Head Office - Court Lodge Limited

Court Lodge Limited provides a supported living service to people with learning disabilities and mental health conditions. The service is provided to people living at two houses in the local area who are supported to live independent lives. At the time of the last inspection seven people were receiving care at the service. During this review, the service was supporting six people.

Background to this report

At our previous comprehensive inspection at Court Lodge Limited on 16 February 2021 we identified concerns relating to well-led. We found that notifiable incidents had not been sent to CQC as required.

This was a breach of Regulation 18 Care Quality Commission (Registration) Regulations 2009 for which we issued a requirement notice. The key question well-led was rated requires improvement and the overall location rating was Requires Improvement.

The full report of that inspection can be found by selecting the ‘all reports’ link for Court Lodge Limited on our website at www.cqc.org.uk.

Why we carried out this review

We carried out this review on 20 April 2022 to follow-up on the requirement notice and assess whether the provider has addressed the improvements required at our previous inspection.

We did this using a ‘desk-based’ review process because evidence to demonstrate that the requirement notice had been met could be obtained and assessed remotely without needing an inspection visit to the location. This was not an inspection: the scope of this review did not include a visit to the service or an assessment of the outcomes for people using the service.

What we found

Details of the findings from this remote assessment can be found under the well-led section of this report.

Through this review we assessed that Court Lodge Limited has taken action to meet the requirement notice issued after the last inspection. They are therefore no longer in breach of Regulation 18 Care Quality Commission (Registration) Regulations 2009.

Rating at last inspection and update

Following the last inspection, this location was rated requires improvement. Although only the well-led key question was rated requires improvement, if there is a breach of a regulation a location cannot be rated higher than requires improvement overall.

Through this review, evidence reviewed remotely provided assurance that improvements had been made to address all issues that resulted in the well-led key question being rated requires improvement. The rating for well-led has therefore been updated to good.

As the breach of Regulation 18 Care Quality Commission (Registration) Regulations 2009 has now been assessed as met and no longer limits the overall rating, this has therefore been updated to good.

Court Lodge Limited provides a supported living service to people with learning disabilities and mental health conditions. The service is provided to people living at two houses in the local area who are supported to live independent lives. At the time of our inspection, the service was supporting a regulated activity to seven people.

People’s experience of using this service and what we found

The provider had not sent statutory notifications to the CQC where it was appropriate to do so. The provider had taken appropriate action and referred the incidents to the local authority. However as CQC were not informed this would limit the rating in the Well Led question to Requires Improvement.

The analysis of incidents and accidents was not always taking place. The provider sent us in an action plan after the inspection to show how this was going to be addressed. We have made a recommendation around this.

Relatives told us they felt their family members were safe with staff. Staff understood risks to people’s care and what they needed to do to reduce the risks of injuries to people. Staff had received training in how to safeguard people and what they needed to do if they suspected abuse. Before staff started employment, checks were undertaken to ensure that they were suitable.

There were sufficient numbers of staff employed at the service. People’s medicines were managed in a safe way by staff. Staff followed best practice with regards to infection control. Staff told us they felt supported and training at the service was effective. People told us staff knew how to provide care and understood their needs.

People’s opinions were sought in relation to how they wanted their care to be delivered. Staff monitored people's health and liaised with relevant health care professionals to ensure people received the care and treatment they required. The registered manager worked with external organisations in relation to improving people’s care.

People, relatives and staff were complimentary of the management and the support they received. Staff worked well as a team and felt supported and valued.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the guidance CQC follows to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

At the previous inspection the service was able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture. As this was a focused inspection looking at specific concerns, we did not look at all aspects of this. We found that people continued to be supported with their independence. People were being treated in a kind and caring way. All staff including the registered manager ensured that people were empowered to make decisions around their care and support.

Right support:

• Model of care and setting maximises people's choice, control and Independence

Right care:

• Care is person-centred and promotes people's dignity, privacy and human Rights

Right culture:

• Ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive and empowered lives

Rating at last inspection

The last rating for this service was Good (published 26 June 2017).

Why we inspected

The inspection was prompted in part due to concerns received about people not always being safeguarded from abuse and neglect. A decision was made for us to inspect and examine those risks.

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 coronavirus and other infection outbreaks effectively.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from Good to Requires Improvement. This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvements. Please see Well Led section of this full report. We found no evidence during this inspection that people were at risk of harm from this concern. You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Head Office - Court Lodge Limited on our website at www.cqc.org.uk.

Enforcement

We have identified a breach in relation to notifications not being made to CQC at this inspection. Please see the action we have told the provider to take at the end of this report.

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.

Court Lodge Limited provides a supported living service to people with learning disabilities and mental health conditions. The service is provided to people living at two locations in the local area. At the time of our inspection, the service was supporting five 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 found creative ways to meet people’s needs in a person-centred way. Where people could not inform staff of their preferences verbally, staff found ways to meet their needs in a way that involved them. People were involved in important decisions about their home.

People spoke fondly of the activities they had been supported to take part in. Staff knew people’s goals and aspirations and plans were in place to support people to achieve them. People’s needs were regularly reviewed and where changes were identified, staff took action.

The registered manager got along well with people and knew people very well. Staff felt supported by management and were involved in the running of the service. Regular staff meetings took place and staff received regular one to one supervision.

Staff understood their role in safeguarding people. They had received training and demonstrated a good understanding of how they would protect people from abuse or potential harm. Where incidents occurred, staff documented them. These were analysed to ensure people received care that was responsive to their needs.

Staff worked alongside healthcare professionals to ensure people’s needs were met. People’s medicines were managed safely and administered by trained staff. Staff received an induction and had been trained in how to support people with learning disabilities and mental health conditions.

People were supported by kind and caring staff that they got along well with. Staff were respectful of people’s privacy and dignity and promoted people’s independence. People’s feedback was regularly sought to ensure they were happy with the care that they received. Robust audits were carried out to ensure people received a good standard of care.

People’s nutritional needs were met. Staff understood people’s preferences and where people had specific dietary requirements, staff were aware of these.

Checks were undertaken to ensure that staff were suitable for their roles. Staff were deployed in a way that ensured people’s needs were met safely.