Cwello Lodge is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.Cwello Lodge is a residential care home for eight people with learning disabilities and/or mental health needs. The accommodation is spread over two floors. There were bedrooms on both levels of the home and all bedrooms had a private toilet.
The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.
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 serious 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.
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The registered manager was a prominent presence in the service. They regularly worked alongside staff to offer support and guidance and had a deep knowledge about people’s needs. Staff were caring and attentive to people and were intuitive about when their moods changed meaning they required distraction or reassurance.
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 support this practice.
People were supported to be as independent as possible. Staff encouraged people to develop their everyday life skills, contribute to the running of the home and broaden their horizons through employment opportunities.
People were treated with dignity and respect. Staff were conscious to respect people’s personal space and privacy and spoke to people in a warm and compassionate manner. Staff were knowledgeable about people’s preferences and communication needs. They used this knowledge to encourage them to make choices around their food and activities.
People were able to personalise their rooms to their taste. People’s skills, creativity and achievements were championed and celebrated throughout the service. There was a calm atmosphere in the home where people felt safe and comfortable.
People’s care plans were thoroughly detailed and gave clear insight into their life histories, physical and emotional wellbeing. Care plans were developed with people’s preferences in mind and gave staff clear guidance about how to provide the appropriate level of support according to people’s mood and behaviour.
There were safe systems in place to manage people medicines. Risks relating to people’s health and wellbeing were assessed and monitored. Staff understood the support people required to manage their anxieties and were proactive in adopting agreed strategies to help people remain calm.
People had access to healthcare services. Where people were reluctant to access healthcare appointments, staff worked in partnership with people, relatives and health professionals to reduce people’s anxieties around these appointments.
The registered manager was focussed on working with other stakeholders to make improvements to the service. When people, relatives or professionals gave incidents or feedback, the registered manager looked for ways to use learning points to develop the quality of the service.
The registered manager carried out a series of audits and checks to monitor the quality and safety of the service. There were systems in place to protect people against the risk of infections spreading.
There were policies in place to appropriately handle complaints. Staff supported people to raise complaints when they had concerns. The registered manager thoroughly investigated complaints and fed back to people when their investigations were complete.
There were systems in place to protect people from abuse and harm. All staff had received training in safeguarding. The registered manager had worked with local safeguarding teams to fully investigate concerns and put measures in place to help keep people safe.
The provider ensured that suitable staff were employed to work with people by making appropriate pre-employment checks. Staff received ongoing training and support in their role to promote effective care. The registered manager regularly held staff meetings to share updates and promote best practice.
The registered manager had attended ‘end of life care’ training and was developing a care planning tool and approach which staff would adopt when supporting people to identify their needs and preferences around their final care arrangements.
Further information is in the detailed findings below.