We carried out a review of the data available to us about Mere Lodge on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Mere Lodge, you can give feedback on this service.
About the service
Mere Lodge is a residential care home providing personal and nursing care to up four people. The service provides support to people living with a learning disability and mental health conditions. At the time of our inspection there were four people using the service.
People’s experience of using this service and what we found
Right Support
The service supported people to have the maximum possible choice, control and independence be independent and they had control over their own lives. People were supported by staff to pursue their interests. The service worked with people to plan for when they experienced periods of distress so that their freedoms were restricted only if there was no alternative. Staff did everything they could to avoid restraining people. The service recorded when staff restrained people, and staff learned from those incidents and how they might be avoided or reduced. People had a choice about their living environment and were able to personalise their rooms.
Right Care
Staff promoted equality and diversity in their support for people. They understood people’s cultural needs and provided culturally appropriate care. Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it. The service had enough appropriately skilled staff to meet people’s needs and keep them safe. Staff and people cooperated to assess risks people might face. Where appropriate, staff encouraged and enabled people to take positive risks.
Right culture
People and those important to them, including advocates, were involved in planning their care. Staff knew and understood people well and were responsive, supporting their aspirations to live a quality life of their choosing. People received good quality care, support and treatment because trained staff and specialists could meet their needs and wishes.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was good (published 30 September 2019). During our last infection prevention and control inspection (published on 30 April 2021), we found the provider to be in breach of a regulation. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively. This included checking the provider was meeting COVID-19 vaccination requirements.
We carried out an announced inspection of this service on 07 April 2021. A breach of legal requirements was found relating to safe care and treatment.
We undertook this focused inspection to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Mere Lodge on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
At the last inspection this key question was rated as Good. We have not changed the rating of this key question, as we have only looked at the part of the key question we had specific concerns about.
The purpose of this inspection was to check a specific concern we had about infection control. We will assess all of the key question at the next comprehensive inspection of the service.
This is the second Infection Control inspection and was planned to follow up the refurbishment of the property.
¿ Some areas of the service were still not well maintained. The flooring in the lounges and corridors have been replaced and some areas of the home have been decorated. However, the flooring in the laundry has not been changed and will not allow proper disinfection.
¿ There were still areas of unpainted wood on doors which could also allow the transfer of infection. Mops are stored outside the back door of the home and are open to the weather and other potential contaminants. There was no defined plan of mop head changing or disinfection programme that would reduce the potential of cross contamination. These areas compromised infection control measures and the effectiveness of cleaning and disinfection, which meant there was a higher risk of infection spread between people and staff.
The provider failed to adequately protect people and reduce the potential of cross infection or cross contamination. This was a breach of regulation 12 (2h) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
¿ The provider had obtained a continuing supply of personal protective equipment (PPE). This included face masks, gloves, aprons and hand sanitiser and we saw staff used these appropriately. Staff told us they were encouraged to change their PPE regularly.
¿ Used PPE was disposed of appropriately in foot operated pedal bins placed throughout the home. This reduced the potential for transfer of infection.
¿ Staff encouraged people to wash their hands frequently throughout the day. Where this was not possible, hand sanitiser was offered to reduce the potential for transfer of infection.
¿ The provider participated in regular COVID-19 testing of people living in the service and staff. This ensured action could be taken swiftly to reduce the potential spread of infection if a positive test was returned.
¿ Areas were disinfected with products approved to reduce the potential transfer of infection.
¿ Risk assessments had been completed to protect people and staff who may be at a higher risk if they contracted COVID-19. Measures were in place to support them.
¿ Staff worked in allocated teams which lessened the potential of cross infection between staff members.
We have also signposted the provider to resources to develop their approach.
Some areas of the service were not well maintained. The flooring in the lounges and corridor was perforated which would not allow proper disinfection. There were areas of unpainted wood on doors and skirting boards which could allow a transfer of infection. This compromised infection control measures and the effectiveness of cleaning, which meant there was a higher risk of infection spread between people and staff.
Quality assurance audits undertaken by the provider were not effective in identifying the shortfalls found during the inspection.
