We carried out an inspection on 15th April 2014. We talked with the manager, the operational manager, the staff and we reviewed information given to us by the provider. We met and spent time with five of the eight people living at Hunters Lodge. They were able to express their views about the service and we saw they all appeared to be happy and relaxed.Below is a summary of what we found. The summary is based on our observations during the inspection, observations of people using the service, the staff supporting them and from looking at records.
If you want to see the evidence supporting our summary please read our full report.
Is the service safe?
From our observations and from the information we saw set out in care plans, policies, procedures and audits the provider's safety monitoring systems were robust. The staff showed that they had a clear understanding of their role in providing care and safeguarding the people they supported. The staff demonstrated that they knew the people well and had read and understood the instructions set out in individual care plans.
We saw evidence that people were supported to make decisions for themselves and develop their independence. The care plans set out detailed instructions for staff as to how each person could give consent. When people lacked the capacity to make important decisions, meetings were held to make decisions for them that were in their best interests.
We saw that everyone was encouraged to eat a healthy balance diet. The staff received regular training in nutrition and food hygiene.
From our observations and from the information we saw set out in policies, procedures and audits the provider's hygiene monitoring systems were robust.
The staff we spoke with understood about the risk management plans that had been written for all the people and how these met with their particular needs. Staff demonstrated that they understood how to show people respect and maintain people's dignity at all times.
The manager told us that there were no deprivations of liberty safeguards in place for the people living at Hunters Lodge. They said that in the light of new guidance they were in the process of making applications for several people who required supervision to leave the grounds on their own.
The staff rotas showed that the manager had taken people's care needs into account when making decisions about the number of staff required, the skills mix and experience staff would need. The rotas showed where necessary additional staff had been used with bank workers and overtime to ensure safe staffing levels were maintained. The night time staffing levels and on call system showed that out of main hours the staffing provision was safe.
There were systems in place to make sure that management and staff learned from events such as accidents and incidents, complaints, concerns and investigations. This meant that people were benefiting from a service that was taking on board lessons learnt.
Is the service effective?
People's health and care needs had been assessed and care plans were in place. There was evidence of people and their representatives being involved in assessments of their needs and planning their care.
Specialist health care needs were always assessed and included in care plans and health action plans. Specialist health and social care professionals regularly gave input to the service. All care, activity and risk assessment plans were being reviewed regularly. Every person had a representative and advocacy services were available if required.
We saw that the people living at Hunters Lodge were being supported to develop their learning and independence. We were told about the activities they enjoyed and what they wanted to do in the future. The staff we spoke with told us how they worked with each person to support them to undertake the things they wanted to do.
Is the service caring?
We observed during our visit and saw in people's care plans that people were supported and encouraged to live full and active lives. People took part in a wide range of leisure and social activities. We were told by the manager that future activities were being organised to include families and promote friendships. We saw that everyone was supported to access the activities they enjoyed.
The staff we spoke with demonstrated to us that they were committed to providing the best levels of care and to facilitate activities for the people who used the service. They demonstrated to they were aware of potential risks, people's rights and their responsibilities.
Is the service responsive?
We found that care plans were person centred and contained lots of information about people's choice and preferences. We saw that everyone's care plans contained detailed information about each person's support preferences.
We found that people's health and care needs were being regularly assessed. There was regular input from external social care and health professionals when needed.
We were told that the service satisfaction questionnaire was being developed to allow families and representatives to comment on the service provided at Hunters Lodge. The survey was to be sent out in the next couple of months.
We saw when we reviewed the complaints log that there had been no complaints or concerns made in the last twelve months. We were told by the operational manager that any complaints or concerns which were received by the provider organisation were always taken very seriously and action taken to resolve the issue.
We were told about and we saw that staff received regular training to meet the support needs of the people who used the service. Training had been provided about the care and support of people with epilepsy and autism.
We were told by the registered manager how people were supported when a hospital admission was required. This support was provided by the provision of additional staffing from Hunters Lodge and support from the hospital liaison nurses. When a person went into hospital they took with them a hospital passport with information about the person and their care needs.
Is the service well-led?
The provider has had stable staff team for some years. There have been changes in the management of the home and a new manager has recently taken up the post. There is a clear management structure within the service and the provider organisation. From the discussions with the manager, they were knowledgeable about the service, the people and staff. They met with their managers and peers regularly to maintain up to date knowledge. The operational manager told us that other senior staff from the provider organisation regularly visited the premises to speak to the staff and the people who lived there.
The provider had a quality assurance system in place. Records seen by us showed that any shortfalls identified had been addressed. There were systems in place to provide feedback to staff about changes and developments at team meetings, the communications book.
The staff we spoke with had a good understanding of the provider's policies and procedures. Information was readily available on the provider's computer system which all the staff were able to access. Information was available around the building on 'easy read' posters about safeguarding and speaking out. All the staff we spoke with said that if they witnessed poor practice they would report their concerns.
Staff we spoke with told us that they had worked with the people who lived at the home for some time and really enjoyed their work. They told us that there was a good team spirit and everyone stepped up to take on responsibly while they were without a manager. They said that they now felt they were supported by the manager and involved in the development of the service.