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Reports


Inspection carried out on 11 August 2017

During a routine inspection

The Lodge is a small residential home for people on the autistic spectrum, with learning and physical disabilities and sensory impairment. The service is registered to support eight people and at the time of our inspection there were six people living there.

The service is a large property in a residential area. It was renovated to ensure it could meet people’s needs. It has seven bedrooms, each with an en-suite bathroom. There were several communal areas, the kitchen and dining room were open plan. There was a large secure garden to the rear.

The service 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 2008 and associated Regulations about how the service is run.

The staff team had an excellent understanding of people's complex needs. Their care was delivered by caring and highly attentive staff. During our observations, it was clear that people had developed trusting relationships with the staff who supported them and were relaxed and comfortable in their presence. There was a strong emphasis on the key principles of care such as compassion, inclusion, respect, dignity and enablement. People were treated with dignity and respect at all times by staff who understood the need to treat private and sensitive information confidentially.

The provider was involved in the day to day management of the service and had taken unprecedented steps to ensure consistency and continuity in people’s care. People who used the service, their relatives and relevant healthcare professionals were extremely positive about the service and its management. They told us how the care and support they received had clear and lasting effects on their lives. The registered manager led by example by promoting an open and inclusive culture. They also fulfilled all of the regulatory requirements as required. The provider ensured inclusive ways of communicating with people had been developed, which meant feedback on the service could be gathered and acted upon. Quality assurance systems were effective and ensured compliance with CQC regulations and best practice guidelines.

People who used the service were supported by staff who had been recruited safely following the completion of appropriate checks. Assessments of people’s care and support needs were undertaken regularly to ensure staff were deployed in suitable numbers. Staff had been trained to protect people from abuse and avoidable harm and knew what action to take if the suspected abuse had occurred. The provider had developed plans to deal with foreseeable emergencies, which included guidance to enable staff to evacuate people safely in an emergency. People received their medicines as prescribed and suitable arrangements were in place to manage medicines safely.

People who used the service received care and support from staff who had completed a range of training to ensure they had skills and abilities to support them effectively. Staff received effective levels of supervision, appraisal and professional development. The principles of the Mental Capacity Act 2005 were followed within the service and staff were aware of how to gain consent from people. People ate a healthy and balanced diet of their choosing. When concerns with people’s health and welfare were identified relevant professionals were contacted for their advice and guidance.

Pre-admission assessments were completed before people moved into the service and the information was used to develop a number of person centred care plans. As people’s needs changed or developed their care plans were updated to reflect their needs and provide up to date guidance for staff. People were encouraged to take part in a wide range of activities and follow their hobbies and interests. We saw that people wer

Inspection carried out on 28 July 2015

During a routine inspection

The inspection took place on 28 July 2015 and was unannounced.

The service is a small residential home for people on the autistic spectrum, with learning and physical disabilities and sensory impairment. The service is registered to support seven people and at the time of our inspection there were six people living there.

The service is a large property on a residential street. When it opened three years ago it was designed and renovated to meet people’s needs. It has seven bedrooms each with an en-suite bathroom. Two bedrooms are downstairs and have wet floor shower rooms so they are accessible for wheelchair users. There are several communal areas and the kitchen and dining room is open plan, with a small lounge leading off to the side. There is a large secure garden to the rear.

The service 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 2008 and associated Regulations about how the service is run.

People, and their relatives, told us the service was safe. Staff knew how to safeguard people from avoidable harm, and the service had an up to date safeguarding policy which provided staff with clear guidance.

People had individual risk assessments and risk management plans in place which ensured staff followed the least restrictive principles. This meant risk was safely managed whilst protecting people’s rights and freedoms. Detailed protocols and risk assessments were in place for the use of restraint.

Medicines were safely managed and administered. The service had individual protocols in place for the administration of PRN (as required) medication and staff had received training for specialist rescue medicines for people living with epilepsy.

Staff were recruited safely and there were enough staff to support people to lead full lives. Staff were supported to have the skills and knowledge they needed to support people, they had access to regular supervision and ongoing training. This meant staff continued to develop their skills.

The service was following the principles of the Mental Capacity Act 2005 and the registered manager had a good understanding of the Deprivation of Liberty safeguards (DoLS).

People enjoyed a healthy and balanced diet and were involved in making drinks and meal preparation.

We received positive feedback from health care professionals who told us the service worked well with them and provided a good standard of care to people.

People who used the service and support workers had a good rapport and support staff knew people well. All of the staff we spoke with told us they would be happy for their family member to live at the service.

We saw evidence of compassionate end of life care, as well as support for people who had lost their friend.

People had detailed support plans which contained personal information about people’s likes and dislikes and how best to support them. The service had detailed behaviour management plans. All of the support plans and risk assessments had been developed in conjunction with the person, their families, health and social care professionals and the support staff who knew them well. People had a key worker who they met with every month to review their support.

The service was keen to seek feedback from people who lived there, their families and health and social care professionals. Regular surveys were sent to people, and we saw evidence of action taken as a result of the feedback.

People were supported to be part of their local community and took part in a range of activities. Relationships with family and friends were valued and support was provided to maintain theses. People’s religious needs were met.

The service was well led with the registered manager being clear about their role. They had systems in place to monitor the effectiveness and the quality of the service they provided to people.

Staff morale was high. They spoke with passion about the support they gave to people. Staff told us they felt well supported by the registered and deputy manager, and that they had a culture of openness.

The registered manager demonstrated a commitment to ongoing service development; the service had recently started to work towards accreditation via the national autistic society.