Archived: Coneyhurst Lodge

Updated 25 May 2018

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 registered persons continued to meet 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.

We used information the registered persons sent us in the Provider Information Return. This is information we require registered persons to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We also examined other information we held about the service. This included notifications of incidents that the registered persons had sent us since our last inspection. These are events that happened in the service that the registered persons are required to tell us about. We also invited feedback from the commissioning bodies who contributed to purchasing some of the care provided in the service. We did this so that they could tell us their views about how well the service was meeting people’s needs and wishes.

We visited the service on 26 March 2018 and the inspection was announced. We gave the registered persons two days’ notice because the people who lived in the service had complex needs for care and benefited from knowing in advance that we would be calling to their home. The inspection team consisted of a single inspector and expert by experience. An expert by experience is someone who has personal experience of using this type of service.

During the inspection we spent time with all of the people who lived in the service. We also spoke with four care staff, the deputy manager, registered manager and locality manager. We observed care that was provided in communal areas and looked at the care records for three of the people who lived in the service. We also looked at records that related to how the service was managed including staffing, training and quality assurance.

After the inspection visit we spoke by telephone with three relatives.

Updated 25 May 2018

We inspected the service on 26 March 2018. The inspection was announced. Coneyhurst 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.

Coneyhurst Lodge is registered to provide accommodation and personal care for 10 people who have a learning disability. There were six people living in the service at the time of our inspection visit. All of the people had complex needs for care and most of them used sign-assisted language to express themselves.

The service was run by a company who was the registered provider. There was a registered manager in post. 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. In this report when we speak about both the company and the registered manager we refer to them as being, ‘the registered persons’.

At the last inspection on 1 February 2017 the service was rated, ‘Requires Improvement’. Although there were no breaches of the regulations, we found that improvements needed to be made to ensure that the service consistently provided people with safe care and treatment. In particular, the arrangements used to protect people’s health and safety when they became distressed needed to be more robust. Changes also needed to be made to ensure that sufficient care staff were always deployed in the service. We also found that improvements were needed to the systems and processes used to manage the service. This was because the shortfalls we have already described had not been quickly resolved. Furthermore, there had been instances when care staff had not promptly liaised with people’s relatives about developments in their family member’s care and some care staff told us that there was low morale in the staff team.

At the present inspection we found that all of these problems had been addressed.

The service had been developed and designed in line with the values that underpin the ‘Registering the Right Support’ and other best practice guidance. These values include choice, promotion of independence and inclusion. This helped to ensure that people with learning disabilities and autism using the service could live as ordinary a life as any citizen.

Our other findings were as follows: People were safeguarded from situations in which they may experience abuse including financial mistreatment. Medicines were managed safely. People had been helped to avoid preventable accidents while their freedom was respected. There were enough staff on duty and background checks had been completed before new care staff had been appointed. Suitable arrangements were in place to prevent and control infection and lessons had been learned when things had gone wrong.

Care was delivered in a way that promoted positive outcomes for people and care staff had the knowledge and skills they needed to provide support in line with legislation and guidance. This included respecting people’s citizenship rights under the Equality Act 2010. People received the individual assistance they needed to enjoy their meals and they were helped to eat and drink enough to maintain a balanced diet. Suitable steps had been taken to ensure that people received coordinated and person-centred care when they used or moved between different services. People had been supported to live healthier lives by having suitable access to healthcare services so that they received on-going healthcare support. The accommodation was designed, adapted and decorated to meet people’s needs and expectations.

People were supported to have maximum choice and control of their lives. In addition, the registered persons had taken the necessary steps to ensure that people only received lawful care that was the least restrictive possible.

People were treated with kindness, respect and compassion and they had been given emotional support when needed. Also, they had been supported to express their views and be actively involved in making decisions about their care as far as possible. This included them having access to lay advocates if necessary. Furthermore, confidential information was kept private.

People received personalised care that was responsive to their needs. This included them having access to information that was presented to them in an accessible way. Also, people had been offered opportunities to pursue their hobbies and interests. Furthermore, the registered manager recognised the importance of promoting equality and diversity. This included appropriately supporting people if they chose gay, lesbian, bisexual and transgender life-course identities. There were arrangements to ensure that people’s complaints were listened and responded to in order to improve the quality of care. In addition, suitable provision had been made to support people at the end of their life to have a comfortable, dignified and pain-free death.

The registered manager had promoted a person-centred culture in the service and had made the arrangements necessary to ensure that regulatory requirements were met. People who lived in the service and members of staff were actively engaged in developing the service. There were systems and procedures to enable the service to learn, improve and assure its sustainability. The registered persons were also actively working in partnership with other agencies to support the development of joined-up care.