We found the following examples of good practice.
¿ The provider had obtained a continuing supply of personal protective equipment (PPE). This included face masks, gloves, aprons and hand sanitiser and we saw staff used these appropriately. Staff told us they were encouraged to change their PPE regularly.
¿ Used PPE was disposed of appropriately in foot operated pedal bins placed throughout the home. This reduced the potential for transfer of infection.
¿ Staff encouraged people to wash their hands frequently throughout the day. Where this was not possible, hand sanitiser was offered to reduce the potential for transfer of infection.
¿ The provider participated in regular COVID-19 testing of people living in the service and staff. This ensured action could be taken swiftly to reduce the potential spread of infection if a positive test was returned.
¿ Areas were disinfected with products approved to reduce the potential transfer of infection.
¿ Risk assessments had been completed to protect people and staff who may be at a higher risk if they contracted COVID-19. Measures were in place to support them.
¿ Staff worked in allocated teams which lessened the potential of cross infection between staff members.
Further information is in the detailed findings below.
Mere Lodge provides care and support for up to four people who live with a learning disability
The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
The service was a small domestic style property. It is registered for the support of up to four people. Four people were using the service at the time of the inspection. The building was situated in a quiet residential area. There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.
People’s experience of using this service and what we found
People were safe from abuse and avoidable harm. Safeguarding procedures were in place and staff followed these. There were enough staff to support people. Staff were recruited safely and, had the skills and experience to meet people’s needs.
People’s needs, and choices were assessed to ensure they could be met before they used the service. Risks to people’s health and well-being were well managed. People were cared for by staff who had received mandatory, and specialist training, which followed best practice guidelines to care for people safely.
People received their medication when they need it, and staff protected people from the risk of infection. The environment was clean and safe however needed much improvement to its décor and furnishings.
People were treated to kind and compassionate care maintaining their dignity and confidentiality. Staff knew and, were sensitive to people’s individual needs. People were supported respectfully and individually and, a warm and welcoming atmosphere had been developed. People looked happy in their surroundings, encouraged to be independent and, hobbies and interests of their choosing were fulfilled.
Support was person centred and delivered the way people preferred and met their individual needs. Staff understood people’s needs with regards to the protected characteristics of the Equality Act 2010. Information was available to people in accessible formats and staff knew people’s communication needs and understood how best to engage and support people.
Changes to people’s health were reported and monitored and staff supported people to their appointments.
People knew how to make a complaint and would feel confident doing so. People had opportunity to meet with the manager to discuss any concerns and visitors were welcomed to the service anytime.
The service was managed well and there was an effective quality assurance processes in place. The service strived to improve the quality of the care for people. Action plans were developed following any shortfalls in the service.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
The service applied the principles and values apply the principles and values Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good report published (02 November 2016) Following this inspection the service remained good overall.
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Mere Lodge is a small registered care home for up to four adults who live with a learning disability. The service is located close to the centre of Leicester. At the time of our inspection visit, there were four people using the service.
We last inspected the service in August 2013 and found the service to be compliant with all our regulations.
The service has a registered manager. 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.
There were good systems in place to keep people safe. Staff felt confident to report any allegation or suspicion of poor practice and were aware of the possible signs and symptoms of abuse. There were enough staff on duty in the service to meet people's needs. Staff had the time to provide both one-to-one and group support for people.
People had detailed assessments which identified actions staff needed to take to protect people from risks associated with their specific needs. People were supported to take their medicines as prescribed.
Staff had the skills and knowledge to ensure people were supported in line with their care needs. Staff received a thorough induction when they started work at the service and demonstrated that they fully understood their roles and responsibilities, as well as the values of the service. Staff had also completed specific training to make sure that the care provided to people was safe and effective to meet their needs. Staff valued the support of managers in enabling them to develop within their role.
The registered manager and staff we spoke with were knowledgeable of and acted in line with the requirements of the Mental Capacity Act 2005. Staff sought consent from people before providing care and support.
