- Care home
Park Lodge
All Inspections
22 November 2022
During a routine inspection
About the service
Park Lodge is a residential care home providing personal care to 7 people at the time of the inspection. The service can support up to 8 people.
People’s experience of using this service and what we found
Right Support:
The provider was not working within the principles of the Mental Capacity Act. They could not demonstrate that people’s consent to care and support was lawfully obtained or that proper legal authorisations were in place to deprive people of their liberty where appropriate. This meant people were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service at the time of this inspection did not support this practice.
The service gave people care and support in a clean, well equipped, furnished and mostly well maintained environment. The provider was making improvements to the living environment at the time of this inspection to make this safer and more comfortable for people. People were able to personalise their rooms. Staff focused on people’s strengths and promoted what they could do, so people had a fulfilling and meaningful everyday life. Staff enabled people to access specialist health and social care support in the community. Staff supported people to make day to decisions about their care and support. They communicated with people in ways that met their needs. Staff supported people with their medicines and to play an active role in maintaining their own health and wellbeing.
Right Care:
Not all people’s care plans were up to date which meant they did not fully reflect their current needs and preferences in relation to their care and support. There was a risk people could receive unsafe or inappropriate care and support. The provider was aware of this concern and was reviewing and updating care plans at the time of this inspection.
Staff promoted equality and diversity in their support for people. People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. They understood and responded to their individual needs. Staff understood how to protect people from poor care and abuse. The service worked with other agencies to do so. The service had enough staff to meet people’s needs and keep them safe. People could communicate with staff and understand information given to them because staff supported them consistently and understood their individual communication needs. People could take part in activities and pursue interests that were tailored to them. The service gave people opportunities to try new activities that enhanced and enriched their lives.
Right Culture:
People’s quality of life was not always enhanced by the provider’s oversight of the service and governance processes. These had not always been effective in taking action to keep people safe, protect people’s rights and provide good quality care and support.
Notwithstanding the issues we found, people received good care and support because staff could meet their needs and wishes. People were supported by staff who understood best practice in relation to the wide range of strengths, impairments or sensitivities people with a learning disability and/or autistic people may have. Staff knew and understood people well and were responsive, supporting their aspirations to live a quality life of their choosing. Staff placed people’s wishes, needs and rights at the heart of everything they did. People and those important to them, were involved in planning their care. The provider was improving the way people, and those important to them, worked with staff to develop the service. The provider was committed to continuous improvement at the service which helped to enhance the quality of people’s lives.
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 23 October 2019).
Why we inspected
The inspection was prompted in part due to concerns received about the change in management and leadership of the service. A decision was made for us to inspect and examine those risks.
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.
We have found evidence that the provider needs to make improvements. Please see the safe, effective, responsive and well-led sections of this full report.
Enforcement
We have identified breaches in relation to the need for consent, safeguarding service users from abuse and improper treatment and good governance at this inspection.
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 from 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 continue to monitor information we receive about the service, which will help inform when we next inspect.
17 September 2019
During a routine inspection
Park Lodge is a care home providing personal care and accommodation to people living with mild to moderate learning disabilities. The service can support up to eight people. The care home accommodated seven people at the time of this inspection in one adapted building.
The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need of people with learning disabilities and / or autism to live meaningful lives that include control, choice and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
People's experience of using this service and what we found
People told us they were safe and they were happy in this their home. The registered manager, the assistant manager and staff understood their responsibilities to raise concerns and report incidents or allegations of abuse.
Risks to people's personal safety were assessed and plans were in place to minimise those risks.
The premises were cleaned and well maintained. Safe infection control procedures were in place that staff implemented effectively.
People enjoyed the food and could choose what they ate. People’s cultural preferences were catered for.
Staff recruitment and staffing levels supported people to stay safe while working towards their goals and going about their lives.
The administration of medicines to people was safe, and people received their medicines as prescribed. The storage of medicines was safe.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.
The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.
People received effective care and support from staff who knew them well and who were well trained and appropriately supported to do their work.
People had their healthcare needs identified and were able to access healthcare professionals such as their GP, optician and dentists. We observed kind and friendly interactions between staff and people. People told us staff were caring and respected their privacy and dignity.
People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.
There were systems in place to ensure concerns and complaints were responded to in an appropriate way.
The service encouraged feedback from people, families, and professionals, which they used to make improvements to the service and protect people against the risks of receiving unsafe and inappropriate care and treatment.
Staff felt the managers were supportive and open with them and communicated what was happening at the service and with the people living there.
The provider had quality assurance systems in place to monitor the running of the service and the quality of the service being delivered. With the help of the staff team, they took actions to address any issues.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
At the last inspection the service was rated good (Report was published 28 March 2017).
