Queens Lodge

About the service

Queens Lodge is a residential care home providing personal care to four people at the time of the inspection. The service can support up to four people.

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

Right Support

¿ Improvements began during the inspection to support people to spend more of their time doing things they enjoyed and spending time with people who were important to them.

¿ The process of regularly reviewing people's aspirations needed to be strengthened so people could work towards goals which were important to them.

¿ Some health needs were not consistently met, action was taken immediately to rectify this.

¿ Staff supported people to make decisions using their preferred communication styles and methods.

¿ Staff supported people with their medicines safely and in the way they preferred.

Right care

¿ Improvements were required to ensure people always received safe care and treatment. For example, in effective recording, monitoring and review of distressed behaviour and accidents/incidents. Staff assessed and knew the risks people might face.

¿ There were enough appropriately skilled staff to meet people’s needs and keep them safe. An action plan was in place to get all aspects of staff support up to date and maintained.

¿ People received kind and compassionate care. Staff protected and respected people’s privacy and dignity.

¿ Staff understood how to protect people from poor care and abuse. Staff had training on how to recognise and report abuse and they knew how to apply it.

Right culture

¿ Management oversight of the service had lapsed in recent months. This was identified prior to the inspection and action was underway to make improvements.

¿ Mealtime experiences were not enriching for people living in the service.

¿ Documentation to support mental capacity assessments and best interest decision making required improvement.

¿ People and those important to them were involved in planning and reviewing their care.

¿ The deputy manager and most of the care team had worked in the service for a long time, which supported people to receive consistent care from staff who knew them well.

Why we inspected

We undertook this inspection to assess that the service is applying the principles of Right Support, Right Care, Right Culture.

The inspection was prompted in part due to concerns about management turnover, and food quality, as well as issues found at a nearby sister service.

Follow up

We will request an action plan from 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.

Queens Lodge is a small residential care home providing personal care to 4 people with learning disabilities and autism.

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.

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

People continued to receive safe care, and staff we spoke with understood safeguarding procedures and how to raise concerns. Staff were confident that management took appropriate actions safeguard people.

Risk assessments were in place to manage risks within people’s lives. This included plans for supporting people who may display behaviour which challenges. Staff were confident in supporting people in this area.

Staff recruitment procedures ensured that appropriate pre-employment checks were carried out, and staffing support matched the level of assessed needs within the service during our inspection.

Medicines were stored and administered safely, staff were trained to support people effectively and were supervised well and felt confident in their roles.

People were able to choose the food and drink they wanted, and staff encouraged healthy options. Any requirements with food and drink were understood and respected by staff.

Healthcare needs were met, and people had regular access to health and social care professionals as required. People's consent was gained before any care was provided, and they were supported to have maximum choice and control of their lives.

Staff treated people with kindness, dignity and respect and spent time getting to know them. Care was personalised to each individual, and staff were passionate about achieving good outcomes for people.

Care plans reflected people likes, dislikes and preferences. People were involved in activities that were tailored to them.

People and their family were involved in their own care planning as much as was possible. A complaints system was in place and was used effectively.

The registered manager was open and honest, and worked in partnership with outside agencies to improve people’s support when required.

Audits of the service were detailed, and any issues found were addressed promptly. The service had a registered manager in place, and staff felt well supported by them.

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 outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. 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, (published 16 September 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.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

People told us they felt safe living at Queens Lodge. Relatives agreed that people were safe living there. People remained safe from avoidable harm because the staff team knew their responsibilities and the actions to take if they suspected someone was at risk of abuse or harm. Risks associated with people’s care and support had been assessed and these were being monitored on a regular basis. Appropriate recruitment processes had been followed when new members of staff had been recruited. There were sufficient numbers of staff deployed to meet the care and support needs of the people living there. People continued to be supported with their medicines safely and in a way they preferred. There were appropriate systems in place to audit the management of medicines.

The staff team were appropriately trained and were supported by the management team through supervisions, appraisals and staff meetings. They were aware of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS) ensuring people’s human rights were protected. People had access to relevant healthcare services and were supported to attend appointments when required. People had been involved in developing menus to include their own likes and preferred choices and their dietary requirements had been identified.

The staff team were kind and caring and treated people with dignity and respect. People’s independence was promoted and they were supported to make choices about their care and support.

People were supported in a way they preferred because plans of care had been developed with them and with people who knew them well. The staff team knew the needs of the people they were supporting well because they had read their plans of care. People knew what to do if they had a concern and they were reminded of this through meetings and conversations with the staff team.

Staff members felt supported by the management team and told us there was always someone available to talk with should they need guidance or support.

People's views of the service were sought through meetings and informal chats. Surveys were also used to get gather people’s thoughts and suggestions of how the service could be improved. Systems were in place to monitor the quality of the service being provided.

Further information is in the detailed findings below

We saw people being supported by staff to make decisions about their daily lives, which included encouraging them to take part in household chores. People were supported by care staff to go out into the local community and to take part in activities within the home. One person helped a member of staff to dry the pots following breakfast and later had a game of cards; they also enjoyed singing along to music before in the afternoon going out to have their hair cut. A second person spent time with a member of staff having their hair styled and make up put on.

People’s needs and the support they required were recorded within care plans. People were supported by a range of health and social care professionals in the monitoring of their health and wellbeing. Staff we spoke with had a good understanding of the needs of people and supported them to ensure their rights were upheld. This included using legislation to ensure people’s best interests were promoted and maintained.

Records we viewed confirmed staff had undergone an effective recruitment and selection process. We viewed records which showed the service had effective systems for the maintenance of the property.