The Lodge

The Lodge provides residential care for younger adults with a learning disability and/or autism. The service is registered to support up to eight people in one adapted building, and eight people were using the service when we inspected.

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 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’s experience of using this service and what we found

People received support from trained staff to reduce any anxiety or distress and help keep them safe. Professionals and relatives praised the effective support provided and the positive outcomes achieved for people who used the service. Not all records included enough information to guide staff on when they might need to use certain medicines or physical restraint to keep people safe.

We made recommendations about reviewing the approach to supporting, recording and analysing incidents of anxiety or distress, and to look at good practice on stopping over medication of people with a learning disability and/or autism.

The registered manager was responsive to feedback and committed to developing the service and improving people’s quality of life.

People were kept safe by staff who had been safely recruited and trained to identify and respond to any safeguarding concerns. The registered manager made sure enough staff were deployed to meet people’s needs. The environment was safely maintained and clean. People were protected from the risk of healthcare related infections.

Staff completed regular training and had supervisions and appraisals to support them in their role. They worked closely with professionals to make sure they were providing effective care and people received medical attention when needed.

People were supported to eat a varied and balanced diet, and to maintain good health.

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. Applications were made when needed to deprive people of their liberty. We made a recommendation about recording in relation to the Mental Capacity Act 2005.

Staff were kind, caring and respectful. People shared positive caring relationships with the staff who supported them and clearly valued and benefited from their company.

Staff provided support in line with the principles and values of Registering the Right Support. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

People had a good quality of life and were supported to pursue their hobbies and interests. Staff encouraged and supported people to take part in a wide range of activities to learn new skills and to reduce the risk of social isolation.

There were systems in place to manage and respond to complaints. Lessons had been learned and changes made to improve the service. People consistently told us staff and management were approachable and responsive to feedback.

For more details, please see the full report which is on the Care Quality Commission’s (CQC) website at www.cqc.org.uk.

Rating at last inspection

The last rating for this service was good (report published 3 August 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 reinspection programme. If we receive any concerning information we may inspect sooner.

We inspected this service on 19 and 26 June 2017. The inspection was unannounced. At the time of our inspection, there were five people using the service. This was the first inspection of this location since it was registered under a new provider, Action for Care Limited, in December 2016.

The inspection was in part prompted by concerns shared with us regarding the care and support provided at the service. This included concerns regarding the conduct of staff, staffing levels and medicine management. We used this information to plan our inspection and have reported our findings in relation to these concerns in the body of our report.

The provider is required to have a registered manager as a condition of their registration for this service. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like 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. At the time of our inspection, the service did have a registered manager.

During the inspection, we found people who used the service were safe. Staff understood their responsibility to safeguard adults who may be at risk of abuse. Care plans and risk assessments were used to guide staff on how to safely meet people’s needs. Appropriate recruitment checks were completed and sufficient staff were deployed to provide safe care to people who used the service. Medicines were managed safely, although me made a recommendation about ensuring medicines were stored at the correct temperature. Effective safeguards were in place to govern the use of physical interventions.

We observed the service to be clean, tidy and well maintained. Maintenance was carried out at required intervals and the manager completed regular health and safety audits to monitor and ensure the safety of the home environment.

Staff completed training and shadowed more experienced workers to gain the knowledge and skills needed to provide effective care and support. Staff received on-going supervisions to support their continued professional development.

People were supported to have maximum choice and control of their lives and staff supported people in the least restrictive way possible; the policies and systems in the service support this practice. Staff supported people to ensure they ate and drank enough. Staff supported people to access healthcare services to maintain their health and well-being.

Staff were observed to be kind and caring. Staff supported people to maintain their privacy and dignity and to have choice and control over their daily routines.

Care plans were detailed and contained person-centred information. Staff knew people well and understood how to best meet their needs. People’s care and support was regularly reviewed to ensure it was meeting their needs. People were supported to engage in a range of activities and to access their wider community.

Systems were in place to gather and respond to feedback. The manager completed a range of audits to monitor the quality and safety of the service. People told us the manager was approachable, supportive and responsive to feedback.