored safely in home. Medication was only administered by staff who had the skills to do so.
Staff recruitment records showed that staff were only offered positions in the home once all satisfactory pre-employment checks had been completed.
Risk assessments had fully explained and explored ways to help mitigate risk. These risk assessments were reviewed every month, and where a change in the person’s needs had been identified, the risk assessment had been updated accordingly to reflect this.
All staff were able to explain the steps they would take to ensure any safeguarding concerns were reported to the registered manager or the relevant safeguarding authority.
New staff underwent a full training programme and induction before they started work. Existing staff had their knowledge updated in line with the providers training programme by attending regular refresher courses. The training matrix showed that all staff were up to date with the training.
The staff and the registered managers were knowledgeable with regards the Mental Capacity Act 2005 and associated legislation. We viewed examples of when best interest processes had been considered for people in line with guidance set out in the MCA.
Everyone told us they enjoyed the food, and the dining experience at Afton Lodge was positive. People said they could chose whatever they liked to eat and they were not restricted to eat at certain times of the day if they did not feel like it and could have what they liked.
We received exceptionally positive comments from everyone we spoke with regarding the caring, kind, and approachable nature of the staff and registered managers. People could not compliment the staff enough on their approach. We observed natural interactions and relationships between people who lived at the home and the staff throughout the duration of our inspection. When we spoke to staff they were extremely passionate about the people they supported, and demonstrated a remarkable knowledge of people and how they wanted to be cared for. This extended to people’s families, who staff equally had good relationships with and who told us staff made a difference to people.
We saw dignified support across the duration of our inspection, ranging from staff discreetly helping people with personal matters, to staff supporting people to eat their meal. Everyone was given support quickly and attentively, and this was done in way which did not appear rushed. Care plans were written equally as dignified, and important information was highlighted in people’s care plans because it mattered most to them.
People’s care plans were presented to them in a way which they understood, and they had been involved in their completion. Family members were kept involved and consulted with anytime there was a change to people’s care needs.
Health care professionals we spoke with on the day of our inspection told us that every time they had visited the home atmosphere never changed and the staff were always attentive to people’s needs and followed instructions from beginning to end if someone needed care delivered in a particular way.
People’s care plans contained information about their likes, dislikes, preferences and routines. People were supported to pursue their interests. Appropriate referrals were made to relevant health professionals when needed.
There had been no formal complaints raised in the home. However, people told us they knew how to complain and the complaints process was displayed in an accessible part of the home.
There were two people who shared the position of registered manager and had been in post for eight months but had worked at the home as deputy managers for a long time before they stepped up into the role.
Quality assurance procedures were robust, and regular auditing of service provision took place in the home. The provider was actively involved in the home, and visited regularly to check if any changes were needed to made.
Everyone was complimentary about the culture of the home and the way it was ran. Everyone we spoke with said they would recommend the home.
The ratings from the last inspection were on display in the communal area of the home.