People were supported to have their mental and physical healthcare needs met and encouraged to maintain a healthy lifestyle. Staff made appropriate use of a range of health professionals and followed their advice to ensure people's physical and emotional well-being was maintained.
People had positive relationships with the staff that supported them and spoke positively about their care and support. The registered manager sought out and respected people's views about the care they received. Staff promoted and upheld people's privacy and dignity.
People were supported to attend social and educational activities of their choice. People had access to a range of social events in the service and in the local community and were supported to build good links with local places of worship. People were supported to visit their relatives or relatives could visit their family members in the service at any time.
Care plans and risk assessments contained relevant information for staff to help them provide the personalised care people required. Care records were regularly reviewed and updated to ensure they reflected people's current needs. Staff demonstrated that they understood the needs of people. Staff were able to communicate well and enable people to make choices about how they lived their lives and how they preferred their care to be provided. People were encouraged and support to express any concerns or complaints they may have about the service.
The registered manager assessed and monitored the quality of care. In addition to regular audits and checks, the registered manager consulted people and their relatives and staff to find out their views on the care provided. They used this feedback to make improvements to the service. The registered manager kept up to date with changes in legislation and best practice and demonstrated that they understood their legal responsibilities within their role.
Mere Lodge provides care and support for four people with learning disabilities and mental health needs. There was a registered manager in post at the time of our inspection. We met three people who used the service on the day of our inspection. We were unable to speak with people who used the service in detail due to their complex communication and behavioural needs; however, we observed that people were comfortable and confident with staff.
There were systems in place that aimed to ensure people were protected from the risk of abuse and avoidable harm. People were cared for in an environment that was safe and appropriate for their needs.
People received care and support that met their individual needs and promoted their well-being. Care plans provided sufficient guidance for staff about how people’s needs should be met and these had been regularly reviewed. We found that people’s health had been monitored and guidance from health professionals had been sought when appropriate.
We spoke with staff and found they had been supported to deliver individualised, appropriate care that met the needs of people who used the service. Staff had received appropriate training and supervision to enable them to provide effective care that promoted people’s independence. The staff team cared for people with kindness, compassion and dignity and demonstrated a genuine rapport with the people who used the service. There were sufficient numbers of staff to ensure the safe and effective delivery of care.
Records showed that people’s views, wishes, preferences and concerns were sought, listened to and responded to. There was effective management in place which ensured the delivery of person-centred care, supported staff learning and development, and which promoted an open culture.
The people who used the service got on well with each other and had formed strong bonds and friendships. This was evident in the way they interacted and enjoyed each other's company. One person told us, 'I like everyone here and I don't want anything to change.'
One person told us they were satisfied with the meals provided. They told us, 'I like the food we have here and I also like the takeaways ' I have fish and chips or sausage and chips.'
The environment was designed to be calm and relaxing with muted colour schemes and big comfy settees. People's bedrooms were spacious and each of the people who used the service had either a double or a king size bed.
Relationships between staff and the people who used the service were good. One person told us, 'The staff are here to help me. I like them and I like my keyworker who is a good man. Keith (the manager) is also a good man and if there was anything wrong I'd tell him.'.
One person told us they could choose their meals, activities and daily routines. They said they liked to get out and about and staff helped them to do this. Their room was being redecorated and they told us they were choosing the colour scheme.
People told us they liked living at Mere Lodge. One person said, 'I like the food here, we have fish and chips and curry and soups and salad and chapattis.' They also said, 'I like the staff. They take me out.'
During our visit the people who use the service were calm and settled. They trusted the staff and worked well with them. One person told us they understood they needed staff support when they went out and had agreed this was appropriate.
We asked one person who used the service what they'd do if there weren't happy about something in the home. They said they'd tell the staff or the manager as 'they're all very helpful to me'.
People got on well with the staff team. One person told us, 'The staff are very kind and they listen to me.' Staff worked with people in a warm and supportive way. They encouraged them to take part in the life of the home and go out into the community.
The people who use the service were consulted on all aspects of how the service was run. They contributed in one to one discussions with staff, group meetings, and through regular questionnaires issued by the service. Their relatives/representatives were also consulted.