Archived: Conifer Lodge

This unannounced comprehensive inspection was undertaken by an inspection manager and one inspector and took place on 9 and 10 February 2017.

At the previous inspection in January 2015 the service was rated as ‘Good’.

A registered manager was in post at the time of the inspection and had been registered since December 2015. 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.

Staff had been trained on how to keep people safe and they knew who they could report any incidents of harm to. Appropriate information was provided in different formats to enable people to report any potential incidents of harm. Accidents and incidents were identified and prompt action was taken to, as far as possible, prevent the potential for any recurrence.

Comprehensive and detailed risk assessments were in place and these helped staff support people in the safest practicable way.

A sufficient number of appropriately recruited and suitably skilled staff were in post to safely meet people’s assessed needs. Medicines were managed and administered safely by staff whose competency had been assessed.

Staff supported people to eat a healthy balanced diet and sought the necessary health care interventions when required. Staff adhered to people’s health action plans.

The CQC is required by law to monitor the Mental Capacity Act 2005 [MCA] and to report on what we find. The provider was aware of what they were required to do should any person lack mental capacity. Appropriate authorisations were in place to lawfully deprive people of their liberty. Staff understood and implemented the MCA code of practice. People’s rights and best interests were fully supported.

People were given the privacy they needed by staff who demonstrated compassion towards them. Staff provided people’s care with dignity, sincerity and in consideration of the way each person wanted to be cared for.

People were provided with various ways they could be involved with their care such as with pictorial guidance, staff, relative or legal representative support. These various ways were used to identify, determine and plan the review of each person’s care.

The service was flexible and responsive to people’s individual needs and preferences, finding creative ways that enabled people to live as full a life as possible. Staff used new and different ways to help people achieve their ambitions no matter how high each person’s aspirations were. People lived busy social lives and they took part in a wide range of interests, education and pastimes which were innovative and met people’s individual needs.

People’s ideas, suggestions, comments and concerns were listened to and effectively acted upon. This was by staff who were able to suggest additional ideas that the people themselves might not have considered. As a result of this people felt empowered, listened to and valued. The health care professional and person-centred care support that people received helped them achieve exceptional results with their abilities and independent living skills.

The registered manager and staff enabled people to take a key role in the local community and they were actively involved in building further links. Engagement in activities and support networks outside the service was seen as a natural part of people’s lives. On-going improvement is seen as essential. The service strived to be known as outstanding and innovative in providing person centred care based on best practice.

The registered manager was supported by a deputy manager, nursing staff, senior support workers and care support workers. Staff had the support mechanisms in place that they needed to fulfil their role effectively.

People, their relatives and staff were completely involved and enabled to make suggestions to improve how the service was run. Effective quality monitoring and assurance processes were in place in driving sustained improvements in the service.

To promote and maintain people's health and well being, they were supported to engage in social activities and access health care services. People said that their health and social needs were met by support from members of staff.

People told us that the food was, 'Okay'. There was a range of meal options available to support people's individual nutritional requirements. People were able to eat out as part of their social activities.

There were safeguarding systems in place and information available to protect and minimise the risks of abuse of vulnerable adults living at Conifer Lodge. We saw that people were cared for by kind staff. People who we spoke with and who were able to tell us, said that they felt safe living at the home.

Staff were supported, supervised, appraised and trained to safely do their job. Members of staff told us that they found their jobs were rewarding.

Improvements had been made regarding the receipt, recording and investigation of complaints. People who used the service were provided with opportunities to make their suggestions, concerns or complaints known. People who we spoke with said they had no cause to make a complaint.

Care and support was planned and delivered in a way that ensured people's safety and welfare. From our observation we found that people were encouraged and supported to maintain their level of independence. However, people living in the home, their relative or advocate had not signed their plans of care to show that they had been involved in their care planning and agreed with the records held.

We found that restraint had not been used with anyone living in the home and staff spoken with showed us that they recognised and understood the care and support needs and behavioural triggers of each person.

We viewed staff rotas and they showed us that enough qualified, skilled and experienced staff were provided to meet people's needs.

People who use the service, their representatives and staff were asked for their views about their care and support and they were acted on.

Information on how to complain was provided in a written and pictorial format that met the needs of people living in the home. However, improvements were needed to the recording of complaints.