Shaf Lodge

About the service

Shaf Lodge is a Supported Living Scheme providing the regulated activity of personal care and support to people living in rented accommodation with a tenancy agreement in place. The service supports autistic people and people with a learning disability; and those with mental health needs in small houses in residential areas, for between 2 and 5 people. The service can support up to 30 people in total within 9 Supported Living Schemes.

Not everyone who used the service received the regulated activity of personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. At the time of our inspection 5 people were receiving the regulated activity of personal care.

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

Right Support:

Staff supported people to have the maximum possible choice, control, and independence over their own lives.

Staff supported people to take part in activities and pursue their interests in their local community.

Staff supported people to make decisions following best practice in decision-making. Staff communicated with people in ways that met their needs.

Staff supported people with their medicines.

Right Care:

People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. They understood and responded to their individual needs.

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.

The service had enough appropriately skilled staff to meet people’s needs and keep them safe.

People’s support plans reflected their range of needs.

Where appropriate people were supported to take positive risks.

Right Culture:

People received good quality care and support.

Staff knew and understood people well and were responsive to their care and support needs.

Management and staff put people’s needs and wishes at the heart of everything they did.

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 Requires Improvement [published 30 November 2021]

The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We carried out an announced comprehensive inspection of this service between 6 and 13 October 2021. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve the need for consent, safe care and treatment and good governance.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions of ‘Safe’, ‘Effective’ and ‘Well-Led’ which contain those requirements.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Shaf 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.

Shaf Lodge provides care and support to people in their own homes. People using the service have a learning disability and/or mental health needs. The service offers 24-hour staffing support to people living in supported living accommodation. These were small houses in residential neighbourhoods, shared by three, five or six people. Where care staff were required to remain at the service overnight, they were provided with appropriate arrangements.

At the time of our inspection, 29 people were using the service, however not everyone was receiving personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.

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

The provider did not always follow best practice guidance in relation to staff recruitment. Complete employment histories had not been obtained for all staff, and risk assessments had not always been recorded. Peoples end of life wishes had not been considered. The provider had not recorded any provisions or plans for peoples end of life care.

We have made recommendations to the provider surrounding recruitment processes and end of life care.

Peoples capacity, and capacity assessments around decision making, were not documented within care plans.

The provider was not following best practice guidance for Infection Prevention and Control (IPC) in relation to the ongoing COVID-19 pandemic. Staff were not wearing masks when supporting people.

The provider did not have robust processes in place to ensure they had oversight of the safety and quality of the service. The concerns found at inspection had not been identified by the checks completed by the provider.

People living in the service told us they felt safe and had choice in their lives. Risks to people were assessed and recorded. There were enough well trained and knowledgeable staff to meet people’s needs.

People received their medicines safely, the provider had systems in place to encourage people to take their medicines independently. The provider worked closely with health professionals to support people’s needs.

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. However, the policies and systems in the service did not always support this practice.

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 statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.

People were actively involved in making decisions about their home, including personalisation and decor, and told us they were happy with where they lived. People were involved with making decisions about their care, and staff demonstrated good understanding of how to support people to remain as independent as possible. People were encouraged and supported to attend education, and to actively access their local communities. The size of each service adhered to current best practice guidance, and people were involved in the planning and delivery of their care.

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 (published 25 November 2019).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service.

We have identified breaches in relation to infection control, recording of capacity and consent, and governance of the service at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Shaf Lodge provides care and support to people in their own homes. People using the service have a learning disability and/or mental health need. The service offers 24 hour staffing support to people living in ‘supported living’ settings.

Where people live in their own home they receive care and support in order to promote their independence. As there is a separation between the care and accommodation, the care they receive is regulated by the CQC, but the accommodation is not.

At the time of our inspection, 17 people were using the service, however not everyone was receiving personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do – we also consider any wider social care provided.

People receiving supported living services rent their accommodation separately from the care that was provided by the service. These were small houses in residential neighbourhoods, shared by three, five or six people. Where care staff were required to remain at the service overnight, they were provided with appropriate arrangements.

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

People were placed at the heart of this service. The service applied the principles and values of Registering the Right Support and other best practice guidance. These principles ensure 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. Outcomes for people using Shaf Lodge reflected these principles. Their support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

People and relatives’ comments were extremely positive. They told us they were very happy with the service and the support they received from the registered manager and staff. People’s comments included, “I like living here”, “We have lots of fun”, “Staff are great” and “I do nice things and go out a lot.”

People received a safe service. Staff supported people in the least restrictive way possible and this helped them to lead their best lives. Staff had a good understanding of the Mental Capacity Act 2005, and people were supported to have maximum choice and control over their lives. The providers policies and systems supported this practice.

Safe recruitment practices ensured the suitability of newly appointed staff. People were supported by enough staff with the right experience, training and skills to meet their needs. Staffing levels were flexible and supported people to follow their interests, take part in social activities and, where appropriate, education and work opportunities.

Medication was managed safely and administered correctly. People were supported to maintain good health. They received continuing healthcare support to meet their needs and had prompt access to healthcare professionals when they became unwell. Staff promoted healthy eating. They supported people to balance choice with healthy options and people's preferences contributed to the menu planning.

The registered manager was knowledgeable, inspired confidence in the staff team and led by example. There was a strong emphasis on promoting good practice and a well-developed understanding of equality, diversity and human rights, and management and staff put this into practice. Quality assurance systems helped to ensure the service delivered was of high quality and safe and continued to improve.

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 (published 11 March 2017).

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.

Shaf lodge is a five-bedded supported living service that offers 24 hours staffing support to people with mental health and mild learning disability. At the time of our inspection there were three people using the service. The focus of the service is to support people to maintain a healthy life style and this is achieved by the services’ commitment to provide a highly individualised support programme that promotes social and mental wellbeing.

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 a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.’

Suitable arrangements were in place to ensure that people received appropriate care and support to meet their needs. Staff knew the needs of the people they supported and they were treated with respect and dignity. People’s healthcare needs were well managed and they had access to a range of healthcare professionals. The management of medicines within the service ensured people’s safety and wellbeing.

People’s needs were met by sufficient numbers of staff. Suitable arrangements were in place to ensure that staff had been recruited safely and that they received opportunities for training and supervision. People were safeguarded from harm as suitable safeguarding arrangements were in place. Staff had received training in Mental Capacity Act (MCA) 2005 and had knowledge of Deprivation of Liberty Safeguards (DoLS) and how to apply these. The registered manager was aware of how and when to make a referral. People had sufficient amounts to eat and drink to ensure that their dietary and nutritional needs were being met.

People were provided with the opportunity to participate and engage in activities of their choice, which met their needs. Relatives and people who used the service knew how to make a complaint and we felt reassured that all complaints would be dealt with and resolved efficiently and in a timely manner.

The service had a number of ways of gathering people’s views, which included holding meetings with people, staff, and relatives. The registered manager carried out a number of quality monitoring audits to help ensure the service was running effectively and to help them make any improvements.