Archived: Conifer Lodge

Conifer Lodge is a residential care home providing personal care and support for up to 16 adults with mental health needs or associated conditions. At the time of the inspection there were 9 people living at the home.

People's experience of using this service and what we found

People and staff had not always been able to speak up when they had concerns. Governance and auditing arrangements had not identified the service as a closed culture. The provider had made a range of significant recent improvements to address this.

The service had no registered manager at the time of inspection. The provider had recruited a new manager and planned for them to register with CQC.

The interim management team demonstrated a strong understanding of the service and the culture, and had a clear vision for how to improve the culture, which had not always empowered staff.

Risks to people's health and safety were person centred, detailed and informed by updates from external healthcare professionals.

Staff worked hard to ensure people’s needs were met and they felt comfortable and safe.

The provider had reviewed safeguarding and whistleblowing policies and procedures to ensure they were understood. Staff now knew they could raise any concerns they had. The provider had worked well recently with external partners to ensure people’s safety when concerns were raised.

The environment was well maintained and clean. All utilities, safety and fire equipment were regularly checked.

Staff were recruited safely. There were competence assessments and themed supervisions meetings in place to ensure they knew how to keep people and themselves safe. The service relied on agency staff due to recent turnover of staff but had long term plans in place to reduce agency reliance.

Medicines were stored and administered safely, in line with best practice guidance.

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.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 26 September 2020)

Why we inspected

We undertook a focussed inspection to follow up on specific concerns which we had received about the service. The inspection was prompted in part due to concerns received about safeguarding and whistleblowing protocols. A decision was made for us to inspect and examine those risks.

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.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

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.

Conifer Lodge is a residential care home providing personal care and support for up to 16 adults with mental health needs or associated conditions. At the time of the inspection there were 15 people living at the home.

People’s experience of using this service and what we found.

At the last inspection we found improvements were required to ensure care records were fully person-centred and up to date. We also found improvements were required in relation to risk assessments and the mealtime experience.

At this inspection improvements had been made in these areas. Care records and risk assessments were reviewed regularly and contained a detailed amount of person-centred information.

We observed positive mealtime interactions and people confirmed they had the flexibility to make their own meals if they were unexpectedly late from an outing or activity. Feedback was consistently positive regarding the standard and choice of meals. The cook played an active and innovative part in the service more generally, for instance with themed evenings.

At the last inspection improvements were required to promote people's involvement in discussing their care and support needs and aspirations on a regular basis. At this inspection people and relatives confirmed they were always involved in care planning and more informal reviews and discussions, such as house meetings.

People were supported to have 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.

Medicines were managed safely by experienced staff, whose competence was regularly assessed. Training was comprehensive and had regard to people’s individual needs as well as core topics.

Quality assurance and audit processes were clear at local and regional level. Appropriate safeguarding and whistleblowing policies and procedures were in place; staff knew how to raise concerns and were confident to do so if needed. The provider specialised in supporting people with a learning disability and/or autism. They were clear that areas of best practice would still have relevance at Conifer Lodge. The registered manager could do more to ensure these transferable areas of best practice were embedded in the service. We have made a recommendation about this.

Despite the coronavirus pandemic staff had ensured people felt safe, supported and played an active part in the service and, where possible, wider community.

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 service was rated requires improvement at the last inspection (published 30 October 2019). At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We carried out an unannounced comprehensive inspection of this service on 5 September 2019. During the inspection we identified areas of improvement were required. During and following the inspection, the provider gave assurances about how improvements would be made.

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 coronavirus and other infection outbreaks effectively.

We completed this focused inspection to make sure improvements had been made. This report covers our findings in relation to two of those key domains: safe and well-led.

The ratings from the previous comprehensive inspection for those key domains not looked at during this inspection were used in calculating the overall rating for this inspection. The overall rating for the service therefore has improved to good based on the findings at this inspection.

You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for Conifer Lodge on our website at www.cqc.org.uk

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Conifer Lodge is a residential care home providing personal care and support for up to 16 adults with mental health needs or associated conditions. At the time of the inspection there were 15 people living at the home.

People’s experience of using this service and what we found

The registered manager monitored the quality of the service through audits and feedback received from people, their relatives, staff and external agencies. However, some improvements were required to governance. Where improvements had been identified by the provider, they were not all actioned in a timely way.

Most risks to people's health, safety and well-being were assessed and measures put in place to remove or reduce the risks. Improvements were required to ensure more regular fire checks took place and more regular review of people’s risk assessments to ensure they remained relevant.

We have made a recommendation about following best practice guidance for food safety.

Most systems were in place for people to receive their medicines in a safe way. However, medicines records did not all correspond to reflect the medicines people were prescribed. This was addressed immediately.

People were part of the community and enjoyed regular outings. Improvements were required in relation to activities in the home to keep people engaged and motivated. People and relatives knew how to complain

Improvements were required to care records to ensure care was person-centred and reflected people’s goals and aspirations and provided evidence of who was involved in decision making.

People were supported to have some 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. However, more regular individual meetings should take place with people to promote their involvement.

Staff had developed good relationships with people, were caring in their approach and treated people with respect. Systems were in place to protect people from abuse.

There were enough staff available to provide individual care and support to each person. Staff upheld people's human rights and treated people with respect and dignity. Staff received training and support to help them carry out their role

Communication was effective and staff and people were listened to. Staff said they felt well-supported and were aware of their rights and their responsibility to share any concerns about the care provided.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 24 October 2018). Since this rating was awarded the registered provider of the service has changed. We have used the previous rating to inform our planning and decisions about the rating at this inspection.

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 re-inspection programme. If we receive any concerning information we may inspect sooner.