Archived: Durlston Lodge

Durlston Lodge is a residential care home providing personal care to five people with autism and learning disabilities.

The home is located within walking distance from the local community. Each person had their own bathroom. One person had a self-contained living space, with their own lounge area. There were communal living and dining spaces, a sensory room and garden.

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.

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

Since the last inspection, the management team had conducted thorough quality audits and monitoring of the service. A quality improvement plan had been created, with clear timescales for improvements to take place.

Further improvements were needed in reviewing and updating people’s mental capacity assessments and best interest decisions. People were supported to have control and choice of their lives and staff supported them in the least restrictive way possible. However, the assessments and records in the service did not consistently support this practice.

There were staff vacancies, however work was taking place to actively recruit into these roles. While recruitment was ongoing, there had been improvements in the consistency of agency or temporary staff. Staff were recruited following safe recruitment processes.

People were supported to receive safe care. There were risk assessments in place and staff had received safeguarding training. People’s medicines were stored safely and administered by trained staff.

There was engagement with the community and a broad range of social activities took place. Records showed people consistently took part in activities based around their hobbies and interests. People also went on holiday.

People’s relatives were welcomed to visit when they wanted to. People were supported to regularly attend home visits.

There was a choice of different food and drink. There was a large kitchen and people were supported where possible to take part in preparing food or drinks.

People’s bedrooms were personalised. They were painted in people’s preferred colours, and had pictures or items displayed which they wanted to have in their bedroom.

Support plans and records were regularly reviewed. People and their relatives participated in these and attended review meetings. The support plans reflected people’s up to date support needs.

We observed positive interactions between people and staff. The care observed showed the staff knew the person and their support needs well.

There had been changes in the management structure at the home. However, there were plans in place to promote consistency during the changeover in home manager. The management team were clear about their roles and were promoting a culture of person-centred care and support.

The service applied the principles and values 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.

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 18 July 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

This was a planned inspection based on the previous rating.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Durlston 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.

People’s experience of using this service:

This was a focussed inspection around the key questions of is the service effective and well-led.

Recruitment initiatives had not proven to be successful, there were long standing vacancies and a reliance upon temporary support staff and agency staff This would not be a cost effective or sustainable measure for staffing the service long-term. It meant people were frequently being supported by staff who may not know them well.

Staff conflict had occurred, and the morale of the service had been discussed at team meetings. Staff told us this had improved in the past few weeks before the inspection. The registered manager told us resolving conflict had taken their time away from other managerial responsibilities.

There was no overarching system for the registered manager to maintain an overview of where improvements were needed in the service. This meant actions were being set following audits or meetings but these were not being met.

Actions identified in team meetings affecting people’s care plans were not always being addressed. For example, one person’s support tool was being raised as not being used correctly for three consecutive monthly meetings.

Actions identified in quality monitoring audits were not always being addressed. This included actions to add additional information to people’s risk assessments.

People’s care plan reviews were behind schedule, as were staff supervision meetings and staff training. There were long-standing requests for redecoration of the home which were only acted upon by the provider following feedback on the first day of the inspection.

The senior and shift lead staff were not able to be given the required administrative time as part of their role, this left additional responsibilities for the registered manager. The registered manager was also being required to also work directly supporting people.

Rating at last inspection: Good

Why we inspected: This focussed inspection was prompted partly by a feedback we received. The feedback identified concerns in the staff culture, staffing levels, and assessments of people’s needs. During the inspection we found aspects of these concerns to be substantiated.

Follow up: We will continue to monitor the service and use intelligence we receive to inform when the next inspection will take place.

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