The unannounced inspection took place on the 24 and 25 September 2015. Carlile lodge provides accommodation and support for up to ten people who may have mental health needs or a learning disability. The service was last inspected in July 2013 and had met our standards of compliance.
At the time of the inspection ten people were living at the service. All people lived in their own personal flat either on the ground floor, female only floor or male only floor. All flats had an en-suite with shower or bath facilities. One person lived in a self-contained annex which was external to the main part of the home. All people had access to a large communal lounge/dining area, kitchen, shared bathrooms and laundry room. There is a small courtyard garden area that people could access when they wished.
The service is run by a registered manager, who was present on both days of the inspection visit. 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 and associated Regulations about how the service is run.
There were enough staff with the right skills and knowledge to support people. Staff felt confident that they received enough training and could ask for more if they felt they would benefit from it. They had good support and supervision to fulfil their role effectively and felt confident in approaching the registered manager, deputy manager or senior if they needed extra guidance.
Staff were trained in safeguarding and understood the processes for reporting abuse or suspected abuse. They were aware of the procedures for whistle blowing and felt confident that the management of the service would respond appropriately to any incidents of abuse.
Staff sought consent from people when providing support, promoted independence and encouraged freedom of choice. People’s wishes were respected, even if decisions may be seen to be unwise. Staff had a clear understanding of the principles of the Mental Capacity Act 2005 (MCA). Where people were being assessed for capacity they were offered advocacy and the service had taken the appropriate steps to meet the requirements of the legislation.
Staff knew the people who lived at the service well, they understood what was important to help them meet their full potential. Each person had their own individual needs assessed and these were regularly reviewed and support plans were updated. People were fully involved in their support plans as much as they wished to be. This was clearly observed within the recorded documentation.
People received their medicine in a safe way. Robust processes ensured that medicine was safely stored, administered and recorded. Regular audits of medicines were conducted and records showed that previous errors had been investigated. People received their medicine in an individual way to meet their preferred needs.
People were offered choice regarding their food. People could choose when and where to have their meals. People were encouraged to take ownership over the preparation of meals and devised rotas together to share out tasks such as the cooking and washing up. People had their dietary preferences met and were supported to manage restrictions to their food due to medical conditions.
We observed throughout our inspection numerous examples of people being shown care and understanding. People were encouraged to follow their own time table of educational and recreational activities and new activities and special days out were arranged with the involvement of the people living at the service. People were supported to have regular resident meetings which they were in charge of. They were given the opportunity to provide feedback to the service about things they wanted to improve or what they thought was going well.
The registered manager and staff took an approach to the service that encouraged independence, freedom and personal ownership. People were supported to live their own individual lives, and people were treated with dignity and as equals. There was a relaxed rapport between staff and people.
People knew how to complain and clear policies were evident. People were given information in an appropriate format that would help them understand what they should expect. Where complaints had been made the service had been responsive and sought solutions. Complaints were used as an opportunity to learn and improve outcomes for people.
People were encouraged to be fully involved in the management of the service. They were asked to be involved in the recruitment of new staff and would be part of the interviewing process.
Good leadership was clearly visible in the service. The registered manager had the right skills, experience and knowledge to lead the rest of the staff team to provide support in a way which improved people’s lives. Good processes were in place for monitoring quality and making improvements.