Why we inspected
This was a planned inspection in line with our inspection schedule based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our reinspection programme. If we receive any concerning information we may inspect sooner.
2 February 2017
During a routine inspection
Park Lodge provides care and accommodation for up to eight people with mild learning disabilities and autism. On the day of the inspection seven people lived at the home and there was one vacancy.
The service had 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.
There were processes in place to review the quality of service delivery and where required action was taken to address areas of concern. We discussed with the registered manager the need to improve recording of staff induction and supervision, as this was lacking, and they agreed to put in place measures to do so.
People and their relatives continued to feel well cared for and safe, living at Park Lodge. Staff knew how to help protect people if they suspected they were at risk of abuse or harm. Risks to people’s health, safety and wellbeing had been assessed and staff knew how to minimise risks and manage identified hazards in order to help keep people safe from harm or injury.
Staffing levels remained sufficient to meet people’s needs. This was endorsed by people we spoke with and their relatives. We found that safe and effective recruitment practices were followed.
People’s health care needs were met and their medicines were administered appropriately. Staff supported people to attend healthcare appointments and liaised with their GP and other healthcare professionals as required to meet people’s needs.
There were regular staff meetings and meetings with people who use the service and their relatives. Both meetings were reported by people to be useful and informative.
Staff had the relevant skills they required to meet people's needs. They had access to effective training and supervision support that equipped them with the skills they required to support people. They had a good understanding of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. They supported people in accordance with the relevant legislation and guidance.
People had access to a variety of nutritionally balanced meals. Staff provided the support people required to have timely access to health care services when they needed them.
Staff had good relationships with people who lived at the home and were attentive to their needs. Staff respected people’s privacy and dignity at all times and interacted with people in a caring, respectful and professional manner.
The home was clean and staff had received training in infection prevention and control. It was well furnished, homely and comfortable. People and their relatives said it was a happy home.
Individualised care plans were in place detailing how people wished to be supported. These had been produced jointly with relatives, staff, healthcare professionals and where possible people using the service.
Relatives told us they were made to feel welcome and were able to visit their family members when they wished to.
People were able to choose how they spent their time and what activities they participated with.
There was a complaints procedure in place and relatives of people felt confident they could raise any concerns either with the staff or with the registered manager if they needed to. The complaints procedure was available in different formats so that it was accessible to everyone.
Staff told us there was an open and honest culture within the team. The registered manager welcomed feedback about service delivery from people, their relatives and staff.
Staff were aware of their roles and responsibilities and liaised with their management team about any concerns identified.
11 December 2014
During a routine inspection
This was an unannounced inspection and took place on 11 December 2014. At our previous visit in June 2013, we judged that the service was meeting all the regulations that we looked at.
Park Lodge is a care home providing personal care and support for up to eight adults with a learning disability. At the time of our visit there were seven people using the service with moderate learning disabilities.
The service has a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (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 2008 and the associated Regulations about how a service is run.
People told us they felt safe at the home. There were arrangements in place to help safeguard people from the risk of abuse. The provider had appropriate policies and procedures in place to inform people who used the service, their relatives and staff about how to report suspected abuse.
People had risk assessments and risk management plans. Staff knew how to use the information to keep people safe.
Staff knew about the requirements of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS), which care homes are required to meet. There were procedures in place that could be used if they were needed. We found that staff sought people’s consent before providing care.
There were enough staff to help keep people safe and the home had safe recruitment procedures to help protect people from the risks of being cared for by staff assessed to be unfit or unsuitable.
Staff received training in areas of their work identified as essential by the provider and in some specialised subjects, all of which helped staff provide support to people more effectively and efficiently. The provider supported and made guidance available to staff through one to one meetings with their line manager and team meetings and they were supported to access further relevant qualifications. This has helped staff to care for people more effectively.
Appropriate arrangements were in place in relation to obtaining, storing, administering and the recording of medicines which helped to ensure they were given to people safely.
People were involved in planning their care and their views or that of their relatives where relevant were sought when decisions needed to be made about how they were cared for. The service involved them in discussions about any changes that needed to be made to keep them safe and promote their wellbeing.
Staff respected people’s privacy and treated them with respect and dignity.
People indicated that they felt that the service responded to their needs and individual preferences. Staff supported people according to their personalised care plans, including supporting them to access community-based activities.
The service encouraged people to raise any concerns they had and responded to them in a timely manner. People and their relatives were aware of the complaints policy.
