Archived: Anita Jane's Lodge

Anita Jane's Lodge is a residential care service providing personal care and accommodation to people with mental heath needs. At the time of the inspection the registered manager confirmed the service was providing personal care to 11 people.

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

People felt safe with staff from the service. Staff understood how to protect people from the risk of harm and understood potential signs of abuse. Care plans provided guidance for staff to follow, and staff had read the care plans. Risk assessments reduced risk for people, though one risk assessment needed to be more detailed in order to fully reduce the risk posed. Staff went through a recruitment process that ensured the provider only employed suitable staff, though this needed to be made more robust.

People received their medicines as prescribed and they were protected from the risk of infections through staff working practices. There were enough staff to meet people’s needs. Staff undertook induction and specialist training which provided knowledge and skills to do their job well and effectively meet people’s needs.

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.

People were provided with care and support that ensured they had good nutrition and hydration. They had access to healthcare that maintained their health and wellbeing. People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible.

Staff knew people well. People had developed positive relationships with staff which helped to ensure good communication and support. Staff respected people’s privacy and dignity. They supported people to be independent.

People were involved and consulted when deciding how support was provided. Staff knew and understood the needs of the people using the service and care was provided based on their assessed needs. Staff were responsive to changes in people's needs to ensure people received help to maintain their health and well-being.

People knew how to raise any concerns or make a complaint. The provider responded to complaints by investigation and solutions to put things right. The complaints policy provided information about how these would be managed and responded to.

People and staff spoke positively about the management and leadership of the service. They said staff were very friendly and caring, and they had built good relationships with them.

Systems were in place to monitor the quality of care and support people experienced through quality assurance systems and processes to improve the service. The service worked in partnership with external agencies to ensure people achieved good outcomes from their care and support.

Rating at last inspection: The last rating for this service was Good. This was published 14 February 2017.

Why we inspected:

This was a planned inspection based on the previous rating.

Follow up:

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

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

Anita Janes Lodge is a residential home which provides care to people with mental health needs. It is registered to provide care for up to 16 people. At the time of our inspection visit there were 11 people living at the home.

There was a registered manager in post. 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 and associated Regulations about how the service is run. The registered manager was responsible for the management of two homes. There was also support manager in post to manage the day-to-day running of the service.

People using the service we spoke with said they thought the home was safe. Staff had been trained in safeguarding (protecting people from abuse) and understood their responsibilities in this area. People's risk assessments had provided staff with information of how to support people safely. People using the service told us they thought medicines were given safely and on time. Staff had been subject to checks to ensure they were appropriate to work with the people who used the service.

Staff had been trained, in the main, to ensure they had skills and knowledge to meet people's needs. Staff understood their responsibilities under the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) to allow, as much as possible, people to have an effective choice about how they lived their lives. People had plenty to eat and drink and everyone told us they liked the food provided. People's health care needs had been protected by referral to health care professionals when necessary.

People told us they liked the staff and got on very well with them, and we saw examples of staff working with people in a supportive and caring way. People and their representatives were involved in making decisions about care, treatment and support.

Care plans were individual to the people using the service and usually covered their health and social care needs. There were not sufficient numbers of staff to ensure that people's needs could be responded to in good time, though this was later rectified by the registered manager. Activities were in place to provide some stimulation for people and people took part in activities in their chosen community activities.

People told us they would tell staff if they had any concerns and were confident that proper action would be taken. People and staff were satisfied with how the home was run by the registered manager and the management team. Management carried out audits to check that the home was running properly to meet people's needs, though not all essential systems had been audited.

Below is a summary of what we found. The summary describes what we observed, the records we looked at, and what the people who used the service and the staff told us. During our inspection we talked with six of the people who used the service and five members of staff.

If you want to see the evidence that supports our summary please read the full report.

Is the service safe?

People told us they felt safe at Anita Jane's Lodge. When we visited the home generally had a good atmosphere and people appeared relaxed and happy. One person said, 'I'm accepted here and I can be myself. We all look after each other, residents and staff. It feels like home.'

There were enough staff on duty to meet the needs of the people living at the home, and the acting manager and other staff were available on call in case of emergencies.

One person did not have a care plan or risk assessment for an ongoing medical condition. A compliance action has been set for this and the provider must tell us how they plan to improve.

