Background to this inspection
Updated
3 March 2018
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This inspection took place on 18 January 2018 and was unannounced. The inspection was carried out by one inspector. This was because this is a small mental health service and past experience has shown that additional inspection staff would be too intrusive for people.
The provider had not sent us a Provider Information Return (PIR) as we had not asked them to. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We reviewed information we held about the service. We looked at notifications received by the Care Quality Commission. Notifications are information we receive when a significant event happens, like a death or a serious injury.
We looked around all areas of the service and grounds. We met and spoke with six people living there. Conversations took place in people’s rooms, with their permission, and in communal areas. We spoke with six members of staff and the registered manager. We observed how staff engaged and spoke with people. We looked at how people were supported with their daily routines and activities and assessed if people's needs were being met. We reviewed three people’s care and support plans. We looked at a range of other records including three staff files, safety checks and records about how the quality of the service was managed.
Updated
3 March 2018
We inspected Avondale Castlemount Lodge on 18 January 2018 and the inspection was unannounced.
Avondale Castlemount Lodge is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.
Avondale Castlemount Lodge is a large detached house in a residential area of Dover. The service provides accommodation, care and support to up to nine people with mental health needs. At the time of the inspection there were seven people living at the service.
This was the first inspection of Avondale Castlemount Lodge.
A registered manager worked at the service each day. A registered manager is a person who has registered with 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 the service and that there were enough staff to give them the support they needed, when they needed it. People were protected from the risks of abuse, discrimination and avoidable harm by staff who were trained and knowledgeable. Staff knew how to report any concerns regarding people’s safety and were confident that the registered manager would act quickly on any concerns raised. Accidents and incidents were recorded and analysed to identify any patterns. When a pattern was identified action was taken to refer people to other health professionals. Such as the mental health team, when needed. People had their medicines safely and on time.
People were supported by sufficient numbers of staff who had been recruited safely. Staff were mentored and coached and completed regular training to keep up to date with best practice. The registered manager and staff also used guidance from expert professional organisations to keep up to date.
The building and grounds were clean and maintained to make sure they were safe and comfortable for people. People were involved in making decisions about the décor in the service and had personalised their own rooms. There was plenty of space for people to spend time with their loved ones when they visited.
People were encouraged and supported to cook their own meals and plan their menus. They had access to health care professionals and staff provided support to make sure their day to day health and well-being needs were met. 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. People’s physical, mental, emotional and cultural needs were assessed and reviewed.
Staff supported people to move into and out of the service, working with external agencies to ensure that any move was well co-ordinated.
People were supported and empowered by staff who were kind, compassionate and caring. People and staff had built strong, mutually respectful relationships and valued each other’s views and opinions. People’s privacy and dignity were respected and promoted.
People were actively involved in writing their care and support plans, setting goals and working on their recovery. People’s choices for their end of life care were discussed and recorded to make sure staff could follow their wishes. Staff supported people to follow their interests and ensured people were not socially isolated. People told us they would speak to the registered manager or staff if they had a complaint or if they were worried about anything and felt comfortable and confident to do so.
People and staff told us the service was well-led and the registered manager was a supportive leader. People felt they received the right amount of support from staff. There was an open, transparent, empowering and blameless culture at the service which was promoted by the registered manager and staff. People and staff were involved in driving improvements at the service.
Regular checks and audits were carried out and action was taken to remedy any identified shortfalls. People, relatives, staff and health professionals were encouraged to provide feedback on the day to day running of the service.
All services that provide health and social care to people are required to inform CQC of events that happen, such as a serious accident, so CQC can check that appropriate action was taken to prevent people from harm. The registered manager notified CQC and the local authority in a timely manner.