The Ark Care Lodge Limited

Updated 25 February 2020

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 Care Act 2014.

Inspection team

The inspection was conducted by one inspector.

Service and service type

The Ark Care Lodge is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. 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.

Notice of inspection

This inspection was unannounced.

What we did before inspection

We reviewed information we had received about the service since the last inspection. 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. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with one person who used the service. We spent time in shared areas with a number of people who were unable to speak with us. We spoke with four members of staff including the registered manager, deputy manager and care workers.

We reviewed a range of records. This included three people’s care records and multiple medication records. We looked at four staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We spoke with four relatives about their experience of the care provided. We spoke with one professional who regularly visits the service.

Updated 25 February 2020

About the service

The Ark Care Lodge is a residential care home which was providing personal care to 15 adults with learning disabilities at the time of inspection. The service can support up to 18 people in two adapted buildings.

The service did not always provide care and support in line with the principles and values that underpin Registering the Right Support and other best practice guidance. These values ensure that people who use services can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service did not always receive planned and co-ordinated person-centred support that was appropriate and inclusive for them.

The service is laid out over two domestic properties with a shared garden but no internal access between them. The buildings each accommodated nine people which is larger than current best practice guidelines. However the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area. There were no identifying signs, intercom, cameras or anything else outside to indicate it was a care home.

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

Records relating to staff recruitment, discipline and training were disorganised. They did not clearly show safe recruitment practices had been followed. It was not clear what training staff had completed. Staff were happy working for the service and felt supported by the registered manager and colleagues.

There were limited systems in place to monitor and improve the quality of the service. The registered manager had not identified the issues we found during inspection.

Checks to ensure the environment was safe were not always completed. Equipment and processes in place in relation to fire safety were not up to date.

Care records contained information which covered people's individualised care and support needs. However, risk assessments and care plans didn't always contain up to date, clear information about people's current risks.

People and their relatives were involved in the planning and delivery of their care, however, the registered manager did not seek opportunities to obtain feedback to monitor and improve the service.

The outcomes for people did not fully reflect the principles and values of Registering the Right Support for the following reasons; lack of choice and control and limited independence. People did not always have choice in the type of food they ate. Menus were developed by staff with limited input from people who lived at the service. Activities were limited and people were not supported to identify and pursue goals, hobbies or dreams.

People's care and support needs were met by staff who knew them well and enjoyed working with them. Staff at the service worked with health and social care professionals to ensure people's needs were met.

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.

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 this service was Good (published 22 June 2017).

Why we inspected

This was a planned inspection based on the previous rating

Enforcement

We have identified breaches in relation to safe care, staffing and governance.

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 for 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.