This comprehensive inspection took place on 8 and 10 November 2017. The first day was unannounced. This was CQC’s first inspection of the service under the current provider’s ownership.Amberwood Lodge is a care home for adults with autism and associated learning disabilities. Nursing care is not provided. 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.
Amberwood Lodge accommodates up to nine people in individual bedrooms within a single building. Nine people were living there at the time of our inspection.
The care service was registered prior to the publication of Registering the Right Support. All but one person had lived there for a number of years. Some people had come from Poole and surrounding areas, whereas others had moved from elsewhere in the south of England and the Channel Islands. They were all supported to maintain regular contact with their families. The service reflects most of 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.
There was a registered manager, who had been in post for several years. 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.
The service had an informal, friendly, homely feel. People were supported with kindness and compassion by staff who knew them well and understood the care they needed.
People’s needs and choices were assessed and support was delivered in line with current guidance. Their independence was promoted.
Activities at home and in the community were based on people’s individual interests and needs and were encouraged on a daily basis. People were encouraged and supported to develop and maintain relationships with people who mattered to them.
Staff made sure people were included in everything and were not barred by conditions such as epilepsy. Where necessary, activities were adjusted so everyone had an opportunity to take part if they wished.
People’s rights were protected because the staff acted in accordance with the Mental Capacity Act 2005. The registered manager had identified a number of people who they believed were being deprived of their liberty, as the front door and gates to the service were kept locked and people were unable to leave unsupervised for their own safety. The registered manager had made the necessary Deprivation of Liberty Safeguards applications. There was a system for tracking expiry dates and any conditions on DoLS authorisations.
Choice was encouraged and people’s preferences were respected. People were involved in decisions about their care and about how the service was run. Staff understood people’s individual communication skills, abilities and preferences and supported them to express their views. Accessible information was provided to support people in making choices.
An independent advocate visited the service each month.
People were protected against the risk of abuse and avoidable harm. The service followed safe recruitment practices that helped ensure only staff who were of good character and suitable to work in care were employed. The premises and equipment were well maintained and kept clean. Staff knew how to blow the whistle and expressed confidence that the management team would act if they raised any concerns.
Risks to people’s personal safety had been assessed and plans were in place to manage these in the least restrictive way possible. Where people could behave in a way that challenged, they had an individualised positive behaviour support plan.
Accidents, incidents and near misses were recorded and monitored to look for developing trends.
Peoples’ medicines were managed and administered safely.
People were supported by sufficient staff with the right skills and knowledge to meet their individual needs. Staff had the support they needed to perform their roles, including training and supervision.
Varied menus with healthy options were designed to accommodate people’s individual preferences and cultural and dietary needs.
People’s health care needs were monitored and any changes in their health or well-being prompted a referral to their GP or other health care professionals.
The provider’s own team of health professionals visited the service regularly. We have made a recommendation regarding liaising and working with community learning disability services.
Quality assurance systems were in place to monitor the quality of the service. There was regular oversight from the provider’s management team, locally, regionally and nationally. There was a programme of audits, and any shortfalls identified were addressed through an action plan.