Archived: Queens Lodge

Updated 30 June 2015

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on the 11 May 2015 and was unannounced. The inspection team consisted of an inspector 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. This expert by experience worked with people with a learning disability and had skills in communication.

Prior to the inspection we reviewed the information we held about the service including notifications of incidents that the provider had sent to us since the last inspection. A notification is information about important events which the service is required to send us by law. We also looked at safeguarding concerns reported to us. This is where one or more person’s health, wellbeing or human rights may not have been properly protected and they may have suffered harm, abuse or neglect.

Not everyone at the service was able to communicate with us verbally. Therefore we spent time observing the care provided by staff to help us understand the experiences of people unable to tell us directly.

We spoke with two people, two relatives, and three care professionals. We spoke with three care staff, and the registered manager. We looked at three staff records; peoples care records and records relating to how the safety and quality of the service was being monitored.

Updated 30 June 2015

The inspection took place on the 11 May 2015 and was unannounced. Queens Lodge provides care and accommodation for up to 6 persons who have a Learning Disability. There were a total of five people living at the service at the time of our inspection.

The service has 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.

Systems were in place which guided staff on how to manage risks and safeguard people who used the service. There were clear procedures in place to ensure peoples safety and there were checks undertaken on the environment as well as assessments on how to minimise risks. There were some issues about storage which presented some risks which had not been fully considered.

Staff could recognise signs of harm or potential abuse but we found some barriers to reporting which meant that people may not be as open as they could be.

Staff turnover was high but efforts were made to ensure consistency by using regular agency staff. Staffing levels were regularly reviewed in consultation with other professionals and adjusted to meet the needs of the people using the service. Recruitment processes ensured that the staff who were appointed were safe to work in this setting.

Medication systems were safe but the guidance directing staff on the use of “as required” medication was not clear. This means that medicines may not be given consistently and when needed.

Staff received induction and training which gave them the knowledge they needed to carry out their role. Staff were regularly supervised and their competency monitored to ensure that they could meet people’s needs effectively.

The service was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS). Appropriate mental capacity assessments and best interest decisions had been undertaken by relevant professionals. This ensured that the decision was taken in accordance with the Mental Capacity Act (MCA) 2005, DoLS and associated Codes of Practice. The Act, Safeguards and Codes of Practice are in place to protect the rights of adults by ensuring that if there is a need for restrictions on their freedom and liberty these are assessed and decided by appropriately trained professionals.

Staff were proactive in their contacts with healthcare agencies and acted on their guidance, in people’s best interests.

People were involved in the developing of the menu and in meal preparation. The quality of the meals we observed were good however the monitoring of food and fluid for individuals, identified as at risk would benefit from greater oversight.

Interactions between people using the service and staff were warm and friendly. Staff knew people they were caring for and what their care preferences were. Care plans were detailed and informative and reflected people’s needs. Where people’s needs changed, advice was sought and the plan evaluated. People were involved in planning their care and this endured that people were provided with care in a way that they wanted to be supported.

People were enabled to access person centred activities and were encouraged to maintain hobbies and interests. Staff supported people to maintain relationships which were important to them.

The registered manager demonstrated clear leadership and was described as approachable and helpful.

The provider had systems in place to assess and monitor the quality of the service, which included sampling of documentation and visits. Action plans were in place to address areas identified by the audit.