Archived: St Ann's Lodge

Updated 22 March 2016

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 6 February 2016 and was unannounced. It was carried out by a single inspector.

Before our inspection we reviewed information we held regarding the home. We also contacted the local authority learning disability team to find out their views of the service.

During the inspection we observed how staff interacted with the people who used the service. We spoke with three people who used St Ann's Lodge or the adjacent care home, St Ann's Lodge 2, which people using the service could also access, one relative, the two directors, one of whom was the registered manager and two care workers who worked across both care homes. We looked at three people’s care records, three staff recruitment files, medicines records and records relating to the management of the service.

After the inspection we received feedback from an occupational therapist, two speech and language therapists and an optician.

Updated 22 March 2016

This inspection took place on 6 February 2016 and was unannounced. At the previous inspection on 28 October 2013 we found the provider to be meeting all the regulations we inspected.

The service provides personal care and support for up to six people within a small care home setting. It specialises in providing care to people who have a learning disability. There were six people using the service at the time of our inspection. There is an adjoining small care home next door, St Ann's Lodge 2 run by the same provider. The registered managers of both services are both directors and work closely to run the two services together and people and staff can move between both services through an interconnecting door. We inspected both services on the same day. We have produced separate inspection reports as the two homes are registered separately and the similarities between the two are reflected in the two inspection reports.

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.

Although the service operated some good medicines management practices the service was unable to account for all medicines which should have been in stock. This was because the service did not keep accurate records of medicines people took out and returned to the service when on social leave. This meant we could not always verify all people received their medicines as prescribed as we were unable to complete some medicines stock checks. The registered manager told us they would improve recording processes to rectify this issue immediately.

Staff understood how to recognise abuse and how to report any concerns they had relating to this. People had appropriate risk assessments in place with suitable risk management plans to manage the risks to them. The premises and equipment were maintained safely.

There were enough staff to meet people’s needs and the manager followed a robust recruitment process so that only suitable staff worked with people at the service.

The registered manager understood their requirements under the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS). DoLS provides a process to make sure that people are only deprived of their liberty in a safe and correct way, when it is in their best interests and there is no other way to look after them. The registered manager had assessed which people required DoLS and made the necessary applications as part of keeping them safe. However, although staff had received training in the MCA and DoLS they did not always understand their responsibilities in relation to these acts. When we raised this with the provider they told us they would put in place extra support for staff to help them achieve a better understanding.

People received a choice of food and drink and people received the right support in relation to their dietary needs. Staff also supported people to monitor and maintain their health and people had access to the healthcare professionals they needed.

Staff received a range of training, much of which was specific to the needs of the people with a learning disability they worked with, to help them to carry out their roles and understand people’s needs. The registered manager supported staff well through a programme of individual supervision and annual appraisal.

Staff understood the people they were working with including their needs and backgrounds and this information was recorded in care plans to guide staff in the best way to support people. Staff supported people to be as independent as they wanted to be and to take part in activities they were interested in. People were involved in making decisions about and reviewing their own care. Care plans contained accurate information about people's needs and the registered manager kept these under review. People, their relatives and staff were involved in the running of the care home. Healthcare professionals fedback to us that the service was particularly caring and well-led.

There was a suitable complaints system and relatives had confidence the manager would resolve any issues they rose with them. The manager and staff had a good understanding of their roles and responsibilities.