Northam Lodge

Updated 5 April 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 21 and 26 February 2018 and was unannounced on the first day. The first inspection day was completed by one adult social care inspector and an expert by experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service.

We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.

We spent time observing how care and support was being delivered and talking with people and staff. We met with most of the people living at the home. We spent time in communal areas of the home to see how people interacted with each other and staff. This helped us make a judgment about the atmosphere and values of the home. Most people were not able to comment specifically about their care experiences, so we used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people with complex needs. We spoke one relative during the inspection and one visiting healthcare professional. Following the inspection we rang six relatives and received feedback from five.

We spoke with five care staff, two service managers, a team leader, the registered manager, CEO and the cook.

We reviewed three people’s care plans and daily records, medication administration records, three staff recruitment files as well as audits and records in relation to staff training and support, maintenance of the building and safety records.

Updated 5 April 2018

Northam Lodge is a residential care home for up to 25 people with learning disabilities and complex physical disabilities. It does not provide nursing care. The service is divided into three separate houses, Northam Lodge, Christopher lodge and Gibson Lodge. Christopher and Gibson are purpose built whilst Northam lodge is an adapted large house which has more than six bedrooms. Although the service had not been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance, the provider was mindful about this guidance. Any future developments would be of houses for six or less people and off site. The values of the service include choice, promotion of independence and inclusion. People with learning disabilities, autism and physical disabilities using the service were encouraged to live as ordinary a life as any citizen. As such the provider was seeking ways to promote people using facilities and the local community so that Northam lodge does not become a large site where people spent all their time.

Rating at last inspection

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.

Why the service is rated Good

Staff had the right skills, training and support to provide personalised care which met people’s complex needs. Care and support was well planned with people being at the heart of this to ensure their preferred routines and wishes were met. The introduction of active support planning will enhance this further. This will ensure people have clear goals and ambitions to develop their independent living skills, enjoy activities of their choice and remain healthy and well.

People are 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. Staff were skilled at interpreting people’s complex ways of communicating their needs, including the use of visual cues and other non-verbal ways of communicating.

People were offered a choice and range of meals to help them maintain a healthy diet. Where people required support to eat and drink, this was done in a sensitive and relaxed manner. People who were at risk of choking, had detailed plans in place to inform staff about how best to support them. Other risks were also being well managed, with clear instructions for staff to mitigate and manage these risks. For example managing a person’s epilepsy.

The home was required by the Care Quality Commission to have a registered manager. 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, senior team and new chief executive of the service were working hard to ensure their approach was open, inclusive and forward thinking.

They had introduced a suggestion box, more leadership and team meetings and incentives to enhance staff morale. This included gift tokens for commitment to service and the introduction of employee of the month. The management team were also actively consulting with people and their families about the future direction of the service. New initiatives included the introduction of eye gaze technology. This would enable some people to be able to communicate their needs in a way that had not previously been possible. This system allows people to use their eyes to indicate their answers to questions. They were also introducing electronic care records to better assist care staff in record keeping and care planning.

Further information is in the detailed findings below.