We inspected West Lodge on 26 August 2015. This was an unannounced inspection which meant that the staff and provider did not know that we would be visiting.
We last inspected the home on 9 February 2014 and found it met the five outcomes we reviewed.
West Lodge is a care home providing accommodation and personal care for six people with learning disabilities. It is a purpose build house situated close to local shops and amenities.
The home had a registered manager in place and they have run the home for over a year. 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.
At the time of the inspection six people lived at the home and we met all of the people who used the service. Two of the people were able to discuss their views about the home at length. They told us they found that the service was well-run and the support from staff had enabled them to develop many of the skills they needed to lead more independent lifestyles. People told us that they really liked the staff and the home met all of their needs.
We saw there were systems and processes in place to protect people from the risk of harm. We found that staff understood and appropriately used safeguarding procedures.
We observed that staff had developed very positive relationships with the people who used the service. Staff were kind and respectful. Throughout our visit there were lots of conversations between the people who used the service and staff. We saw that people were very comfortable in each other and staff presence and there was lots of laughter.
We saw that they were aware of how to respect people’s privacy and dignity. People told us that they made their own choices and decisions, which were respected by staff but they found staff provided really helpful advice. People discussed how they were fully involved in the development of their care records.
People told us they were offered plenty to eat and assisted to select healthy food and drinks which helped to ensure that their nutritional needs were met. We saw that each individual’s preference was catered for and people were supported to manage their weight and nutritional needs.
We saw that people were supported to maintain good health and accessed a range of healthcare professionals and services. We found that staff worked well with people’s healthcare professionals such as consultants and community nurses.
We saw that detailed assessments were completed, which identified people’s health and support needs as well as any risks to people who used the service and others. These assessments were used to create plans to reduce the risks identified as well as support plans. The people we spoke with discussed their support plans and how they had worked with staff to create them. We were in agreement with the registered manager that it would be beneficial if these were produced in accessible formats so used pictorial images as well as the words.
We found that staff had worked well with people and enabled them to develop skills they needed to live more independently. One of the people told us that because of staff support they had now developed to the point whereby they would be living more independently.
People were supported to maintain good health and had access to healthcare professionals and services. People were supported and encouraged to have regular health checks and were accompanied by staff to hospital appointments. We saw that people had hospital passports. The aim of a hospital passport is to assist people with a learning disability to provide hospital staff with important information they need to know about them and their health when they are admitted to hospital.
Staff had received a range of training, which covered mandatory courses such as fire safety, infection control and first aid as well as condition specific training such as working with people who have learning disabilities. Staff had also received training around the application of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. The staff we spoke with fully understood the requirements of this Act and were ensuring that where appropriate this legislation was used.
Staff shared with us a range of information about how they as a team worked very closely with people to make sure the service enabled each person to reach their potential. We found that people who used the service had been involved in producing the annual development plan and they could readily discuss whether staff and the home had met the goals that had been set.
People and the staff we spoke with told us that there were enough staff on duty to meet people’s needs. We saw that a senior staff member and two staff were on duty during the day and one person was on duty overnight. We found that the registered manager oversaw another home. The provider had therefore employed an additional senior support worker who worked at the home when the registered manager was working in the other home.
Effective recruitment and selection procedures were in place and we saw that appropriate checks had been undertaken before staff began work. The checks included obtaining references from previous employers to show staff employed were safe to work with vulnerable people.
We reviewed the systems for the management of medicines and found that people received their medicines safely.
We saw that the provider had a system in place for dealing with people’s concerns and complaints. People we spoke with told us that they knew how to complain and felt confident that staff would respond and take action to support them. People we spoke with did not raise any complaints or concerns about the service.
We found that the building was very clean and well-maintained. Appropriate checks of the building and maintenance systems were undertaken to ensure health and safety. We found that all relevant infection control procedures were followed by the staff at the home.
The registered provider had developed a range of systems to monitor and improve the quality of the service provided. We saw that the registered manager had implemented these and used them to critically review the service
We found that one of the people who used the service had become a service user representative for the home and regularly went to meetings at the provider’s headquarters. The person who used the service and undertook the role told us they were the voice of the people in the home and felt their views were listened to and acted upon. They told me how they had, with staff support, argued that the home should remain in the cluster of services with the other home the registered manager oversaw. We found that the provider had listened to this argument and agreed to not changing the current cluster arrangements.