Archived: Cwello Lodge

Cwello Lodge is a residential care home providing accommodation for persons who require personal care. The service can accommodate up to eight people with learning disabilities and/or mental health needs. At the time of inspection there were eight people living in Cwello Lodge. The accommodation is spread over two floors. There were bedrooms on both levels of the home and all bedrooms had a private toilet.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

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

People were happy living at Cwello Lodge. They told us they felt safe, got on well with the staff, were given choice as to how they lived their lives, and were able to speak up if needed.

We found the provider ensured people were supported safely. There were sufficient numbers of suitable, motivated staff. Processes and procedures were in place to store and administer medicines safely. We were assured appropriate infection prevention and control measures were in place to protect people against the risk of COVID-19 and other infections.

The service was well led. The staff team told us they felt supported by the provider and manager. People who used the service and staff could contribute their views on how the service was managed. The manager had processes in place to monitor and improve the quality of service people received.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

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 10 May 2018).

Why we inspected

This was a planned inspection based on concerns that the service had no registered manager. Managers are expected to register with CQC.

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.

As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service remained good.

Please see the safe and well-led sections of the full report.

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

Cwello Lodge is a residential care home for eight people with learning disabilities and/or mental health needs. The accommodation is spread over two floors. There were bedrooms on both levels of the home and all bedrooms had a private toilet.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

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The registered manager was a prominent presence in the service. They regularly worked alongside staff to offer support and guidance and had a deep knowledge about people’s needs. Staff were caring and attentive to people and were intuitive about when their moods changed meaning they required distraction or reassurance.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice.

People were supported to be as independent as possible. Staff encouraged people to develop their everyday life skills, contribute to the running of the home and broaden their horizons through employment opportunities.

People were treated with dignity and respect. Staff were conscious to respect people’s personal space and privacy and spoke to people in a warm and compassionate manner. Staff were knowledgeable about people’s preferences and communication needs. They used this knowledge to encourage them to make choices around their food and activities.

People were able to personalise their rooms to their taste. People’s skills, creativity and achievements were championed and celebrated throughout the service. There was a calm atmosphere in the home where people felt safe and comfortable.

People’s care plans were thoroughly detailed and gave clear insight into their life histories, physical and emotional wellbeing. Care plans were developed with people’s preferences in mind and gave staff clear guidance about how to provide the appropriate level of support according to people’s mood and behaviour.

There were safe systems in place to manage people medicines. Risks relating to people’s health and wellbeing were assessed and monitored. Staff understood the support people required to manage their anxieties and were proactive in adopting agreed strategies to help people remain calm.

People had access to healthcare services. Where people were reluctant to access healthcare appointments, staff worked in partnership with people, relatives and health professionals to reduce people’s anxieties around these appointments.

The registered manager was focussed on working with other stakeholders to make improvements to the service. When people, relatives or professionals gave incidents or feedback, the registered manager looked for ways to use learning points to develop the quality of the service.

The registered manager carried out a series of audits and checks to monitor the quality and safety of the service. There were systems in place to protect people against the risk of infections spreading.

There were policies in place to appropriately handle complaints. Staff supported people to raise complaints when they had concerns. The registered manager thoroughly investigated complaints and fed back to people when their investigations were complete.

There were systems in place to protect people from abuse and harm. All staff had received training in safeguarding. The registered manager had worked with local safeguarding teams to fully investigate concerns and put measures in place to help keep people safe.

The provider ensured that suitable staff were employed to work with people by making appropriate pre-employment checks. Staff received ongoing training and support in their role to promote effective care. The registered manager regularly held staff meetings to share updates and promote best practice.

The registered manager had attended ‘end of life care’ training and was developing a care planning tool and approach which staff would adopt when supporting people to identify their needs and preferences around their final care arrangements.

Further information is in the detailed findings below.

We carried out an unannounced comprehensive inspection of this service in July 2015. After that inspection we received new information regarding concerns we had received regarding the staff’s ability to manage the risks relating to the behaviour of a person living at the home and, the impact this may have on the support and care provided for the other people living in the home. As a result we undertook a focused inspection on 08 March 2016 to look into those concerns. This report only covers our findings in relation to this topic. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Cwello Lodge on our website at www.cqc.org.uk

Although, there was a registered manager in place at the home, this person had recently been promoted to the role of service manager providing oversight across all of the provider’s services. A new manager was in post and in the process of becoming registered. A registered manager is a person who has registered with the Care Quality Commission to manage the home. 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 home is run.

People, a family member and a health professional told us they felt the home was safe.

The management team had systems and processes in place to identify and respond to safeguarding concerns. The provider and service manager were able to demonstrate the actions they had taken when the concerns, which had prompted this focused inspection, had been identified. The action taken included, a multi-agency response to facilitate a placement, prior to this inspection, of the person at a location more suited to meet their needs; a review of the lessons learnt leading to the commencement of their internal disciple action, changes to their assessment process, staff training and safeguarding policies.

The risks relating to people’s health and welfare were assessed and these were recorded along with actions identified to reduce those risks in the least restrictive way. Staff had developed caring and positive relationships with people and were able to explain the risks relating to people’s care and the action they would take to help reduce the risks from occurring. Staff were attentive to people and checked whether they required any support.

People were supported by staff who had received an induction into the home and appropriate training, professional development and supervision to enable them to meet people’s individual needs safely. There were enough staff to meet people’s needs and to enable them to engage with people in a relaxed and unhurried manner.

There were suitable systems in place to ensure the safe storage and administration of medicines. Medicines were administered by staff who had received appropriate training and assessments.

People, a family member and a health professional told us they felt the home was well-led and were positive about the management team. Staff were aware of the provider’s vision and values, how they related to their work and spoke positively about the culture and management of the home.

There were systems in place to monitor quality and safety of the home provided. Accidents and incidents were monitored, analysed and remedial actions identified to reduce the risk of reoccurrence.

People were assessed prior to receiving care. Risk assessments and care plans were developed to support people's needs and independence. Equipment as required was in place and staff told us training in their use was available prior to them using these. Staff completed training in safeguarding adults. There was an induction process in place and the staff were supported to undertake training relevant to their role.

There was an auditing system that assessed the quality of the service provision and an action plan was developed to address any shortfalls. People were consulted and their views were sought about the care they were receiving. There was a process in place to deal with any concerns and complaints. We saw the staff followed their internal complaints process and responded to people's complaints as required.

People said they had a choice of meals and were able to request different food if they wanted to. We observed people requesting different meals at lunchtime. People said they were able to get snacks when they wanted them and there was a choice of fresh fruits available. People told us they felt safe and said they would talk to staff if they had any concerns. People were confident that any concerns they raised would be taken seriously and staff would help them to resolve the issue.

We found that people expressed their views and were involved in making decisions about their care and treatment .Peoples' needs were assessed and care and treatment was planned and delivered in line with their individual care plan. People were confident that any concerns they raised would be taken seriously and staff would help them to resolve the issue. Medicines were managed appropriately.