Archived: Elstow Lodge

Elstow Lodge is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection. The service accommodates up to 12 people with learning disabilities and other long-term health conditions. At the time of the inspection, eight people were being supported by the service.

At our last inspection in October 2016, we rated the service ‘good’. At this inspection we found the evidence continued to support an overall rating of ‘good’, and there was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns.

People were safe because there were effective risk assessments in place, and systems to keep them safe from abuse or harm. There were safe staff recruitment processes in place and there was sufficient numbers of staff to support people safely. Staff took appropriate precautions to ensure people were protected from the risk of acquired infections. People’s medicines were managed safely, and there was evidence of learning from incidents.

People’s needs had been assessed and they had care plans that took account of their individual needs, preferences, and choices. Staff had regular supervision and they had been trained to meet people’s individual needs effectively. The requirements of the Mental Capacity Act 2005 were being met, and staff understood their roles and responsibilities to seek people’s consent prior to care and support being provided. People had been supported to have enough to eat and drink to maintain their health and wellbeing. They were also supported to access healthcare services.

People were supported by caring, friendly and respectful staff. They were supported to have maximum choice and control of their lives, and the policies and systems in the service supported this practice.

Staff regularly reviewed the care provided to people with their input to ensure that this continued to meet their individual needs, in a person-centred way. The provider had an effective system to handle complaints and concerns. People were supported to pursue their hobbies and interests. The provider was still working towards recording people’s wishes about the kind of care they would like at the end of their lives.

There was a registered manager in post. The provider’s quality monitoring processes had been used effectively to drive improvements. People and staff we spoke with were happy with the quality of the service.

Elstow Lodge provides residential accommodation and personal care for up to 10 people with learning disabilities and autism.

At the time of our inspection the provider confirmed they were providing care to eight people.

There was a registered manager in post. 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.

Staff had a good understanding of abuse and the safeguarding procedures that should be followed to report abuse and people had detailed risk assessments in place to enable them to be as independent as possible.

Staffing levels were adequate to meet people's current needs. The service had enough staff in place to cover all the shifts required.

The staff recruitment procedures ensured that appropriate pre-employment checks were carried out to ensure only suitable staff worked at the service.

Staff induction training and on-going training was provided to ensure they had the skills, knowledge and support they needed to perform their roles. Staff were able to identify and partake in areas of training that would benefit them and their work.

People told us that their medicines were administered safely and on time. Medication storage and administration systems were secure and accurate.

Staff were all well supported by the registered manager and administrator, and had regular one to one supervisions, as well as the opportunity to ask for support as and when required.

People's consent was gained before any care was provided and the requirements of the Mental Capacity Act 2005 were met. Staff had a good knowledge of the Deprivation of Liberty Safeguards (DoLS)

People were able to choose the food and drink they wanted and staff supported people with this. Fresh food was available for people, and staff encouraged healthy lifestyles. People were supported to access health appointments when necessary, and their health needs were fully documented.

Staff treated people with kindness, dignity and respect and spent time getting to know them and their specific needs and wishes. Staff had excellent knowledge of the best way to communicate with individuals who had communication difficulties.

People and their families were involved in their own care planning and were able to contribute to the way in which they were supported. People had keyworker staff that would regularly seek input from them and update care plans accordingly .

The service had a complaints procedure in place to ensure that people and their families were able to provide feedback about their care and to help the service make improvements where required. The people we spoke with knew how to use it.

Quality monitoring systems and processes were used effectively to drive future improvement and identify where action was needed. All areas of the service were regularly checked and monitored by the registered manager.

Breaches of legal requirements were found. After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements relating to Safe Care and Treatment Regulation 12 (2) (b) of the Health and Social Care Act 2008. People’s individual risk assessment and the service’s environmental risk assessment were not being followed consistently. Regulation 18 of the Care Quality Commission (Registration) Regulations 2009.The registered manager did not always comply with their CQC registration requirements to ensure that notifiable incidents in relation to people’s safety and well-being were reported.

We undertook this focused inspection to check that they had followed their plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Elstow Lodge on our website at www.cqc.org.uk

Elstow Lodge provides care and support for up to 12 people with a learning disability. There were nine people living at the service on the day of our inspection.

The service had 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 and associated Regulations about how the service is run.

During this inspection, we found that staff were now following people’s individual risk assessments and the environmental risk assessment, when assisting wheelchair users to enter and exit the premises to ensure their safety.

We found that the registered manager was now ensuring that notifiable incidents relating to people’s safety and well-being were reported to the Care Quality Commission in line with their registration requirements.

While improvements had been made we have not revised the rating for these domains. To improve the rating to ‘Good’ would require consistent good practice over a longer time period. We will review our rating for safe and well-led at the next comprehensive inspection.

People experienced effective, safe and appropriate care. Care plans were well documented to promote continuity of care.

During our inspection we saw evidence that people's nutritional requirements were assessed and managed in line with their needs, and that these were reviewed on a regular basis.

We found that people living in the home received their prescribed medication when they needed it and in a way that suited them.

We found the premises to be well maintained to ensure the home remained safe for people using the service, staff and visitors.

Suitable arrangements were in place to address people's comments and complaints, and ensure they were listened to.