Roxburgh Lodge

Updated 17 August 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

This inspection was carried out by an inspector, a regulatory officer and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Roxburgh Lodge is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Roxburgh Lodge is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post. A manager was in post at the time of inspection and had submitted an application to register.

Notice of inspection

This inspection was unannounced.

Inspection activity started on 28 June 2023 and ended on 17 July 2023. We visited the location’s service on 28 and 29 June 2023.

What we did before the inspection

We reviewed information we had received about the service. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We completed observations of the care provided and staff interaction with people who lived at the service. We spoke with 2 people and 4 relatives about their experience of care. We spoke with 5 staff including the manager, deputy manager and 2 team leaders.

We reviewed a range of records. This included 4 people's care records and multiple medication records. A variety of records relating to the governance of the service, including policies and procedures were reviewed.

We looked at 4 staff files in relation to recruitment. We reviewed supervision data and quality assurance records. We reviewed feedback from professionals involved with the service. We continued to seek clarification from the provider to validate evidence found following the inspection.

Updated 17 August 2023

About the service

Roxburgh Lodge is a new build, residential care home accommodating up to 8 adults with a learning difficulty who may also have a physical disability. At the time of our inspection there were 8 people using the service.

People’s experience of using this service and what we found

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Culture:

The culture of the service supported people and staff in an inclusive way; enabling people to live their day-to-day lives as they chose to. The provider had quality assurance systems to regularly assess and monitor the service, however, these had not always identified the concerns we found.

Feedback was requested from people, relatives or health care professionals. Staff ensured the quality and safety of the service had been assessed to ensure people were safe. Safe recruitment practices were followed. Staff knew and understood people well.

Right Support:

Staff enabled people to identify plan and achieve daily and longer term goals. Staff focussed on maintaining and developing people’s independence and promoted what they could do. People were encouraged to learn and develop new skills. Staff enabled people to access health, well being and social activities that met their individual 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.

Right Care:

Staff had completed the necessary training to meet peoples’ needs and knew how to protect them from abuse and avoidable harm. Medicines were managed safely. Staff knew how to protect people's privacy and dignity. There were good examples how people’s human rights were being protected through person centred care plans. People could communicate with staff as staff understood their individual communication. People were empowered to take part in activities of their choice. People were supported to keep in touch with relatives and other people important to them.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

This service was registered with us on 23 July 2020 and this is the first inspection.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Recommendations

We have recommend the provider consider current guidance and review of their auditing systems and processes on lessons learnt.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.