Queens Lodge

Updated 10 March 2020

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was carried out by one inspector over two days.

Service and service type

Queen’s Lodge is a ‘care home’. People in care homes receive accommodation and personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced on the first day of the inspection.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used this information to plan our inspection.

During the inspection

We spoke to four members of staff, including the registered manager. We spoke to two people who use the service and a relative of a person that uses the service about their experience of the care provided.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We reviewed a range of records. This included four people’s care records and multiple medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at staff rotas and training data. We spoke with two professionals who visit the home, and two relatives of people who use the service.

Updated 10 March 2020

About the service

Queen’s Lodge is a respite service and residential home providing personal care to people with autism, mental health issues and/or learning disabilities. The service can support up to 22 people and at the time of the inspection there were 20 people living there. The service consists of two houses which share a garden, Queens Lodge is the respite home, with rooms for 12 people, while Southview is a ten bedded home for people staying longer term. People have their own rooms but share communal kitchens, bathrooms, and lounge areas.

The service consisted of two large homes, bigger than most domestic style properties. This is larger than current best practice guidance. Despite this, the service was run 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

People were kept safe from harm, and from the risk of abuse, by trained staff who cared about them. People’s personal risks were assessed and continuously updated in their support plans so that staff could look after them safely. The home was safe and the registered manager ensured it was kept well maintained. The home was clean and fresh and people and staff took pride in keeping the home tidy. Staff supported people to take their medicines safely. The service learned from things that went wrong.

People had support plans in place that were started before they arrived at the service. The registered manager and other staff organised tea visits for prospective new residents and worked hard to make people feel at home. Staff followed clear support plans for people including positive risks. Staff had specific training in people’s particular needs. Staff had infection control training and food hygiene training. People and staff cooked together and made healthy food with a varied menu. People were able to make their own decisions about their hobbies and the way they spent their days. People at the respite care home left the site during the day to attend day centres and education facilities. Some people at the residential home also had hobbies or jobs outside of the service and staff supported people to go out into the community.

Staff were very caring and friendly. We saw staff and people joking and laughing together as they prepared food at the home. Staff took time to communicate with people in ways that works for them, using clear speech, hand gestures and facial expressions. People were treated with dignity and respect by staff who encouraged them to be as independent as possible. A person told us, “I like it here, at the last place no one said hello.” And another person said, “I can talk to people here.”

People’s care was personalised. The registered manager got to know people and their families before they came to stay at the home and continued to update support plans as staff grew to know people well. People were encouraged to fulfil their potential and staff took pride in seeing people get jobs and flourish in the community. Policies for the home were available for people in easy read formats. The staff focussed on how to enable people to live full lives and make friends. The registered manager acted on complaints and when necessary changed procedures to ensure incidents were not repeated.

The registered manager was a positive, proactive person who supported staff well. Staff were proud to work at the home and enjoyed spending time with people. One staff member told us, “The teamwork is very good. The managers are really good, it's flexible. The flexibility is good, and you meet different people every day, it's challenging but interesting.” And another said, “I call this place my home. I love my job.” A relative told us, “Beyond all expectation, the registered manager and the team work with us collaboratively all the time to encourage [person] to grow skills and build confidence in carrying out tasks in a safe environment where he is comfortable. They are knowledgeable and empowering, offering great advice and creative solutions.”

People were supported to have maximum 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.

The service applied the principles and values of 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

The last rating for this service was Good (published 5 August 2017).

Why we inspected

This was a planned inspection based on the previous rating.

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.