We carried out a review of the data available to us about Walkern Lodge on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Walkern Lodge, you can give feedback on this service.
About the service
Walkern Lodge is a residential care home providing accommodation and personal care to three people at the time of the inspection. The service can support up to four people. Each person’s accommodation included a self-contained lounge, kitchen, bedroom and bathroom as well as a shared garden area and summer house.
People's experience of using this service and what we found
Right support
People were supported in a safe environment. Staff supported people them in a safe way. Staff followed safe practice to reduce the risk of COVID-19 spreading within the service.
Staff encouraged people to live full lives and meet their goals which included learning new skills. People were supported by staff to do things they enjoyed and to get out and about.
The provider, management and staff team developed the service in way that ensured they had the resources and knowledge to support people when they experienced periods of distress. Restrictions were minimised and people had the freedom and choice how to live their lives.
Staff received the right training for their role, and this included training for specific complex needs people had. Staff received training in the use of restraint and positive behaviour support. At the time of our inspection, they had no needed to use physical restraint but knew if it was needed it was as a last resort and for the shortest time possible.
People were supported to communicate their needs, views and choices. Communication plans and tools were personalised to enable this. People were supported to personalise their rooms.
People were supported to access the community and to join in with activities and days out in their local area. People were supported by staff to live healthy lifestyles and access health and social care support. This helped improve people’s wellbeing. Medicines were managed safely and regularly reviewed.
Right care
People received support and care that was kind, compassionate and reflected people’s own culture and preferences. Staff promoted people’s equality and diversity, supporting and responding to their individual needs. People’s care plans were an accurate reflection of the support they needed and what people could do independently. They included strategies and plans to help people reach their aspirations and goals.
Staff had received training on safeguarding people from the risk of harm and abuse. Staff knew how to recognise and report abuse. There were enough appropriately skilled staff to meet people's needs and keep them safe. The service rarely used agency staff.
People were supported by staff who had a good understanding of people’s needs, how people communicated and what their preferences were. Staff listened to people. People received care that supported their needs and aspirations, was focused on their quality of life, and followed best practice.
Right culture
The provider, manager and staff monitored the quality of service provided to people. People, their relatives, staff and professionals were involved in the process.
People were supported by staff who had a good understanding of best practice and how to implement this into their roles. Staff put people's wishes, needs and rights at the heart of everything they did.
People and their relatives were involved in planning their care. People also had the support and involvement of an advocate. This helped to ensure that people had a service that was tailored to them. Staff respected people and their views. People had been put at the forefront of all they did. The risk of a closed culture was minimised as people received care and support in line with their wishes, and staff were open and inclusive.
For more information, please read the detailed findings section of this report. If you are reading this as a separate summary, the full report can be found on the Care Quality Commission (CQC) website at www.cqc.org.uk
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
Rating at last inspection
This service was rated requires improvement (published 28 June 2019). At the last inspection, the service was not rated (published 24 March 2021).
Why we inspected
This inspection was prompted by a review of the information we held about this service.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
Walkern Lodge is a residential care home providing personal and nursing care to up to four people. At the time of the inspection two people were living at Walkern Lodge.
The building consists of two ground floor flats. The second floor consisted of a two-bedroom flat. There is an office on the ground floor.
People’s experience of using this service and what we found
The provider gave examples of where they investigated any safeguarding concern and notified the correct people. Whilst people felt safe with the support being received there were mixed views about how well some staff supported them.
People were supported to administer their medicines. The manager ensured regular checks were completed to check medicines were managed safely and in line with the company’s policy.
The provider and manager had robust quality assurance checks in place to continuously improve the service. The manager was open and honest where improvements were needed and these lessons learnt were communicated with staff.
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.
The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.
The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.
Overall people were happy with the support they received. People were supported with their day to day wishes.
At the time of the inspection the manager was going through the application to become a registered manager.
The provider had systems in place to ensure that infection prevention controls were robust and staff ensured they followed the guidance in place.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 27 June 2019) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
We undertook this targeted inspection to check on a specific concern we had about how the provider investigated any safeguarding concerns and to check people’s basic human rights were at the centre of their care. The overall rating for the service has not changed following this targeted inspection and remains requires improvement.
CQC have introduced targeted inspections to follow up on Warning Notices or to check specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
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 that 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 using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
Improvement action plan issued following the previous inspection
Following the previous inspection on 20 April 2018 we rated the service ‘Requires improvement.’ The provider sent us an improvement action plan following the last inspection, that told us what they would do and by when. We found at this inspection that some of these improvements had been made. However, we found continued concerns with how the service had been managed, and how staff had been supported. Although recent changes to the management team had demonstrated some improvement we identified a breach of regulations in relation to the governance of the service and keeping people safe from harm or abuse.
