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Archived: Wesley Lodge Good

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Inspection carried out on 20 September 2016

During a routine inspection

Wesley Lodge is a care home for up to eight people who have a learning disability, physical disability and complex needs. On the day of the inspection eight people were living in the home.

This was an unannounced inspection that took place on 20 September 2016.

The home had 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 and associated Regulations about how the service is run. The registered manager assisted us with our inspection on the day.

There was a kind, caring atmosphere in the home where staff displayed an inclusive attitude towards people. Relatives were happy with the care provided. Staff supported people to take part in various activities and staff were attentive to people to help ensure that activities were individualised and meaningful to people.

People had care responsive to their needs and staff knew people extremely well. People who had dietary requirements received appropriate foods and people could choose which foods they had. Staff followed the guidance of healthcare professionals where appropriate and involved healthcare professionals to help ensure people received effective care.

Staff provided care in line with the Mental Capacity Act (2005). Records demonstrated that people’s rights were protected as staff acted in accordance with the MCA when specific decisions needed to be made. Where there were restrictions in place appropriate applications had been submitted to the supervisory body in relation to this.

Staff followed correct and appropriate procedures in administering medicines and medicines were stored safely. Care was provided to people by staff who were trained and received relevant support from their manager. This included regular supervisions and appraisals. Staff told us they felt valued by the registered manager and they worked together well as a team.

Staff understood their role in safeguarding people. They had received training and demonstrated a good understanding of how they would protect people from abuse or potential harm. Staff routinely carried out risk assessments and created plans to minimise known hazards whilst encouraging people’s independence.

In the event of an emergency where the home would have to close, there was a contingency plan in place to help ensure people’s care would continue uninterrupted.

There were sufficient staff in the home to help ensure people received the care and support they required when they required it. This included enabling people to attend their activities. Good recruitment processes were in place to ensure that those staff who were providing the care were suitable to be working in such a setting.

Care plans contained detailed information to guide staff on how someone wished to be cared for. Information included detail around people’s mobility, food and personal care needs. Staff had a good understanding of people’s needs and backgrounds as detailed in their care plans.

Quality assurance checks were carried out to help ensure the environment was a safe place for people to live and they received a good quality of care. Staff were involved in the running of the home as regular staff meetings were held and they were encouraged to give their feedback. Relatives and other stakeholders were given the opportunity to provide feedback on the care provided through surveys. Relatives told us they told us if they had any concerns they would have no hesitation in speaking with the registered manager.

It was evident the registered manager had good management oversight and staff, relatives and professionals felt the home was well managed. The registered manager was keen to improve the quality of care provided.

Inspection carried out on 27 May 2015

During a routine inspection

Wesley Lodge is a residential home which provides accommodation and personal care for up to eight people, who are living with a learning disability, physical disabilities and have complex needs. At the time of our inspection there were eight people who lived at home. Whilst people were unable to take part in full discussions, we were able to speak with people and observe how they interacted with staff. The home is on one level which enables people to move around the home freely and there is a spacious and secure garden for people to use.

The inspection of Wesley Lodge took place on 27 May 2015 and was unannounced.

This inspection was a follow-up to a previous inspection which was carried out on 9 January 2014, where we found that the provider had not met the standards required in the Management of medicines, requirements relating to workers, supporting workers and assessing and monitoring the quality of service provision. During this visit, we found that the provider had made some improvements.

At the time of the inspection there was not a registered manager in post. 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.’ Since the inspection, we note that an application to become the registered manager has been submitted to the CQC.

People were safe at Wesley Lodge, a relative told us, “Yes, they are very safe, no issues, not at all.” Staff had a clear understanding of the signs of abuse and were aware of what to do if they suspected abuse was taking place.

The provider had not conducted all of the necessary checks to ensure that people were safe to work with people at the home. We have recommended that the provider reviews and implements the requirement set out in the regulations.

Care was provided to people by staff who were competent to carry out their role. Staff told us they received supervision, but did not have appraisals.

