Conifer Lodge

Updated 12 October 2022

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 undertaken by one inspector.

Service and service type

Conifer Lodge is a 'care home' with nursing care. People in care homes receive accommodation, personal and nursing care as a single package under one contractual agreement dependent on their registration with us. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced for both site visit dates.

Inspection activity started 26 July 2022 and ended on 28 July 2022. We visited the service location on 26 July, and in the evening on 28 July 2022.

What we did before the inspection

We reviewed information we had received about the service since it was registered under the current provider. We sought feedback from the local safeguarding authorities, a social worker and people's clinical commissioning groups (CCGs). 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 spoke with six people, five of their relatives and one person’s advocate. We also spoke with 10 staff including the registered manager, a visiting area manager, deputy manager, nursing and senior care staff, support workers, the cook and maintenance staff. We received feedback from two health professionals.

We reviewed a range of records. This included two people's care records and medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the

management of the service were also reviewed, including training records, incident records, complaints, compliments, quality assurance processes and various policies and procedures.

What we did after the inspection

We sought assurance about people's medicines administration records and the policies around this for people when they visited friends or families at their homes.

Updated 12 October 2022

About the service

Conifer Lodge is a residential care home providing accommodation and personal care for up to 13 people. At the time of the inspection there were 13 people using the service. Each person had their own en-suite room and other communal lounge and bathroom areas. The service has a large garden with many facilities for bar-be-cues, outdoor games and places to have privacy.

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.

Although best practice is for no more than six people using this type of service, people using the service had developed long-term friendships and lived a life being treated equally well. There were plans in place to support people to move where this had been deemed in people's best interests.

Based on our review of is the service safe, effective, caring, responsive and well-led questions, the service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.

Right support

The staff supported people to have the maximum possible choice, control to be independent and they had control over their own lives. The service gave people care and support in a safe environment that was clean and suitably equipped to meet people's physical and emotional needs. Staff complied with measures designed to reduce the risk of COVID-19 spreading within the service.

Staff totally focused on people's strengths and promoted what they could do, enabling the opportunity for people to lead exceptionally fulfilling and meaningful lives. One person told us it was the best day of their life having been to a professional football match.

Staff supported people to pursue their interests inside and outside the home. People had aspirations and goals which staff helped people to exceed. The service worked completely with people to plan for when they experienced periods of distress; to minimise any restrictions and to ensure people had as much freedom, choice and control over their lives as possible. One person told us they would remember the day for ever when they met a famous sports star.

Staff received highly effective training in the use of restraint and were confident in their ability to deploy this training. At the time of our inspection no person required restraint. Any restraint would be in an emergency situation as a last resort and for the shortest time possible. One person told us not having medicines anymore during such periods had, “Changed their life for the better for ever.” Staff supported people to make decisions following best practice in decision-making. Staff communicated with people in ways that met their needs.

Staff enabled people to access the community and pursue their interests in their local area. People were administered their medicines in a way that respected their independence and achieved the best possible positive health outcomes.

Right Care

Staff totally focused on and promoted people's equality and diversity completely, supporting and responding exceptionally well to their individual needs. This totally changed people's lives for the better. One person was proud to show us a photograph of them attending a remembrance day parade dressed in a way they chose that represented their passion.

People helped create and review their care plans when they chose to, and as such were an exact reflection of the support they needed and what people could do independently. Staff had training on how to recognise and report abuse, and had the skills protect people from poor care and abuse, or the risk of this happening. The service worked with other agencies to do so. The service had enough appropriately skilled staff to meet people's needs and keep them safe. All those we spoke with felt people were safe and had enough support to do this.

Staff had a very thorough understanding of people's individual ways of communicating and this enabled people to be listened to. People received care that supported their needs and aspirations, was focused on their quality of life, and followed best practice.

Right Culture

People were supported by staff who totally understood best practice in relation people's strengths, impairments or sensitivities people with a learning disability and/or autistic people may have. Staff knew people exceptionally well and responded to their needs and wishes.

Staff's diligence and persistence enabled people to exceed their aspirations. This helped people live a meaningful life full of opportunities they might otherwise not have had. One person was now seeing a relative they had not seen for 20 years.

Staff put people's wishes, needs and rights at the heart of everything they did. Staff ensured risks of a closed culture were minimised so that people received support based on transparency, respect and inclusivity.

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

Rating at last inspection

The last rating for the service under the previous provider was Outstanding, published on 26 September 2017. Although there was a new owner of the home, the registered manager and most of the staff team had been with the home for many years. The current provider registered the service with us on 5 March 2021 and this is their first inspection.

Why we inspected

This was a planned inspection since ownership of the home changed.

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.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Conifer Lodge on our website at www.cqc.org.uk

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.