19 August 2017
During a routine inspection
The inspection took place on 19 August and was unannounced. Laburnum Lodge provides care and accommodation for up to six people with learning disabilities.
The service had a registered manager. 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.
We met and spoke to all six people during our visit. People were not all able to fully verbalise their views and used other methods of communication, for example pictures. We therefore spent time observing people. One person when asked if they were happy at Laburnum Lodge said; “Yes I like living here” and another said; “My room is lovely and I like it here.” A relative said; “If they can’t be at home then they only want to stay here.”
Surveys returned to the service recorded; “The staff are excellent in their professionalism and kindness.” Another said; “They (the staff) all have a very professional open and friendly approach to their work, their residents and visitors” and “[…] is very safe living at Laburnum Lodge. I am very pleased with how Laburnum Lodge is run.”
Staff had completed safeguarding training and further updates were arranged. Staff had a good knowledge of what constituted abuse and how to report any concerns. Staff understood what action they would take to protect people against harm and were confident any incidents or allegations would be fully investigated. Staff confirmed they’d have no hesitation reporting any issues to the registered manager or provider.
The Provider Information Return (PIR) records; “ We hold monthly service user forums where we discuss abuse and bullying ensuring our service users know what the term “abuse" or "bullying" means and if they felt comfortable telling us if they felt they were being bullied. They also have a keep safe book in their room in an easy read version which reminds them what to do if they felt bullied and how to report it. They also have 1-1 meetings monthly with their key workers.”
People who required it had two to one or one to one staffing at certain times. Staff confirmed there were sufficient staff to meet these requirements. Staff had completed appropriate training and had the right skills and knowledge to meet people’s needs. New staff completed an Induction programme when they started work and staff competency was assessed. Staff also completed the Care Certificate (A nationally recognised training course for staff new to care) if they did not have any formal care qualifications. People were protected by safe recruitment procedures.
All significant events and incidences were document and analysed. Evaluation of incidents was used to help make improvements and keep people safe. Improvements helped to ensure positive progress was made in the delivery of care and support provided by the staff. Feedback to assess the quality of the service provided was sought from people living in the home, relatives, professionals and staff.
People’s medicines were managed safely. Medicines were stored, given to people as prescribed and disposed of safely. Staff received appropriate training and understood the importance of safe administration and management of medicines. People were supported to maintain good health through regular access to health and social care professionals, such as speech and language therapist.
People’s care records were detailed and personalised to meet individual needs. Staff understood people’s needs and responded when needed. People were not all able to be fully involved with their support plans, therefore family members or advocates supported staff to complete and review people’s support plans. People’s preferences were sought and respected.
People’s risks were documented, monitored and managed well to ensure they remained safe. People lived full and active lives and were supported to access local areas and activities. Activities reflected people’s interests and individual hobbies. People were given the choice of meals, snacks and drinks they enjoyed while maintaining a healthy diet. People had input as much as they were able to in preparing some meals and drinks.
People were engaged in different activities during our visit and enjoyed the company of the staff. People were busy; however there was a calm and relaxed atmosphere within the service.
The provider and staff understood their role with regards to ensuring people’s human and legal rights were respected. For example, the Mental Capacity Act (2005) (MCA) and the associated Deprivation of Liberty Safeguards (DoLS) were understood by the registered manager. They knew how to make sure people, who did not have the mental capacity to make decisions for themselves, had their legal rights protected and worked with others in their best interest. People’s safety and liberty were promoted.
The manager and registered provider had an ethos of honesty and transparency. This reflected the requirements of the duty of candour. The duty of candour is a legal obligation to act in an open and transparent way in relation to care and treatment.
Staff described the registered manager and provider as being very approachable and supportive. Staff talked positively about their roles.
People lived in an environment that was clean and hygienic. The environment had been refurbished to a high standard taking into account people’s needs.