29 April 2015
During a routine inspection
Gatehouse Cottages is registered with the Care Quality Commission [CQC] to provide accommodation for up to 24 people who may have learning disabilities. The service is situated in open countryside near Immingham. There is a main building and a unit called The Lodge where three people reside. There is a car park for visitors to use. Staff are available 24 hours a day to support people.
This inspection was undertaken on 29 April 2015 and was unannounced. The service was last inspected on 12 August 2013 and was compliant with the regulations looked at.
This service has a registered manager in place. 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 the legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
The people who lived at the home had complex needs which meant they could not tell us their experiences. We used a number of different methods to help us understand the experiences of the people who used the service including the Short Observational Framework for Inspection [SOFI]. SOFI is a way of observing care to help us understand the experiences of people who could not talk with us. We saw that staff understood how people communicated their needs, likes, dislikes and preferences which ensured people’s needs were met.
Staff were aware of the different types of abuse that may occur. Staff knew what action they must take to protect people from harm. Issues were reported appropriately to the local authority and to the CQC.
The CQC is required by law to monitor the operation of the Mental Capacity Act [MCA] 2005 Deprivation of Liberty Safeguards [DoLS], and to report on what we find. DoLS are applied for when people who use the service lack capacity and the care they require to keep them safe amounts to continuous supervision and control. These safeguards protect the rights of adults by ensuring if there are restrictions on their freedom and liberty these are assessed by appropriately trained professionals. The registered manager and staff understood their responsibilities in regard to this and they made appropriate requests for people to be independently assessed. This helped to protect their rights and prevent people being deprived of their liberty unlawfully.
Staffing levels were appropriate to meet people’s needs. People’s individual needs and risks to their health and wellbeing were assessed and monitored, and known by the staff.
Staff recruitment processes were robust. The staff were provided with training, supervision and appraisal which helped to support them and maintain their skills.
People were treated as individuals with dignity and respect. People were seen to make their own decisions about how they wished to spend their time, what they wanted to do or where they wanted to go. People had time to think about their responses and they communicated their wishes in their own way. This communication was listened to and was acted upon by the staff to ensure that people lived the life they chose.
People’s dietary and fluid needs were known and were monitored by the staff and the chef. Food was home cooked and a balanced healthy diet was promoted. Patient attentive staff assisted or prompted people to eat and drink. Adapted crockery and cutlery were used to promote people’s independence. Advice was gained, where necessary from relevant health care professionals to ensure people’s nutritional needs were met.
The main building had wide corridors and spacious, airy communal areas. People chose how they wanted their bedroom to be decorated and chose the furniture they wanted to make them homely. Pictorial signage assisted people to locate the lounges, bathrooms and toilets. The buildings were maintained and service contracts were in place to ensure all areas remained pleasant and safe for people to live in.
There was a complaints procedure in place which was available in a format that met people’s needs.
The registered manager undertook regular audits to help them monitor, maintain or improve the service. People’s views were asked for on a daily basis by staff and through residents meetings or by using surveys. Any feedback received was acted upon by the staff to ensure people remained satisfied living there.