This was an unannounced inspection of Cheddle Lodge on 29 April 2016. We last inspected the home in November 2013. At that inspection, we found the service was meeting all the regulations that we reviewed.
Cheddle Lodge is registered to provide accommodation for thirteen residents who require support and care with their daily living. At the time of our inspection the home was fully occupied. The home is a single story building situated in a residential area of Cheadle in Stockport. Care staff are available twenty-four hours a day to provide support and ensure the safety and well-being of the residents. All the residents have physical needs and some have learning disabilities. Cheddle Lodge is situated in its own grounds with a garden and small car park to the rear of the building.
The home had a manager registered with the Care Quality Commission (CQC) who was present on the day of the inspection. A registered manager is a person who has registered with 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 and associated regulations about how the service is run.
We found one breach of the Health and Social Care Act (HSCA) 2008 (Regulated Activities) Regulation 2014, and we have made two additional recommendations.
The home had a supervision policy which recommended staff receive a formal supervision every two months, but we found that this policy had not been adhered to, and some staff had not had a formal supervision from their line manager for over three years. This meant that staff were not receiving the appropriate support to enable them to carry out their duties effectively.
The home did not formally seek feedback from residents or their relatives about the quality of service provision.
When we looked at the complaints procedure we saw that this was written in a format which many of the residents may not be able to understand. We made a recommendation that this is reviewed and a separate complaints leaflet be produced so residents would be able to better understand how to make a complaint.
You can see what action we have told the provider to take at the back of the full version of the report.
We saw that Cheddle Lodge was clean and well maintained, and all rooms were fitted with tracking rails to assist with safe transfers into and out of beds and seats. Access to the building was secure and staff understood how to protect the residents from different forms of abuse. The service had whistleblowing and safeguarding policies and staff was aware of their responsibilities to report any untoward behaviour they might witness.
Residents were supported by a stable staff team who had worked together for a number of years and knew the residents well. We saw that there were enough staff and people told us that the staffing ratio reflected the needs of the residents.
Care records gave a good indication of resident’s abilities and provided a good description of their likes and dislikes. Where risk had been identified, risk plans were in place to minimise the risk of harm occurring. The staff were trained to administer medicines and we saw residents were assisted to take their prescribed medicines in a way they were comfortable with by staff who understood their needs.
The visitors we spoke to told us they believed the staff were competent and knowledgeable. We saw from training records that all new starters received a thorough induction and ongoing refresher training to maintain their competence. The service also provided bespoke training to assist staff to meet the identified needs of residents who lived at Cheddle Lodge, such as epilepsy training or training in supporting residents with swallowing difficulties.
Staff communicated well with each other and we saw that information was exchanged between staff informally throughout the working day, and a detailed handover meeting took place at the start and finish of every shift. This ensured that care staff were aware of any change in need and of any tasks which might need to be completed.
The registered manager and the care staff we spoke to demonstrated a good understanding of capacity and consent. When residents were being deprived of their liberty the correct processes had been followed to ensure that this was done within the current legislation.
Attention was paid to resident’s diet and residents were supported to eat and drink in a way that met their needs. We were told that the food was good and that they had enough to eat and drink.
Care staff at Cheddle Lodge monitored residents’ general health, and where specific healthcare needs were identified the service was proactive in seeking the right level of support; liaising with health care professionals to provide an appropriate level of support.
We saw residents were comfortable and well cared for. Staff were vigilant to residents’ needs and were able to respond in a timely way to requests for assistance. All residents had difficulty with speech but staff had learnt to understand and interpret what they were saying without being presumptuous. They respected needs need for privacy, but understood the risk of social isolation and did not leave residents unattended. Staff spent time talking with residents on a one to one basis or in small groups so that residents felt like they were included. A volunteer who was visiting the service said to us: “Residents have a life here…all the staff are looking for ways to engage with them”. We saw, and residents indicated to us, that they were happy living at Cheddle Lodge.
We saw that residents were encouraged to maintain hobbies and interests, and were supported if they wanted to go on holiday.
Relatives informed us that they were listened to, and felt comfortable speaking to any of the staff if they had any concerns.
The home had a registered manager who was respected by staff, residents and their relatives, and had a visible presence throughout the home.
To help ensure that residents received safe and effective care, systems were in place to monitor the quality of the service provided and there were systems in place for receiving, handling and responding appropriately to complaints, but these were not available in a written format which residents could understand.