Archived: St Lukes Lodge

Updated 14 December 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.

This inspection was brought forward in response to concerns surrounding an alleged incident of serious physical abuse, the actions taken after the alleged incident and the failure to notify the Care Quality Commission of the incident at the time. The incident itself remains subject to a criminal investigation and as a result this inspection did not examine the circumstances surrounding it.

These events took place during the tenure of the previous registered manager, who was no longer in post at the time of this inspection. The trustees of St Luke’s Trust had, with support from the local authority and another registered provider, put in place suitable interim management arrangements pending recruitment of a new manager and their application for registration. A new manager had since been appointed and had applied to become registered.

This inspection took place on 29 and 30 October 2018. The inspection was announced and was carried out by one inspector.

We gave the manager 2 days’ notice of the inspection site visit because St Lukes Lodge provides a supported living service. We wanted to make sure the manager would be present to assist with the inspection and to provide time to prepare people for our visit.

The service had submitted a provider information return (PIR), in June 2018. This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We looked at the information provided in the PIR and used this to help us plan the inspection.

Prior to the inspection we reviewed the information we held about the service. This included any notifications that we received. Notifications are reports of events the provider is required by law to inform us about. We contacted a representative of the local authority who funded people supported by the service for their feedback and received no concerns.

During the inspection we spoke with the registered manager, the nominated individual, and six other staff. We examined a sample of two care plans and other documents relating to people’s care. We looked at a sample of other records to do with the operation of the service, including training and supervision records and medicines recording. We spoke with four people receiving support from the service to obtain their views. We also observed the care and interaction between people and the support workers on both days of the inspection.

Updated 14 December 2018

This inspection took place on 29 and 30 October 2018. The inspection was announced and was carried out by one inspector. At the previous inspection, the service was rated “Outstanding”.

This inspection was brought forward in response to concerns surrounding an alleged incident of serious physical abuse, the actions taken after the alleged incident and the failure to notify the Care Quality Commission (CQC) of the incident at the time. The incident itself remains subject to a criminal investigation and as a result this inspection did not examine the circumstances surrounding it. These events took place during the tenure of the previous registered manager, who was no longer in post at the time of this inspection.

The trustees of St Luke’s Trust had, with support from the local authority and another registered provider, put in place suitable interim management arrangements pending recruitment of a new manager and their application for registration. A new manager had since been appointed and had applied to become registered. 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.

St Lukes Lodge provides supported living support to 10 people with moderate to severe learning difficulties. Service users reside either in the main premises, St Lukes Lodge, or if they need less intensive support, in the on-site annex, known as Lyndale House. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

Not everyone using St Lukes Lodge receives regulated activity. CQC only inspects the service being received by people provided with ‘personal care’, help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

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.” (Registering the Right Support CQC policy).

We found people were now provided with safe care and support. Appropriate action had been taken to address the previous issues referred to above. The new manager and the staff fully understood their responsibilities to safeguard people from harm and the action they must take if they had concerns about this.

People felt safe and well cared for by the staff and it was evident they felt at ease around all of the staff. Staff had received nationally recognised training on how to support people whose behaviour could sometimes challenge the service.

Identified risks were assessed and action taken to mitigate them as far as possible, without restricting people’s freedom of choice.

A robust recruitment process helped ensure staff recruited had the necessary skills and the right approach to provide the support people needed. Additional staff had been recruited to provide consistent care to people, going forward.

People’s needs were met effectively by staff who understood how people communicated their needs and wishes and who listened to people. People’s diverse needs, their rights, privacy and dignity were protected and respected by staff.

People received appropriate support with their healthcare and dietary needs. Staff consulted external healthcare specialists when necessary and advocated on behalf of people to ensure they received the healthcare they needed.

Staff were appropriately trained and supported to help them deliver effective and consistent care.

People received caring and patient support from staff who actively involved them in decision making and supported them to make meaningful daily choices about their lives.

The high level of commitment of staff to the people they supported, was very evident in their approach and the positive way they spoke about people.

People’s needs and wishes were recorded clearly in detailed care plans which were subject to ongoing review and development. People and their representatives had been consulted about their wishes and needs.

People were enabled to live fulfilling lives and be involved in the local community. They had opportunities to be involved in a wide range of activities. Their views were sought and they felt listened to by the manager and staff.

Effective use was made of a range of assistive technologies to safeguard and improve people’s experience. Key documents had been adapted, using images, to make them more accessible.

The service was moving forward positively under the new management. Effective monitoring and audit tools had been established to help ensure more effective governance by the trustees.