Archived: Park Lodge

About the service

Park Lodge is a residential care home providing personal care to 7 people at the time of the inspection. The service can support up to 8 people.

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

Right Support:

The provider was not working within the principles of the Mental Capacity Act. They could not demonstrate that people’s consent to care and support was lawfully obtained or that proper legal authorisations were in place to deprive people of their liberty where appropriate. This meant people were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service at the time of this inspection did not support this practice.

The service gave people care and support in a clean, well equipped, furnished and mostly well maintained environment. The provider was making improvements to the living environment at the time of this inspection to make this safer and more comfortable for people. People were able to personalise their rooms. Staff focused on people’s strengths and promoted what they could do, so people had a fulfilling and meaningful everyday life. Staff enabled people to access specialist health and social care support in the community. Staff supported people to make day to decisions about their care and support. They communicated with people in ways that met their needs. Staff supported people with their medicines and to play an active role in maintaining their own health and wellbeing.

Right Care:

Not all people’s care plans were up to date which meant they did not fully reflect their current needs and preferences in relation to their care and support. There was a risk people could receive unsafe or inappropriate care and support. The provider was aware of this concern and was reviewing and updating care plans at the time of this inspection.

Staff promoted equality and diversity in their support for people. People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. They understood and responded to their individual needs. Staff understood how to protect people from poor care and abuse. The service worked with other agencies to do so. The service had enough staff to meet people’s needs and keep them safe. People could communicate with staff and understand information given to them because staff supported them consistently and understood their individual communication needs. People could take part in activities and pursue interests that were tailored to them. The service gave people opportunities to try new activities that enhanced and enriched their lives.

Right Culture:

People’s quality of life was not always enhanced by the provider’s oversight of the service and governance processes. These had not always been effective in taking action to keep people safe, protect people’s rights and provide good quality care and support.

Notwithstanding the issues we found, people received good care and support because staff could meet their needs and wishes. People were supported by staff who understood best practice in relation to the wide range of strengths, impairments or sensitivities people with a learning disability and/or autistic people may have. Staff knew and understood people well and were responsive, supporting their aspirations to live a quality life of their choosing. Staff placed people’s wishes, needs and rights at the heart of everything they did. People and those important to them, were involved in planning their care. The provider was improving the way people, and those important to them, worked with staff to develop the service. The provider was committed to continuous improvement at the service which helped to enhance the quality of people’s lives.

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 23 October 2019).

Why we inspected

The inspection was prompted in part due to concerns received about the change in management and leadership of the service. A decision was made for us to inspect and examine those risks.

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.

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

Enforcement

We have identified breaches in relation to the need for consent, safeguarding service users from abuse and improper treatment and good governance at this inspection.

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.

Park Lodge is a care home providing personal care and accommodation to people living with mild to moderate learning disabilities. The service can support up to eight people. The care home accommodated seven people at the time of this inspection in one adapted building.

The service has been developed and designed 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 of 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 told us they were safe and they were happy in this their home. The registered manager, the assistant manager and staff understood their responsibilities to raise concerns and report incidents or allegations of abuse.

Risks to people's personal safety were assessed and plans were in place to minimise those risks.

The premises were cleaned and well maintained. Safe infection control procedures were in place that staff implemented effectively.

People enjoyed the food and could choose what they ate. People’s cultural preferences were catered for.

Staff recruitment and staffing levels supported people to stay safe while working towards their goals and going about their lives.

The administration of medicines to people was safe, and people received their medicines as prescribed. The storage of medicines was safe.

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.

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.

People received effective care and support from staff who knew them well and who were well trained and appropriately supported to do their work.

People had their healthcare needs identified and were able to access healthcare professionals such as their GP, optician and dentists. We observed kind and friendly interactions between staff and people. People told us staff were caring and respected their privacy and dignity.

People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

There were systems in place to ensure concerns and complaints were responded to in an appropriate way.

The service encouraged feedback from people, families, and professionals, which they used to make improvements to the service and protect people against the risks of receiving unsafe and inappropriate care and treatment.