Staff worked within best practice guidelines to ensure people’s care, treatment and support promoted well-being and independence.

Medicines were managed safely. Any changes to people’s medicines were prescribed by the person’s GP.

Staff were up to date with current guidance to support people to make decisions. Information about the home was given to people and consent was obtained prior to any care given. Where people had restrictions placed on them these were done in their best interests using appropriate safeguards.

People had enough to eat and drink throughout the day and night and there were arrangements in place to identify and support people who were nutritionally at risk. People were supported to have access to healthcare services and were involved in the regular monitoring of their health. The home worked effectively with healthcare professionals and was proactive in referring people for treatment.

A relative told us staff were, “Very caring.” They know my relative, they like them and they go out of their way to please them.” Staff treated people with compassion, kindness, dignity and respect. People’s preferences, likes and dislikes had been taken into consideration and support was provided in accordance with people’s wishes. Relatives and friends were able to visit. People’s privacy and dignity were respected and promoted for example when personal care tasks were performed.

The home was organised to meet people’s changing needs. People’s needs were assessed when they entered the home and on a continuous basis to reflect any changes in their needs.

People were encouraged to voice their concerns or complaints about the home and there were different ways for their views to be heard. Suggestions, concerns and complaints were used as an opportunity to learn and improve the home.

People had access to activities that were important and relevant to them. People were protected from social isolation through systems the home had in place. We found there was a range of activities available within the home and community.

The provider actively encouraged and supported people’s involvement in the improvement of the home. We have made a recommendation about how to best capture people’s voices.

People’s care and welfare was monitored regularly to ensure their needs were met within a safe environment. The provider had systems in place to regularly assess and monitor the quality of the service provided. Management liaised with, obtained guidance and best practice techniques from external agencies and professional bodies.

People told us the staff were friendly and management were always approachable. Staff were encouraged to contribute to the improvement of the home. Staff told us they would report any concerns to their manager. Staff felt that management were very supportive.

Inspection carried out on 9 January 2014

During a routine inspection

We were not able to hear the views of people who used the service directly. We spoke with four relatives, seven staff members, observed interactions, read two care plans, four staff files and other records.

We saw staff assisted people in a kind and respectful manner. They understood their verbal and non-verbal communications well and responded quickly.

Relatives told us “the care is excellent” and one person said “staff know him very well and treat him kindly.”

We saw the care records, the format of which was under review, contained detailed information in order for staff to understand how to deliver care and support. They were up to date and health professionals were involved in reviews.

The home was clean and tidy and free from offensive odour. Staff were seen to work within infection control guidelines.

The system for storage, administration and recording of medicines was not in line with best practice and people were not protected by it.

The processes for recruiting staff were not robust and did not ensure staff were able to carry out their job and were of good character.

Staff did not receive sufficient support, supervision or appraisal of their performance. They did not have the opportunity to develop their skills and knowledge.

There had been a review of the service in April 2013 and progress towards the resulting action plan was ongoing. There were areas of the service delivery where the quality was not monitored.

Inspection carried out on 7 August 2012

During a themed inspection looking at Dignity and Nutrition

We were not able to hear the views of people who use the service directly. We used a number of different methods to help us understand people’s experiences, including a short observational tool for inspection (SOFI), speaking to relatives and obtaining feedback from healthcare professionals who had an involvement with the service. These professionals included a speech and language therapist, a dietitian, a care manager, a specialist health care team leader, a lead nurse from the psychology and challenging needs service and an independent mental capacity advocate (IMCA).

This feedback enabled us to gain an understanding of what it was like to live in Wesley Lodge, including how people were treated by staff and their involvement in making choices about their care. Feedback from relatives and professionals also told us about the quality and choice of food and drink available. This was because this inspection was part of a themed inspection programme to assess whether older people in care services were treated with dignity and respect and whether their nutritional needs were met. Wesley Lodge provides care for people from a range age groups, some of whom are older people.

The inspection team was led by a Care Quality Commission (CQC) inspector joined by an Expert by Experience, who has personal experience of using or caring for someone who uses this type of service.