Archived: Conifer Lodge

Updated 13 December 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.

The inspection took place on 19 and 23 October 2018 and was unannounced on the first inspection day. One inspector undertook the inspection.

Prior to the inspection we used information the provider sent us in the Provider Information Return on 5 September 2018. 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 the improvements they plan to make. We looked at the notifications received by the Care Quality Commission (CQC) and other information we hold about the service. A notification is information about important events which the service is required to send us by law.

We contacted other health and social care organisations such as representatives from local authority commissioning team, social worker team and safeguarding team and Healthwatch (an independent organisation for people who use health and social care services). We also contacted a representative from the advocacy service used. This was to ask their views about the service provided to aid with our inspection planning.

We spoke with three people who used the service and one relative. We also spoke with a registered manager, deputy manager/ nurse, support worker, activities co-ordinator and the administrator. We looked at care documentation for three people, three staff recruitment files, staff supervision, and training records. We also looked at other records relating to the management of the service including audits and action plans, feedback questionnaires, the service user guide and statement of purpose.

Updated 13 December 2018

Conifer 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. Conifer Lodge accommodates 13 people in one adapted building. The service specialises in providing care to people who have a learning disability, people who are on the autistic spectrum and people who may also have associated mental health needs.

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.

This unannounced inspection took place on 19 and 23 October 2018. This is the first Care Quality Commission (CQC) inspection since the service reregistered on 10 November 2017. There were 12 people using the service during our inspection.

There was a registered manager in place. 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.

Staff knew how to protect people from risk and harm and how to report concerns. Information was provided in different formats, including assistive technology, to help enable people to understand how to report any incidents of harm. Staff identified any accidents and incidents that happened and quick action was taken. Learning was shared with other staff, to reduce the risk of it happening again.

People’s care records were held securely to ensure confidentiality. Risk management plans provided detailed information for staff on how to reduce and monitor the risks to people’s health and welfare. People were having their medicines as prescribed. Staff were working with external health professionals and current guidance to try to reduce the number of medicines people were on.

An advocacy service regularly supported people to make sure their needs and wishes were communicated and listened to. People were provided with pictorial guidance and other communication tools to involve them in decisions about their care and support. These various methods helped staff, alongside the person, plan the review of each person’s care.

Staff were flexible and responsive to people’s individual needs and preferences. Often finding creative and innovative ways to help people live a full a life as possible.

People lived busy social lives and took part in a wide range of interests, including volunteer work that helped promote their confidence and well-being. Engagement in activities and support networks outside of the service was an important part of people’s lives. Staff enabled people to take a key role in the local community and were always looking to build further links.

Staff promoted, maintained and developed people’s independence and living skills as far as practicable. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

People received a kind and compassionate service from staff who knew their care and support needs very well. Staff maintained people’s privacy and dignity when supporting them with their personal care. Staff respected people’s equality and diversity. Staff assisted people, where needed, with their drinking and eating to help people’s well-being.

People’s wishes, ideas, suggestions and concerns were listened to, respected, and acted upon. Staff proposed additional suggestions about how people wanted to spend their leisure time that people themselves may not have considered. This made people feel empowered and valued. The registered manager and staff worked hard to be innovative in providing person centred care based on best care practice and current guidance. People were put at the heart of the service. Compliments about how the service was run and care delivered were received from relatives of people using the service.

People received external health professional support that helped them achieve their goals and aspirations. Personal protective equipment was in place for staff to maintain infection prevention and control when supporting people.

When people became end-of-life staff would work in partnership with other healthcare professionals to ensure people’s care was dignified and comfortable.

People were involved in the recruitment of potential new staff. Required checks to make sure new staff were of a good character and were considered suitable to support people safely were carried out. Staff were trained to meet people’s care and support needs and development opportunities were in place for staff to increase their skills and knowledge. Supervisions and competency checks were in place to monitor and develop staff.

People, their relatives, representatives, and staff were involved and enabled to make suggestions to improve how the service was run. Audit and governance systems were in place to monitor the service, to drive forward any sustained improvements required. The registered manager and their staff team linked up, communicated and worked with other organisations to ensure people’s well-being. This was when they were using different services and, or moving between services.

Further information is in the detailed findings below.