This inspection took place on 11 September 2018 and was unannounced. At our last inspection visit in June 2017 the service was rated as required improvement, but there were no breaches of the legal requirements. Charnwood 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.
Charnwood Lodge accommodates a maximum of 17 people in one adapted building. The home was registered with the CQC prior to the CQC’s publication of ‘Registering the Right Support’ guidance for homes for people with learning disabilities and autism. This recommends that homes should cater for a maximum of six people. The provider had tried to reduce the need for people to use large communal areas by providing cooking facilities and eating and sitting areas in each person’s ‘flat’ or bedroom so they did not have to engage with a larger group of people if they do not wish to.
At the time of our visit, 16 people lived at the service.
The service had been through a challenging period. Issues related to the previous management team had resulted in staff leaving the service. Temporary management had been put in place whilst the provider sought to stabilise the staff group and make improvements.
A new manager had recently started at the service and intended to apply for registration with the CQC. 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.
A person who lived at the home, had behaviours which had become increasingly challenging to staff and to people who lived at Charnwood Lodge. This had left people and staff not feeling or being safe, as staff did not have the skills to support the person. This person had recently moved to a different service and people and staff were beginning to feel safe again.
There were enough staff on duty to keep people safe. There had been a high number of agency staff working at the service, but this was now decreasing and people had started to experience more continuity of care. Staff recruitment procedures reduced the risks of the provider employing people unsuitable to work in care.
People’s opportunities to undertake activities outside the home had been curtailed because of staffing issues; and there had been limited activities for people within the home environment. This was beginning to improve with more continuity of staff; and the appointment of a person to support activities within the home which reflected people’s interests and wants.
Medicines were managed safely and people were supported to receive healthcare when necessary. The risks related to people’s health and well-being was known by the staff group. Records informing of risks were in the process of being updated.
The premises were mostly clean but there were areas of the home which were dirty, and the laundry area did not fully comply with good practice guidance for infection control. The provider acted to put this right on the day of our visit.
Staff had not previously supported people with end of life care, but recently had received in-house training to support them in delivering this care.
The provider and new management team were improving the quality of life for people who lived at the home, and the confidence of staff in supporting people. They were addressing safety issues and improving the management of the service.
Staff understood the policies and procedures for safeguarding people from harm. They had received training to support them in their role, and were feeling more supported in their work by the new management team.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible
People enjoyed the meals provided. People who could cook independently were supported by staff to do so.
People were supported by a staff group who were caring and kind; and who understood the importance of maintaining people’s independence where possible. People’s dignity and privacy was respected by staff.
This was the second time the service has been rated as 'requires improvement'.