People told us they were satisfied with how staff managed their medication. One person said, 'The staff put my tablets in a little pot then tip them in my hand and give me a glass of water to take them with.' Some medication records needed updating. A compliance action has been set for this and the provider must tell us how they plan to improve.

The acting manager and staff understood their responsibilities under the Mental Capacity Act Deprivation of Liberty Safeguards (MCA DoLS). Where appropriate, applications had been submitted to the relevant authorities.

Is the service effective?

People were supported to be as independent as possible. Those who were safe to do so made their own hot drinks and snacks in the kitchen. One person told us, 'I've been making bacon sandwiches with the staff when I want to, and I make my own tea all the time.'

The home had acquired a kitten at the request of the people who used the service. People introduced us to the kitten and told us how much they enjoyed looking after it. When we inspected people were playing with the kitten, taking it into the garden, and feeding and petting it.

We found improvement to some care plans and risk assessments, with evidence of regular reviews and updates. One person who used the service told us they had been involved in the review process and said this had been a positive experience as they could see how they had progressed and become more independent.

Is the service caring?

People got on well with the staff who worked with them in a warm and supportive way. One person who used the service said, 'The staff are like family and always look out for me. There is only one word for them ' excellent.' The staff team was established and some staff members had worked at the home for a number of years. This meant they had provided continuity of care and built up relationships of trust with the people who used the service.

Some people who used the service needed staff to support them when they left the home. Others were safe to leave the home on their own, but preferred to go out with staff. As this was their choice staff accompanied them on request. Records showed people had recently gone out with staff, on their own or in small groups, to two local parks, to cafes, and shopping.

Is the service responsive?

When we visited the home was undergoing major refurbishment. The people who used the service told us they were pleased with the changes and had been involved in choosing the new d'cor. One person said, 'The owners have pulled out all the stops ' it's the most I've seen done to this home in years.' Another person told us, 'With the painting the home's looking better and it makes me feel alright.'

Although improvements had been made to parts of the premises, some areas were still in a poor state of decoration and repair. A compliance action has been set for this and the provider must tell us how they plan to improve.

One person told us they'd been helping to look after the home's large rear garden. When we inspected they were in the garden with their keyworker digging flowerbeds and planting vegetables. They told us how much they enjoyed doing this.

Is the service well-led?

The acting manager had been running the home for two years. In May 2014 she submitted an application to CQC to become the registered manager. This was being processed at the time of our inspection. The people who used the service told us they had confidence in the acting manager. One person said, 'She's here for us and you can talk to her about anything.'

People had asked for an alternative to residents meetings which they said they didn't find useful. These had been replaced with monthly one-to-one meetings when people met with their key workers to give individual feedback on the home. The acting manager said this approach gave everybody the opportunity to comment on the service and the results would be used to help ensure the home was run in the way people wanted it to be.

The home's audits of care plans and risk assessments, and medication records had not always been effective as they had failed to identify some errors or omissions. A compliance action has been set for this and the provider must tell us how they plan to improve.

We looked at the way medication was obtained, recorded, stored, administered and disposed of. We found that people were not protected against the risks associated with medicines because medicines had not always been managed safely.

We found parts of the premises were not safe or in good order, nor did they promote the wellbeing of the people who used the service. Although there had been improvements to some areas of the home, others were in an unacceptable state. As a result people had not been fully protected against the risks of unsuitable premises.

People told us they liked living at Anita Jane's Lodge and thought the care was good. One person said, 'I can do most things for myself but if there's anything I can't do the staff help me.' Another person commented, 'This is a special place where you feel safe and looked after. The staff are here for us day and night.'

During our inspection the evening meal was served in the dining room. The atmosphere was relaxed and convivial and people appeared to enjoy the meal as a social event. A variety of dishes were served, depending on people's preferences, including curry, omelette, meatball bolognaise, and corn beef hash. People sat in small groups at pine tables. Music chosen by one of the people who used the service was played in the background.

People said they liked the premises which were clean and homely. One person told us, 'It's fine here, nice and comfy. We've got a big garden at the back and I like to sit our there in the summer.' Another person commented, 'The staff are always cleaning. I think they do a good job.'

People told us they got on well with the staff. One person said, 'The staff are always here for me and make me feel safe.' Another commented, 'The staff look after me very well.' We observed that relationships between the staff and the people who used the service were warm and friendly. Staff told us they enjoyed working at Anita's Jane's Lodge and felt they were well-trained and supervised.