This inspection took place on 6 December 2016. The provider was given 48 hours’ notice because the location was a small care home for adults who are often out during the day and we needed to be sure that someone would be in.
Solent Lodge is a four bedroomed house in a residential area. The service can accommodate up to four people with learning and physical disabilities. There is a lounge, dining room and kitchen and each person had their own individualised room. There were four people living in the home at the time of the inspection.
The service had a registered manager in place. 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.
Appropriate checks were not always being done to ensure that medicines were stored correctly. There was insufficient guidance for staff about administering medicines that were to be given ‘as required’ and there were some gaps in the medicine administration records.
Staff had received medicines training but had not had their competency checked regularly.
There were some systems in place for monitoring and assessing the safety and quality of the service but they had not picked up on the issues that we found.
There were systems and processes in place to protect people from the risk of harm. Staff had received safeguarding training and were aware of the action they should take if they suspected abuse was taking place. Staff were aware of whistle blowing procedures and all said they felt confident to report any concerns without fear of recrimination. The registered provider had up to date safeguarding and whistle blowing policies in place and information on how to report any concerns was displayed within the service. The safeguarding policy was also discussed with people using the service and was available in an easy read format.
There were sufficient numbers of staff on duty in order to meet the needs of people who used the service. There was a contingency plan in place in case of an emergency and either the registered manager or deputy manager were on call for every shift.
We found that safe recruitment and selection procedures were in place and appropriate checks had been undertaken prior to staff starting work. The checks included obtaining references from previous employers and disclosure and barring service checks to ensure that staff were safe to work with vulnerable people.
We saw that environmental risk assessments had been carried out. Safety checks and certificates were in place for items that had been serviced and checked such as fire equipment, gas and electrical safety.
Staff received appropriate training and demonstrated that they had the skills and knowledge to provide support to the people they cared for. Staff received some supervision but these meetings were not as frequent as the registered provider’s guidance stipulated. Despite this staff were in regular contact with the management team and felt supported. Further training is being undertaken by the deputy manager in an effort to improve the formal supervision process.
Staff understood the requirements of the Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards which meant they were working within the law to support people who may lack capacity to make their own decisions.
The records we viewed showed us that people had appropriate access to health care professionals such as dentists and opticians and had annual health checks with their GP.
We saw that people were provided with a choice of healthy food and drinks to help ensure their nutritional needs were met. People were involved in the menu planning and shopping and staff were happy to accommodate changes to the menu if people requested it. People’s weight was monitored and portions monitored to avoid weight gain.
During our inspection we saw people engaged with staff in a positive way and there was a relaxed and homely feel around the service. From our observations it was clear that staff knew the people who lived at the service well and we saw that they responded to their care needs in a kind and calm way. Staff were observed to be caring and respected people’s privacy and dignity.
We observed that people were encouraged to be independent and to participate in a variety of activities that were meaningful to them. People were supported to go out into the local community on a regular basis and also went on day trips and holidays of their choice.
We looked at people’s support plans and found that they covered all aspects of care but the inclusion of greater detail would ensure they were more person centred.
We spoke with staff who told us they felt supported by the registered manager. The registered manager told us they felt supported by the registered provider however they were not receiving regular supervision or appraisal. Throughout our visit we saw that people who used the service and staff were comfortable and relaxed with the registered manager and each other.
We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These related to the proper and safe management of medicines, effective auditing and quality assurance. You can see what action we told the provider to take at the back of the full version of the report.