People gave positive feedback about the management of the service. There was an open and positive family feel at this home. The registered manager and the staff were approachable and fully engaged with providing good quality care for people who lived there. The provider had systems in place to continually monitor the quality of the service and people were asked for their opinions via surveys and action plans were developed where required to address areas for improvements.
28 June 2013
During a routine inspection
On the day of our inspection we met with three of the people using the service and observed how staff supported and cared for individuals. We saw that the registered manager and staff respected people's privacy and dignity, and took account of what people expressed and said in relation to the way their care and support was provided.
We spoke with three people who lived in the home. One person told us that they had just returned from attending a keep fit class and were now making lunch with a member of staff. Another person told us that they had a range of activities they enjoyed doing every day including going to a local swimming pool. We saw that people were supported to undertake a range of activities in the community and had varied and individual routines.
We spoke with two representatives of people who use the service. One person told us 'I feel that the staff and manager always act in people's best interest and any issues or concerns are always very well addressed'. Another person told us 'My son is very happy and content living at Park Lodge. The staff and management are excellent'.
People had consented to their care and treatment. Where people did not have the capacity to consent, decisions had been made in their best interest and with people's representatives fully involved. People's needs were assessed and they had individual person centred care plans to make sure that their needs were met.
The home had an appropriate and safe system in place for the recruitment of staff. All staff had received training and supervision. Staff had completed training on the safeguarding of vulnerable adults and information about how to report concerns was displayed in the home. The provider had systems and checks in place to audit and monitor the quality of care and support that was provided.
25 July 2012
During an inspection looking at part of the service
We last inspected this care home on 4th April 2012 and found the former proprietors were not compliant with all the essential standards of quality and safety.
Improvements were needed because of a lack of appropriate information available for people using the service, no protocols for staff to access regarding the administration of 'as required' medication, and insufficient numbers of staff not trained in basic food hygiene and first aid.
We carried out this review, which did not include a site visit or talking to people who live at this care home, to look specifically at all the actions the new provider told us they had taken to achieve compliance with the essential standards of quality and safety.
It was clear from all the recorded evidence the new providers supplied us that they had taken appropriate steps to ensure staff who worked at the care home were now properly trained and had access to protocols regarding the safe use of 'as required' medication, and people who use the service were given appropriate information to help them make informed decisions about their lives.
This meant the health and welfare needs of the people who use the service are being met.
4 April 2012
During an inspection in response to concerns
Our records indicate that a Mr and Mrs Goodoree have submitted an application for the Care Quality Commission (CQC) to consider registering them both as the new owners of Park Lodge and for Mr Goodoree to be the registered manager of the care home. The current co-owner of Park Lodge, Mr Hoozeer, was able to confirm that he had recently sold Park Lodge as a going concern to Mr and Mrs Goodoree. We understand Mr and Mrs Goodoree plan to take over control of the care home by the end of April 2012.
During our visit we found evidence that showed us the provider promotes independent living by encouraging people who use the service to do as much for themselves as they were wiling and capable of doing so safely. We also saw the provider is good a supporting people to engage in meaningful and interesting activities in their local community.
The provider ensures peoples needs are always assessed, and care and support is planned and delivered safely in line with their person centred care plan.
People who use the service are also kept safe and the provider has taken reasonable steps to minimise the risk of people being abused, harmed and/or neglect. Furthermore, it was clearly evident that lessons have been learnt after 2 safeguarding incidents that were both substantiated following investigations into concerns about staffing levels at Park Lodge. We can confirm that appropriate steps have now been taken by the provider to improve staffing levels at the care home.
We found the providers medication handling arrangements in relation to obtaining, storing, recording, administering and disposing of medicines were also robust.
However, while we found no evidence of any risk to people who use the service, we have suggested that the provider may find it useful to seek advice from their local pharmacist about developing person centred protocols for the safe use of 'as required' behavioural modification drugs. This will minimise the risk for medication errors occurring because support staff know exactly who is responsible for authorising the use of 'as required' medication, and when and how to administer it.
The provider has effective staff recruitment and selection processes in place.
The provider has also improved the training staff receive since we last visited the care home, although further action is required to ensure everyone who is authorised to handle food and administer basic first aid at Park lodge is suitably qualified to perform these tasks safely. We judged that this is having a minor impact on people using the service, but action must still be taken in order for the provider to fully comply with this essential standard.
We found evidence to indicate that the provider continues to have good quality monitoring systems in place. For example, every year the provider seeks the views of the relatives of the people who use the service. Nonetheless, we have made a number of minor improvements for the provider to consider implementing regarding its quality monitoring arrangements. This includes ensuring the people who use the service have far greater opportunities to have their say about how their home is run and to have access to more useful information about what's available to them at Park Lodge.