Portchester Lodge

Portchester Lodge provides care and support for up to 11 people who may be living with a learning disability or have mental health needs. At the time of the inspection 10 people were using the service.

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

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and 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 supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support: The model of care and setting maximised people’s choice, control and independence.

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.

Right Care: Care was person-centred and promoted people’s dignity, privacy and human rights.

Right Culture: The ethos, values, attitudes and behaviours of leaders and care staff ensured people using services lead confident, inclusive and empowered lives.

People received care, support and treatment which was properly assessed and centred to their needs.

Staff were knowledgeable about safeguarding and people were protected against the risk of abuse. Staff received training in relation to the management of medicines and had their competence checked frequently.

The provider had suitable arrangements in place in respect of infection control.

Any complaints received were investigated and responded to appropriately.

When people needed additional care and support after they had finished their treatment plan, the provider supported people by signposting them to the appropriate organisations.

The culture of the organisation was good and people told us staff were friendly, had good values and enjoyed their jobs.

Staff were complimentary about management and told us they were supportive, knowledgeable and positive role models.

The provider had effective governance systems in place and regularly reviewed the quality of care provided.

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 the service was good, (published on 12 July 2018).

Why we inspected

We carried out a focused inspection. We undertook this focused inspection to review the key questions of safe and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

Portchester Lodge provides care and support for up to ten people who are living with mental health issues, a learning disability or dementia. There were seven people living at the home at the time of the inspection.

A new registered manager had been employed since our previous inspection. 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.

People were safeguarded from avoidable harm. Staff adhered to safeguarding adults procedures and reported any concerns to their manager and the local authority.

Staff assessed, managed and reduced risks to people’s safety at the service and in the community. There were sufficient staff on duty to meet people’s needs.

Safe medicines management was followed and people received their medicines appropriately.

Staff protected people from the risk of infection and followed procedures to prevent and control the spread of infections.

Staff completed regular refresher training to ensure their knowledge and skills stayed in line with best practice guidance. Staff shared knowledge with their colleagues to ensure any learning was shared throughout the team.

Staff supported people to eat and drink sufficient amounts to meet their needs. Staff liaised with other health and social care professionals and ensured people received effective, coordinated care in regards to any health needs.

Staff applied the principles of the Mental Capacity Act 2005. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

An appropriate, well maintained environment was provided that met people’s needs.

Staff treated people with kindness, respect and compassion. They were aware of people’s communication methods and how they expressed themselves. Staff empowered people to make choices about their care.

Staff supported people to maintain relationships with families. People’s privacy and dignity was respected and promoted.

People received personalised care that met their needs. Assessments were undertaken to identify people’s support needs and these were regularly reviewed.

People participated in a range of activities.

A complaints process ensured any concerns raised were listened to and investigated.

The registered manager adhered to the requirements of their Care Quality Commission registration, including submitting notifications about key events that occurred.

An inclusive and open culture had been established and the provider welcomed feedback from staff, relatives and health and social care professionals in order to improve service delivery.

A programme of audits and checks were in place to monitor the quality of the service and improvements were made where required.

The provider had learnt lessons from our last inspection and had improved.

Portchester Lodge provides care and support for up to ten people who are living with mental health issues, a learning disability or dementia. There were seven people living at the home at the time of the inspection.

There was 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 2008 and associated Regulations about how the service is run.

However, the registered manager had resigned in March 2017. The provider had moved a registered manager from another of their services to manage Portchester Lodge on a permanent basis and this person had started at the end of March 2017, a week before the inspection. The report will refer to the registered manager (the one who had resigned) and the new manager (who had been in post a week at the time of the inspection).

People told us they mainly felt safe and happy living at the home especially since the new manager had started work there.

Risks to people's health conditions were not fully assessed in order to minimise risks, and staff had variable awareness and understanding of people's individual risks.

People were supported by adequate numbers of staff, most of the time.

People received their medicines safely, although the new manager identified the need to update administering staff’s training.

People's consent was sought before staff provided care, however there were no mental capacity assessments in place where there were concerns about people’s capacity to consent.

There were concerns with lack of a robust recruitment process to ensure people were being cared for safely. Staff had not all received adequate induction and training and a concern was raised regarding the validity of the training information given to us that had been compiled by the previous registered manager.

People were relaxed and comfortable around staff and had their dignity and privacy respected. People were supported to be as independent as possible.

People had not always been involved in developing their care plans. People had not had regular meetings with staff regarding their recovery using the Recovery Star model, to be used alongside care planning in helping people to set goals.

People told us if they had any concerns they had been dealt with appropriately by the new manager.

People and staff had not always felt listened to by the registered manager however they felt very differently about the new manager.

We were concerned about the management of the home and lack of quality assurance/monitoring of the service, poor records in a number of areas, particularly care plans, staff training and staff recruitment. The new manager had plans in place to address the shortfalls we had identified.

We found four breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and a breach of the Health and Social Care Act 2008 (Registration) Regulations 2009. You can see what action we told the provider to take at the back of the full version of the report.