Archived: Queen Ann Lodge

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well-led?

We met with all seven people who live in the home and spoke with four people, two relatives, five members of staff and the finance manager. The new care manager was not on duty at the time of our inspection. We were told that an application had been made to register the new manager with the Care Quality Commission (CQC).

This is a summary of what we found:

Is the service safe?

People felt involved in making decisions about their care and treatment. Their care plans had been appropriately maintained and staff adhered to the provider's policy on confidentiality. One person remarked, 'Staff are very helpful; I feel safe here and I am happy to live here.'

The premises were clean and tidy and equipment had been appropriately checked and cleaned and had been serviced regularly.

There was enough staff cover to ensure people received appropriate care and treatment. New staff commenced work only after Disclosure and Barring Service (DBS) checks and clearance had been carried out. The service had adhered to its recruitment and selection policy. This meant the service had systems in place to ensure the staff were of good character and were suitably qualified and competent to carry out their roles.

Staff knew how to raise concerns and how to make safeguarding referrals.

The Care Quality Commission monitors the operation of the Deprivation of Liberty Safeguards (DoLS), which apply to care homes. Staff had received training and had an understanding of when an application should be made and how to submit one to be authorised by the local authority. There had been no cases requiring the application of DoLS since the last inspection.

Is the service effective?

Staff had knowledge of people's care needs and assisted them accordingly. They had received appropriate training to help them care for people who used the service. Staff had ensured people's personal, social and healthcare needs were closely monitored and maintained. Regular reviews of people's care needs and risk assessments had been carried out, where appropriate.

One person commented, 'It is a lovely place. Staff really help me to improve my health.'

One relative commented, 'The care is very good. The staff know their job very well. They keep me informed of any changes and discuss issues with me. They know what (my relative) needs.'

The service had worked closely with the local authority and other healthcare professionals, including the community psychiatric team, to ensure people had received appropriate care and treatment.

Is the service caring?

People and relatives were complimentary about the care and treatment provided. They felt staff were compassionate, understanding and caring. One person said, 'The staff are very good. I can say anything to them; they listen and help me feel better.' One relative said, 'Staff are very friendly, obliging and helpful. We are very pleased with the service.'

Is the service responsive?

People felt involved in their care and treatment and their informed consent was sought before care and treatment was provided. People's care plans reflected their wishes and preferences as to how they wanted care to be delivered.

People were involved in weekly group meetings to discuss activities they would like to do and plan the weekly menu. People's choices and preferences had been respected. The weekly activity records were detailed and reflected each person's preferences, lifestyle and daily routine. Some people had attended their respective day centres. One person said, 'On Thursday, I joined in a quiz game next door. Last week we had a family garden party. I enjoy seeing my family and friends. Another time, we went to the seaside.' Another told us, 'I can come and go as I please; I travel by myself to work every morning. Staff would help me if I needed help.'

Is the service well-led?

People and relatives had been complimentary about the service and the care provided. Stakeholder surveys and audits had been carried out as part of the provider's quality monitoring process.

The new management had made positive changes. Staff now had clearly defined job descriptions with clear responsibilities. There was a clear reporting structure. Staff had been made aware of the service's plan and the service's target, which was to improve communication. Each member of staff had an agreed personal target and a personally chosen development target.

Since our last visit in February 2013 staffing numbers had been increased, with an additional floating care staff employed to work across the service. The provider was also in the process of recruiting staff. Although this had helped to meet the needs of people requiring additional support, staff felt this could be further increased during busier times in the mornings. Most care plans and risk assessments had been reviewed and falls risk assessments in place for people prone to falls.

There were appropriate arrangements in place to manage medicines safely. People living at the home told us that staff explained to people the medication they were taking before administering these. One person told us, 'they explain why I'm taking the medication.' Another person said, 'I take two tablets in the morning.'

People's needs were assessed and care and treatment were planned and delivered in line with their individual care plan. People's care plans were up to date and the care they received was reviewed. The organisation took steps to ensure people's safety and welfare.

There were systems in place to ensure that people were protected from abuse and that they received the care they needed. Systems were in place to monitor and to make improvements to the quality of care and support provided to people by the home. However, we were concerned that records relating to people who use the service were not always up to date.