Background to this inspection
Updated
28 November 2018
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 1 October 2018 and was unannounced. The inspection team consisted of one inspector, one assistant inspector 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. The expert-by-experiences’ area of expertise was in supporting people with learning disabilities.
We used information the provider sent us in the Provider Information Return (PIR) to complete the inspection report. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We looked at this and other information we held about the service. This included notifications. Notifications are changes, events or incidents that the provider must inform us about.
We spoke with all the people who used the service and to one relative over the telephone. During the inspection we spoke with three care staff and the registered manager. After the inspection we contacted four health and social care professionals for feedback and received a response from one.
We reviewed a range of records about people's care and how the service was managed. These included the care records for all four people, medicine management, staff training, quality assurance audits, incident reports and records relating to the management of the service. We also looked at the recruitment files of four staff members. We made informal observations of care, to help us understand people's experience of the care they received.
The service was last inspected on the 11 February 2016 and was awarded the rating of Good. At this inspection the service remained Good.
Updated
28 November 2018
A comprehensive inspection took place on 1 October 2018. The inspection was unannounced.
Bishops Lodge is a home registered to provide accommodation and personal care to a maximum of six people with learning disabilities, specialising in support for people with Prader-Willi syndrome. Prader-Willi syndrome is a rare genetic condition that causes a wide range of physical symptoms, including an excessive appetite and overeating, learning difficulties and behavioural problems. At the time of the inspection there were four people living at the service. The home was a converted house that provided accommodation for people over two floors.
The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.
At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.
Staff remained kind and caring and had developed good relationships with people. People's privacy was respected and staff supported people to be as independent as possible.
Systems remained in place to protect people from abuse and staff received training in their responsibilities to safeguard people. Risks relating to people's care were reduced as the provider assessed and managed risks effectively.
People were supported with their nutritional needs by staff who had very good knowledge of the additional considerations needed to manage this prominent symptom of Prader-Willi syndrome. Adaptions had been made to the premises to ensure that peoples safety with their syndrome was protected.
People's medicines were managed safely by staff. People were supported by staff who had been assessed as suitable to work with them. Staff had been trained effectively to have the right skills and knowledge to be able to meet people's assessed needs. Staff were supported through observations, supervisions and appraisals to help them understand their role. The provider had ensured that there were enough staff to care for people.
People continued to receive care in line with the Mental Capacity Act 2005 and staff received training on the Act to help them understand their responsibilities in relation to it. People’s capacity to make decisions had been carefully assessed. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
People’s needs continued to be assessed and person-centred care plans were developed, to identify what care and support was required. People received personalised care that was responsive to their needs.
People were encouraged to live healthy lives and received food of their choice. People received support with their day to day healthcare needs.
People were informed of how to complain and the provider responded to complaints appropriately. The provider communicated openly with people and staff. Staff worked closely with professionals and outside agencies to ensure joined up support.
People and staff spoke highly of the leadership of the service. Quality assurance and information governance systems remained in place to monitor the quality and safety of the service. Staff worked well together and were aware of their roles and responsibilities.
Managers and staff learnt from feedback and took action to improve service delivery following incidents, accidents and audits.
Further information is in the detailed findings below