13 March 2018
During a routine inspection
Helene 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. Helene Lodge accommodates up to six adults with a learning disability in one house. There were four people living there when we inspected.
The care service has been developed and designed in line with the values that underpin 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.
The service had a registered manager. 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 a positive culture that was person-centred, open, inclusive and empowering. The people living at the service were happy, looked well cared for and were very comfortable around the staff looking after them. Caring staff knew people well and had good relationships with them. The staff treated people as individuals, with kindness and compassion. People’s privacy was respected and their dignity upheld.
People, and where appropriate their relatives, were involved in the planning and delivery of their care and support. Care and support plans were comprehensive and kept up to date. People were encouraged to do what they could for themselves.
The service met the Accessible Information Standard. Communication needs were flagged up in support plans. The Accessible Information Standard sets out requirements for care providers to identify, record, flag, share and meet the information and communication needs of people with a disability, impairment or sensory loss. Staff had a good understanding of how people communicated. Communications were clear and understood by both parties.
People were supported to follow their interests and take part in social activities, education and work opportunities as they chose. They were encouraged to use community facilities such as shops and hairdressers.
Staff helped people keep in touch with relatives through visits, telephone calls, video calls and instant messaging.
Medicines were managed and administered safely, including epilepsy rescue medicines.
People were supported, but not compelled, to live healthily. They each had an up-to-date health action plan, which described the support they needed to manage their health, and were supported accordingly. People’s care records included a summary of their care and support needs to pass on to hospital staff in the event people were admitted. The registered manager and staff also worked closely with day centres to ensure people who attended them received consistent, person-centred care.
People were supported to maintain a balanced diet, whilst maintaining their preferences. They chose what they had to eat and were encouraged and supported to get involved in preparing meals, snacks and drinks.
People’s rights were protected because the registered manager and staff worked in line with the Mental Capacity Act 2005, including the Deprivation of Liberty Safeguards. However, consent, mental capacity assessments and best interests decisions were not always clearly documented. We have made a recommendation about the recording of consent and best interests decisions.
People were protected against the risk of neglect and abuse. The registered manager and staff had a good understanding of their responsibility for reporting possible abuse or neglect, including raising whistleblowing concerns. Robust procedures were in place to ensure the registered manager and staff could account for monies held on people’s behalf.
Risks were assessed and managed, protecting people in the least restrictive way possible. People involved in accidents or incidents were supported to stay safe and action was taken to prevent further injury or harm. The provider monitored accidents and incidents for trends that might indicate changes were required.
The premises had a homely feel and were maintained in a safe and clean condition. Procedures were in place to protect people from infection.
People were supported by sufficient staff with the right skills and knowledge to meet their individual needs, including community activities. The service had not had to use agency staff, as any gaps in the rota, for example due to sickness, were covered by the registered manager and other staff. This provided continuity for people.
The registered manager and staff were clear about their roles and responsibilities. Staff were enthusiastic and positive about their work. They had the necessary skills, knowledge and understanding to work effectively. They were supported through training, regular supervision and informal discussions with the registered manager. The registered manager frequently worked alongside staff to ensure people had the care and support they needed and staff felt supported.
Safe recruitment practices were followed before new staff were employed, to help ensure they were of good character and suitable for their role.
Easy-to-read information about how to make a complaint was displayed on a noticeboard in the hall. Relatives confirmed they had been made aware of how to complain, should they feel this were necessary.
Quality assurance systems were in place to monitor how the service was run. There were regular audits by the registered manager and staff. The provider’s regional director visited the service each month to support the registered manager and monitor how they were performing.