We carried out a review of the data available to us about The Lodge on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about The Lodge, you can give feedback on this service.
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 any 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.
At this inspection we found the service remained Good.
Why the service is rated Good.
The service continued to meet all the fundamental standards and had a registered manager as required. The registered manager was present and assisted us with the inspection.
People were protected from the risks of abuse. Risks were identified and managed effectively to protect people from avoidable harm. Recruitment processes were in place to make sure, as far as possible, that people were protected from staff being employed who were not suitable. Medicines were handled correctly and safely.
People received effective care and support from staff who knew them well and were trained and supervised. People received care and support which was personalised to meet their individual needs. They knew how to complain and staff knew the process to follow if they had concerns.
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 supported this practice. People's right to make their own decisions were protected.
People benefitted from a service which had an open and inclusive culture. Staff were happy working at the service and people benefitted from having staff who felt well managed and supported.
People were treated with care and kindness and their right to confidentiality was protected. People were treated with respect and their dignity was upheld. People's diversity needs were identified and incorporated into their care plans where applicable.
Further information is in the detailed findings in the full report.
The Lodge is a care home without nursing that provides a service to up to five people with learning disabilities and/or autistic spectrum disorder. At the time of our inspection there were four people living at the service. Those four people have lived together at the service for over 17 years.
The service had a registered manager as required. 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 registered manager was present and assisted us with our inspection.
People were protected from the risks of abuse and from risks associated with their health and care provision. People were protected by robust recruitment processes and could be confident that staff were checked for suitability before being allowed to work with them. There were sufficient numbers of staff on each shift to make sure people's needs were met.
People benefitted from staff who were well supervised and received training to ensure they could carry out their work safely and effectively
People's rights to make their own decisions were protected. Managers and staff had a good understanding of the Mental Capacity Act 2005. They were aware of their responsibilities related to the Act and ensured that any decisions made on behalf of people were made within the law and in their best interests.
People received appropriate health care support. Their health and well-being were assessed and measures put in place to ensure people's needs were met in an individualised way. Medicines were stored and administered safely.
Staff showed skill when working with people and it was obvious they knew them well and people were treated with care and kindness. Staff were aware of people's abilities and encouraged them to be as independent as possible.
People's wellbeing was protected and all interactions observed between staff and people living at the service were caring, friendly and respectful. People's rights to confidentiality were upheld and staff treated them with respect and dignity.
People received support that was individualised to their personal preferences and needs. Health and social care professionals told us they thought the service provided personalised care that was responsive to people's needs.
People and their relatives knew how to raise concerns and felt they were listened to and taken seriously if they did. Staff recognised early signs of concern or distress from people living at the service and took prompt and appropriate action to reassure them when needed.
People benefitted from living at a service that had an open and friendly culture. People and their relatives felt staff were happy working at the service. Health and social care professionals felt the service demonstrated good management and leadership and worked well in partnership with them.
We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask:
- Is the service safe?
- Is the service effective?
- Is the service caring?
- Is the service responsive?
- Is the service well led?
This is a summary of what we found-
Is the service safe?
We found people experienced care and support that was planned and delivered in a way that was intended to ensure their safety and welfare. People were protected from unsafe or unsuitable equipment because the provider had systems in place that ensured all equipment was properly used, maintained, tested, serviced and replaced.
CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While no applications had needed to be submitted, proper policies and procedures were in place. Relevant staff had been trained to understand when an application should be made, and how to submit one.
Is the service effective?
Before people received any care they were asked for their consent and the staff acted in accordance with their wishes. People we spoke with confirmed staff took time to explain what was happening and made sure they agreed with any changes. One person commented "if I want help I just ring my bell and they come."
Staff we spoke with demonstrated a good understanding of people's rights to make their own decisions and their own responsibilities under the requirements of the Mental Capacity Act 2005.
People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard. People we spoke with told us staff knew what they were doing when they supported them every day. Observations we made on the day of our inspection showed staff were experienced and clearly had the skills they needed when working with the people living at the home.
Is the service caring?
People's care plans were clearly written and person centred. They were in formats that were accessible to the person whose care plan it was. People had been involved in drawing up their care plans and had chosen pictures they wanted to use and also used different pictures to identify their choices and preferences.
People we spoke with told us they felt their needs were being met and their care was delivered in the way they preferred. One person told us staff were: "nice, we are all friends."
Is the service responsive?
People completed a range of activities in and outside the service regularly. On the day of our inspection one person went out to work and everyone else went out for lunch, two people going together by choice and the third person had lunch with a member of staff after having their hair cut.
There was evidence that learning from incidents / investigations took place and appropriate changes were implemented. The provider had a complaints procedure in place that was available in a picture and easy read format. People we spoke with knew how to complain and confirmed they felt staff would act on any concern they raised.
Is the service well-led?
Staff we spoke with were clear about their roles and responsibilities. All said they received the advice and support they needed from their managers and colleagues.
The provider had developed and introduced a new and effective system to regularly assess and monitor the quality of service that people receive against the requirements of the essential standards. Audits we saw showed that any shortfalls identified had been addressed promptly. We saw the manager's assessment of the outcomes we assessed during this inspection matched our own findings of compliance.
People's views and experiences were taken into account in the way the service was provided and delivered in relation to their care. People we spoke with felt staff always respected their privacy and dignity and helped them to remain as independent as possible. One person told us staff "are good and do things the way I like. They helped me choose my holiday and we had fun."
People were protected from the risks of inadequate nutrition and dehydration. The manager was aware of the NHS England heat wave guidelines and had implemented government guidelines to protect people from heat wave related risks.
We found there were enough qualified, skilled and experienced staff to meet people's needs at all times. People told us staff were available when they needed them and had the skills they needed when providing their care and support. One person told us "Staff are nice, they help me do things." Another person said "Staff are good, they know what they are doing."
People were protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were maintained.
People's needs were assessed and care was planned on an individual basis. We saw people gave consent for their care and they were able to make choices in all aspects of their lives.
The premises were suitable for the people living at the home and there was a maintenance programme in place to address minor repairs and refurbishment. We noted the programme did not have dates for the completion of the work. The provider was, however, able to provide us with dates for the work to be completed.
Staff received training to support them in their job. Staff told us they felt supported by the manager. We looked at training records and found there was a system in place to record and monitor training.
The people living at the home told us they felt safe living at the home; that staff had the skills they needed when providing their care and treatment and were available when they needed them. They felt their views were actively sought by the home and that their opinions were listened to and taken into account by the management and staff.