Archived: Pro-Care Dispersed Housing Ltd - Clevedon Lodge

At the last inspection on 07 October 2015, the service was rated ‘Good’. At this inspection, we found the service remained ‘Good’.

During this inspection visit, people we spoke with said they felt safe whilst living at the home. One person stated, “I absolutely feel safe.” Care files we looked at contained risk assessments intended to protect people against unsafe or inappropriate care. The provider had a good system to review accidents and whether there were lessons to learn to improve the service. Staff displayed a good understanding of safe infection control standards to ensure people lived in a hygienic environment.

We saw information about safeguarding and whistleblowing was made available to staff, people and visitors on a display board in the hall. One staff member commented, “I would have no hesitation to whistleblow poor practice.”

We found the registered manager ensured staff had medication training to underpin their skills. They completed regular audits of associated procedures to maintain safe medicines management.

The management team had recently recruited staff in ways that protected people from the employment of unsuitable personnel. We saw there were sufficient numbers of skilled employees to continuously meet people’s needs. A staff member stated, “It’s great here, I can be more one-to-one with people I have the time to support residents.” Staff files we looked at showed employees completed regular training, which was refreshed to update them to new evidence-based practices.

We found people were offered a choice of nutritious meals and they told us they enjoyed their food. Care records we saw included a ‘dietary requirements’ document that covered special diets, medical conditions, allergies, swallowing difficulties, hydration needs and preferences.

People commented staff had a kind, respectful attitude. One person told us, “In all the homes I’ve been in, the staff here are by far the best, they really care.” People said they were fully involved in their care planning and able to explore their mental, physical and social needs with experienced staff.

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.

Care files we reviewed included details about people’s backgrounds, choices and preferences to support and treatment. This guided staff to provide person-centred care based upon each person’s individuality.

Records we looked at contained confirmation of the management team completing regular quality assurance audits. People were complementary about the management team and expressed the home was well run. The provider sought people’s views and experiences of life at the home.

We considered our inspection findings to answer questions we always ask: -

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well-led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, the staff supporting them and from looking at records.

Is the service safe?

People were comfortable and relaxed during our inspection. One person told us, 'I feel very safe here. The home is securely locked, but I can come and go if I need to'.

Our discussions with staff demonstrated they understood the needs of people they supported. Although we found care plans were brief and limited, information was recorded about people's different support needs. This meant the provider had protected people from unsafe care by ensuring care planning and risk assessment was appropriate.

Is the service effective?

People told us the home was efficient in meeting their needs. One person explained, 'The staff discuss my care with me and we look at what support I need'.

Documents we reviewed showed support plans and risk assessments were individualised and updated. Support planning matched people's assessed needs. This meant people were protected against ineffective care provision because people's needs were adequately assessed.

We observed Clevedon Lodge worked effectively with other providers. People received the additional support required because the service had acted appropriately in referring to other services.

We noted that staff had received formal supervision and appraisal. Staff told us they felt supported by the registered manager and had completed appropriate training. One person who lived at the home told us, 'I think the staff are really well-trained and experienced. I feel very safe in their hands'.

However, we noted one staff member's appraisal and supervision was overdue. This meant staff were not always fully supported because formal supervision and appraisal were not provided on a regular and consistent basis. We were assured this would be addressed as a priority.

Is the service caring?

We observed staff interacting with people in a respectful and friendly manner. One person told us, 'The staff are great. They're very caring and fun to be around'.

People were comfortable and relaxed during our inspection. Staff engaged with people in an appropriate manner and had a good understanding of their needs. The manager told us, 'The most important aspect of our work is promoting our service user's independence'.

Is the service responsive?

Care records we reviewed evidenced that where people's needs changed, care planning was amended to incorporate these changes. This demonstrated the service had minimised the risks of unsafe care because the service had responded to people's changing needs.

The service worked well with other providers. People were monitored and, where required, other providers were referred to gain increased support. This meant Clevedon Lodge enabled people to access additional support when this became necessary.

The home had a complaints policy in place. We discussed this with the manager, who told us, 'We've worked hard to develop good relationships with our service users. They are much more confident at telling us if they're having any problems'. This meant the provider had minimised the risks of unsafe care because systems were in place to manage complaints.

Is the service well-led?

There were a range of quality audits in place to monitor service delivery. Appropriate policies and other regular processes underpinned this, such as resident meetings, satisfaction surveys and staff meetings. This meant people were protected against inappropriate support because the manager had systems to check the quality of care.

Care delivery was well-led and there were clear lines of responsibility. Care planning was personalised and updated. One person told us, 'It's really well-managed round here. The staff and manager are great and organise the home well'. This meant care delivery was appropriate and safe because Clevedon Lodge was well-led.

The home monitored and managed people's changing health needs by proactively engaging with other providers. The manager told us, 'Where people are deteriorating, particularly with their mental health, I would contact their social worker or consultant. We support them with their appointments so that we then know how best to support someone'.

The managers had a good understanding of the appropriate handling of complaints. The complaints policy was made available to service users, who had signed to show they understood related procedures. This meant the service was well-led because people were enabled to make complaints.

We saw that care plans had been developed that included the views and opinions of the person the care plan related to. Both people spoken with confirmed that they were aware they had a care plan. They told us that the content had been explained to them before they had signed the document. People told us that the detail in their care plan reflected their current wants, needs and wishes and that they were happy with this.

We asked people if they felt safe living at the home. We were told, 'Yes'. Neither of the two people spoken with expressed any concerns what so ever.

People were satisfied with their bedroom accommodation and communal area of the home. People confirmed that they looked after their own bedroom although staff sometimes helped. We were also told that meetings were arranged between staff and the people they supported. They told us the meetings provided them with the opportunity to have their say and help make changes.

We found that people at the home thought the staff were caring and respectful, and we have taken note that the general manager and staff team are looking to implement better ways of providing person centred care. This requires effective leadership, training and a commitment from the provider. The evidence suggests that these are in place, but our experience of life in the home suggest these can only be effectively implemented with a review of the staffing levels.