Staff felt the managers were supportive and open with them and communicated what was happening at the service and with the people living there.

The provider had quality assurance systems in place to monitor the running of the service and the quality of the service being delivered. With the help of the staff team, they took actions to address any issues.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

At the last inspection the service was rated good (Report was published 28 March 2017).

Why we inspected

This was a planned inspection in line with our inspection schedule 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 reinspection programme. If we receive any concerning information we may inspect sooner.

Park Lodge provides care and accommodation for up to eight people with mild learning disabilities and autism. On the day of the inspection seven people lived at the home and there was one vacancy.

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.

There were processes in place to review the quality of service delivery and where required action was taken to address areas of concern. We discussed with the registered manager the need to improve recording of staff induction and supervision, as this was lacking, and they agreed to put in place measures to do so.

People and their relatives continued to feel well cared for and safe, living at Park Lodge. Staff knew how to help protect people if they suspected they were at risk of abuse or harm. Risks to people’s health, safety and wellbeing had been assessed and staff knew how to minimise risks and manage identified hazards in order to help keep people safe from harm or injury.

Staffing levels remained sufficient to meet people’s needs. This was endorsed by people we spoke with and their relatives. We found that safe and effective recruitment practices were followed.

People’s health care needs were met and their medicines were administered appropriately. Staff supported people to attend healthcare appointments and liaised with their GP and other healthcare professionals as required to meet people’s needs.

There were regular staff meetings and meetings with people who use the service and their relatives. Both meetings were reported by people to be useful and informative.

Staff had the relevant skills they required to meet people's needs. They had access to effective training and supervision support that equipped them with the skills they required to support people. They had a good understanding of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. They supported people in accordance with the relevant legislation and guidance.

People had access to a variety of nutritionally balanced meals. Staff provided the support people required to have timely access to health care services when they needed them.

Staff had good relationships with people who lived at the home and were attentive to their needs. Staff respected people’s privacy and dignity at all times and interacted with people in a caring, respectful and professional manner.

The home was clean and staff had received training in infection prevention and control. It was well furnished, homely and comfortable. People and their relatives said it was a happy home.

Individualised care plans were in place detailing how people wished to be supported. These had been produced jointly with relatives, staff, healthcare professionals and where possible people using the service.

Relatives told us they were made to feel welcome and were able to visit their family members when they wished to.

People were able to choose how they spent their time and what activities they participated with.

There was a complaints procedure in place and relatives of people felt confident they could raise any concerns either with the staff or with the registered manager if they needed to. The complaints procedure was available in different formats so that it was accessible to everyone.

Staff told us there was an open and honest culture within the team. The registered manager welcomed feedback about service delivery from people, their relatives and staff.

Staff were aware of their roles and responsibilities and liaised with their management team about any concerns identified.

On the day of our inspection we met with three of the people using the service and observed how staff supported and cared for individuals. We saw that the registered manager and staff respected people's privacy and dignity, and took account of what people expressed and said in relation to the way their care and support was provided.

We spoke with three people who lived in the home. One person told us that they had just returned from attending a keep fit class and were now making lunch with a member of staff. Another person told us that they had a range of activities they enjoyed doing every day including going to a local swimming pool. We saw that people were supported to undertake a range of activities in the community and had varied and individual routines.

We spoke with two representatives of people who use the service. One person told us 'I feel that the staff and manager always act in people's best interest and any issues or concerns are always very well addressed'. Another person told us 'My son is very happy and content living at Park Lodge. The staff and management are excellent'.

People had consented to their care and treatment. Where people did not have the capacity to consent, decisions had been made in their best interest and with people's representatives fully involved. People's needs were assessed and they had individual person centred care plans to make sure that their needs were met.

The home had an appropriate and safe system in place for the recruitment of staff. All staff had received training and supervision. Staff had completed training on the safeguarding of vulnerable adults and information about how to report concerns was displayed in the home. The provider had systems and checks in place to audit and monitor the quality of care and support that was provided.