People’s experience of using this service:
The service was not consistently well led. Effective audits to maintain the safety and quality of care had not been consistently provided. Audits and checks were not consistently robust and did not fully capture the issues relating to risk management. People were happy with the management of the home, however staff felt unsupported at times, and for some staff morale was low.
People felt safe and were supported by staff who knew how to identify when a person was at risk of harm. However, where concerns were raised that put people at risk of harm, these were not responded to in a timely manner. Where incidents were reported, investigations were not consistently documented to ensure people were not at risk of harm.
Staff were provided with training in some key areas, and the training provided had been reviewed since the previous inspection. However specific training did not always meet people’s specific needs. We have made a recommendation that supervision and appraisal encourages staff to develop their skills to specifically meet the needs of people they support.
People’s nutritional needs were known and assessed but not consistently supported by staff.
People were supported by sufficient numbers of staff at this inspection. However this had been poorly managed prior to this inspection. We have made a recommendation that managers proactively plan for staff absence and review contingency arrangements for staff cover.
Staff were employed following a robust recruitment process.
People received their medicines as the prescriber intended and medicines were safely managed. Regular reviews of people’s medicines were undertaken.
People’s consent was sought and processes were followed to ensure consent was obtained in line with the legal requirements.
People lived in a purpose built environment, however work was ongoing to ensure the home was reflective of the people who lived there, and more of a homely environment.
People received support from a range of healthcare professionals when needed. Staff supported people to attend these appointments, and ensured actions arising were followed up.
People’s privacy and dignity was met, and people felt the staff were caring and attentive. People were provided with good support to communicate and staff knew people well.
People were involved in developing their care plans and ensuring the care and support they received reflected their personalities and preferences. People were supported to be part of a wider community and engage in a range of activities and interests they enjoyed.
People felt able to raise any concerns or complaints to the staff or managers.
The service met the characteristics of Requires Improvement in some areas. For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection: Requires improvement when we inspected on 20 April 2018 (the report was published on (12 June 2018.
Why we inspected: This inspection was a scheduled inspection based on previous rating.
Follow up: This is the second time the service has been rated ‘Requires improvement.’ We will therefore meet with the provider to seek assurances they will meet the characteristics of a ‘Good’ service and maintain those standards. We will visit the service again in the future to check if they have made these changes to the quality of the service. We will refer our findings to the local authority.
Walkern Lodge is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The service accommodates up to four people. At the time of the inspection there were three people living there.
The service had a manager who was not registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the 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 and associated Regulations about how the service is run.
The home has been established for ten months prior to this inspection and was working in line with the values that underpin the Registering the Right Support. These values include choice, promotion of independence and inclusion, although the home did not always record how this was being done. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.
People were consistently supported in a safe manner by staff who knew them well. Staff were aware of the risks to people’s safety and wellbeing. Risk assessments were not always completed to support staff with keeping people safe. Staff knew how to report any risks to people’s safety and incidents were reported where people may have been at risk of harm. However, incidents were not robustly reviewed as required to mitigate the chances of the incident recurring. People received their medicines as the prescriber intended and were regularly reviewed. People were supported by sufficient numbers of staff. People lived in a clean, hygienic environment although not all staff had up to date infection control training. Staff completed fire safety checks regularly however not all staff had received training.
Staff were supported by the manager and received a range of training to support people’s needs. However this training was not always specific to the needs of the people staff supported. Most people were supported in accordance with the principles of the Mental Capacity Act 2005; however, this was not consistent.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. Policies and systems in the service support this practice. Consent to care and treatment was clearly documented and appropriate authorisations were in place when people lacked
capacity to make decisions.
People’s nutritional needs were met and monitored. People were supported by a range of health professionals when they needed this. People lived in a suitable environment that was well maintained.
People were supported by staff in a respectful and kind manner with staff ensuring people’s dignity was maintained. People received care in a person centred way that took account of their wishes and views. People were supported to engage in a range of activities that took account of their interests, hobbies and choices. There was a complaint’s process which people knew how to use should they need to.
People and staff were positive about the management of the home. There were systems in place to monitor the quality of the home. However, they had not identified the areas that required improvement that we found on inspection. People’s records were not consistently maintained as their needs changed. Information that is required to be submitted to CQC was done in a timely manner.