We carried out a review of the data available to us about Apasen Lodge on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Apasen Lodge, you can give feedback on this service.
Apasen Lodge is a residential care home providing personal care to five people with a learning disability or on the autistic spectrum at the time of the inspection. The service can support up to ten people.
The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
People’s experience of using this service and what we found
Procedures were in place to help protect people from the risk of abuse and staff understood their responsibility with regard to safeguarding people. Risk assessments were in place which provided guidance about how to support people safely. There were enough staff working at the service to meet people’s needs and robust staff recruitment practices were in place. The service sought to learn lessons when accidents and incidents occurred. Steps had been taken to protect people from the risk of infection. Medicines were managed safely.
People’s needs were assessed before they commenced using the service to ensure those needs could be met. Staff received training and supervision to support them in carrying out their role effectively. The design and layout of the building was suitable for the people using it. People had a choice of what they ate and drank. The service worked with other agencies and professionals to support people’s health care needs. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
People told us staff were kind and caring and treated them respectfully. Staff had a good understanding of how to promote people’s privacy, dignity and independence. The service sought to meet people’s needs in relation to equality and diversity, although we have recommended that care plans cover needs around sexuality.
Care plans were in place which set out how to meet people’s needs. People and their relatives were involved in developing these plans. People had access to a range of social activities and we saw people enjoying these on the day of our inspection. Complaints procedures were in place.
Quality assurance and monitoring systems were in place to help drive improvements at the service. The service had links with other agencies to help develop best practice. Systems were in place for seeking the views of people who used the service and their relatives.
The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement.
As part of thematic review, we carried out a survey with the registered manager at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 12 December 2018) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Apasen 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. The service is registered to provide support with personal care and accommodation to a maximum of ten adults with learning disabilities or on the autistic spectrum. Seven people were using the service at the time of our inspection, one of whom was there for respite care. The other six were permanent residents of the service.
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.
The service had 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.
During this inspection we found three breaches of regulations. This was because the not all matters of safety were managed appropriately, effective systems were not operated to protect people from the risk of financial abuse and quality monitoring systems were not effective. You can see what action we have asked the provider to take at the end of the full version of this report.
There were enough staff working at the service to meet people’s needs and robust staff recruitment procedures were in place. Appropriate safeguarding procedures were in place and safeguarding allegations were managed appropriately. Risk assessments provided information about how to support people in a safe manner. Procedures were in place to reduce the risk of the spread of infection. Lessons were learnt when accidents and incidents occurred.
People’s needs were assessed before they started using the service to determine if those needs could be met. Staff received on-going training to support them in their role and undertook induction training on commencing work at the service. People were able to make choices for themselves and the service operated within the principles of the Mental Capacity Act 2005. People told us they enjoyed the food and that they had enough to eat. People were supported to access relevant health care professionals.
People told us they were treated with respect and that staff were caring. Staff had a good understanding of how to promote people’s privacy, independence and dignity. Confidentiality was respected and records were held securely.
Care plans were in place which set out how to meet people’s individual needs. Care plans were subject to regular review. People were supported to engage in various activities. The service had a complaints procedure in place and people knew how to make a complaint.
Staff and people spoke positively about the senior staff at the service. Quality assurance and monitoring systems were in place which included seeking the views of people who used the service. The service worked with other agencies to develop good practice.
The service had two registered managers. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.
People and relatives told us they felt safe in the home and they were comfortable using the service. Records showed that people had a risk assessment which identified possible risks to them and how staff could manage them. Staff were aware of how to deal with incidents and were knowledgeable about adult safeguarding. The registered manager and records confirmed that there were systems for auditing and testing various aspects of the service including medicines, fire alarms and the electrical equipment. These ensured that the facilities and equipment were checked and any errors or shortfalls were addressed so people were not put at risk
People and relatives told us that staff were nice and knew how to support them. Staff received supervision and had training opportunities in areas relevant to their roles. For example, they had received training in Mental Capacity Act 2005 (MCA), medicine administration and moving and handling. Records showed that new staff underwent recruitment processes which involved completing an application form and providing satisfactory evidence such as a police check, two reference letters and evidence to confirm they had the right to work in the country. This ensured that the staff employed at the home were suitable to deliver care and support people needed.
Staff supported people to take part in activities of their choice. People were encouraged to make decisions about their care. Records and observations showed people were asked for their consent about their care. We noted staff supported people to practice their faith. People told us the food provided at the home was good and they were happy with the service.
The home had a complaints procedure. People and relatives told us staff listened to them and they knew how to make a complaint if they were not happy about the service. The registered manager had recorded and investigated complaints. People, relatives and staff had been asked through annual surveys for their views of different aspects of the service. This ensured that the registered manager received feedback from others to improve the service as required.
During the inspection we spoke with one person who used the service and observed staff communication with two other people using the service. We spoke with staff and the manager during our visit. We checked the documents such as care plans, the home's policies and procedures and viewed the premises.
Below is a summary of what we found. The summary describes what people using the service and the staff told us, what we observed and what we saw in the records we looked at.
If you want to see evidence that supports our summary please read the full report.
Is the service safe?
People were cared for in an environment that was safe, clean and hygienic. Staff had experience and training to respond to people's needs.
Is the service effective?
People told us that their needs were being met. One person who used the service told us 'I like [the home]' and 'the staff are good'.
Is the service caring?
We saw that staff were polite and friendly when interacting with people. We noted that the staffing level was increased when and as needed to meet people's needs.
Is the service responsive?
People's preferences and needs were recorded. Staff worked well with people's relatives and other professionals involved in their care. Even though people looked well with their needs being met, we noted that one person, who had recently moved in, did not have a completed care plan in place.
Is the service well-led?
Staff had a good understanding of the ethos of the home and quality assurance processes.
Systems were in place to monitor the safety of the service provided to people.
The service worked well with other agencies and services to make sure people received their care and support in a joined up way. People's health, safety and welfare were protected as they received the advice and treatment that they needed from a range of health and social care professionals.
Overall we found that the service involved people in how they were cared for and that assessed need was being met through planned and coordinated care. We found that the service had suitable arrangements in place to safeguard people from abuse. The service was sufficiently staffed and appropriately monitored the quality of service provision.