Hunters Lodge

We found the following examples of good practice.

Staff and people followed robust testing in line with current government COVID-19 guidance. People were supported to pursue activities and go out whilst staying as safe as possible. People were supported to visit friends and family and receive visitors in their home. Visitors were supported to follow testing and safe infection prevention and control procedures during their visits.

Staff understood and followed robust infection prevention and control procedures. This included wearing personal protective equipment (PPE) and washing and sanitising hands regularly. PPE stations were available throughout the service and we saw there were sufficient stocks of PPE available. The environment was clean and hygienic, staff followed cleaning schedules which included regular cleaning of high contact areas, such as door handles and grab rails.

The service was meeting the requirement to ensure non-exempt staff and visiting professionals were vaccinated against COVID-19.

Hunters Lodge is a residential care home and a supported living service. One person received personal care support in their own home, and 12 people received personal care in the care home, at the time of the inspection.

The care home was bigger than most domestic style properties. It was registered for the support of up to 17 people. Twelve people were using the care home service. This is larger than current best practice guidance. 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 deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.

Hunters Lodge is also a domiciliary care agency which provides personal care to people in their own homes. They support adults who have learning disabilities. At the time of our inspection the service supported one person, in their own property, in a neighbouring village. Night time support was provided by sleep-in staff.

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

People told us they felt safe living in the care home. The arrangements in place ensured people were protected from the risk of abuse.

People lived in a property that was well maintained and regular health and safety checks ensured the care home environment was safe.

People were supported by enough care staff to meet their needs.

People received their prescribed medicines when they needed them, and the care staff had been appropriately trained to administer medication safely.

People lived in an environment that was clean and tidy. They were protected from the risk of infections spreading by the cleaning procedures the care home had in place.

People had appropriate care plans in place which guided staff on how they needed to be supported. People, and their relatives where appropriate, were involved in reviewing care plans to make sure they were accurate.

People were supported by care staff who had received appropriate training.

People liked the food, and the care staff helped people to eat and drink safely and maintain a balanced diet.

People were supported to attend local day centres and there was good communication between the care home and day centre staff.

People had personalised their bedrooms and lived in a building which had been adapted to meet their needs.

People were enabled to access health care support when they needed to, and care staff had good links with health care professionals.

People’s privacy and dignity were respected by the care staff, and people were supported to maintain and increase their independence.

People were supported by care staff who were kind to them.

People could choose to take part in house meetings and be involved in decisions about menus, activities and transport.

People were supported by care staff who were attentive to their changing needs. Care plans were updated when people’s needs changed.

People’s communication needs were understood by the care staff. Documents were written in accessible formats.

People were supported to maintain contact with their relatives if they wished to.

People took part in activities within the care home and in their local community. Care staff wanted to increase the range and frequency of activities for people.

People had access to an easy read complaints procedure and told us they would tell the care staff if they were unhappy about anything.

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.

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.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 2 August 2018) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do, and by when, to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This was a planned inspection 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 re-inspection programme. If we receive any concerning information we may inspect sooner.

The care service has been developed and designed in line with the values that underpin Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. The aim is that people with learning disabilities and autism using the service can live as ordinary a life as any citizen.

The service had a registered manager in place at the time of our inspection. 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. At the time of our inspection the registered manager was on leave.

This was the first inspection of this service under its current registration.

At this inspection we found that the behaviours of one person using the service, which posed a risk to staff and other people using the service, had not been safely managed by the provider. This was having a significant impact on every aspect of the service and this is reflected in this report. Incidents had not been notified as required by law and as a result CQC had not been made aware of the level of risk at the service at the time of our inspection.

People were not always able to spend their time in ways they would have chosen to due to the risk posed by one person who used the service. These behaviours, which staff struggled to manage, were impacting on people being enabled to remain as independent as possible and, at times, people using the service did not feel safe.

Staff had not been adequately trained in providing safe support for people and staff felt they had not always been adequately supported in their roles.

There were enough staff at the service to safely meet people's needs although staff's time was often taking up managing one person's behaviours and this restricted the amount of time they were able to spend with other people.

Care and support plans contained relevant and up-to-date information on risks associated with the delivery of people's support and were written to reflect people's personal needs and preferences.

People were protected against the risk of infection as we found the service to be clean and hygienic. People received their medicines safely and there were plans in place for any potential emergency situations.

People's consent was sought by the service and the principles of the Mental Capacity Act 2005 had been followed.

People's nutritional risks were assessed and planned for and people had a choice in what they had to eat and drink. People had access to various healthcare professionals to maintain their health and well-being.

There was a management structure within the service and people and their relatives felt they could approach the management of the service should they need to raise any issues. However, there had been a lack of action in relation to concerns raised by staff, people and their relatives in relation to risk associated with one person's behaviours at the service. These were beginning to be addressed following our inspection as we raised a safeguarding concern about this.

You can see what action we told the provider to take at the back of this report.