St Ann's Lodge 1

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

The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.

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. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.

Right Support

People’s medicines were not always managed safely. People were kept safe from avoidable harm because staff knew them well and understood how to protect them from abuse. The service worked well with other agencies to do so. The service had enough staff, including for one-to-one support for people to take part in activities and visits how and when they wanted. People received supported from staff to make their own decisions about medicines wherever possible.

Right Care

Staff supported people to express their views using their preferred method of communication. People had the opportunity to try new experiences, develop new skills and gain independence.

Right Culture

The registered manager worked hard to instil a culture of care in which staff truly valued and promoted people's individuality, protected their rights and enabled them to develop and flourish. Staff felt respected, supported and valued by senior staff which supported a positive and improvement-driven culture.

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.

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 22 November 2017).

Why we inspected

We undertook this inspection as part of a random selection of services rated Good and Outstanding.

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.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for St Ann’s Lodge 1 on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to medicines management at this inspection. We have also made a recommendation in relation to records management, specifically incident and accident recording and auditing systems.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

The service provides personal care and support for up to six people within a small care home setting. It specialises in providing care to people who have a learning disability. There were six people using the service at the time of our inspection.

This was our first inspection of the home since changes were made to its registration with CQC in October 2016.

The home had 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 2008 and associated Regulations about how the service is run.

People told us they liked living at St Ann’s Lodge and said staff were kind and caring towards them. There was a relaxed friendly and homely atmosphere when we visited.

Relatives of people said the service provided was exceptional and went ‘above and beyond’ in responding to each person's needs and aspirations.

People received care and support from a long standing group of managers and staff who knew them very well and understood their needs and preferences. Each person had accessible individualised support plans to make sure they received the support they required. The service was responsive to people’s changing needs and linked well with external health professionals to help ensure positive outcomes for people.

There were clear procedures in place to recognise and respond to abuse and staff had been trained in how to follow these. Staffing numbers were sufficient to help make sure people were kept safe.

People were supported to have their health needs met. We saw that people’s prescribed medicines were being stored securely and managed safely.

The registered manager supported staff to deliver appropriate care and support. Staff attended regular training which gave them the knowledge and skills to support people effectively. Staff had received training in the Mental Capacity Act (MCA) 2005 and the Deprivation of Liberty Safeguards (DoLS).

There was a system in place for dealing with people’s concerns and complaints. People and their relatives told us they knew how to complain and felt confident that the registered manager would respond and take appropriate action.

There were suitable systems in place to monitor the safety and quality of the service and drive improvement where required.