Ambleside Lodge - London

At the last inspection on 4 August 2015 the service was rated Good.

At this inspection we found the service remained Good.

People continued to be protected against the risk of harm and abuse. Staff received on-going training in safeguarding and were able to identify, report and escalate suspected abuse.

The service developed risk management plans to keep people safe from identified risks. These were regularly reviewed to incorporate people’s views and reflect their changing needs. People were encouraged to help identify risks and develop their risk management plans.

The service continued to employ sufficient numbers of suitable staff to keep people safe. Staff records contained two references, proof of identity and employment history. Staff deployed reflected people’s needs and were flexible to people’s needs.

The service had an embedded culture that ensured safe medicines management. Stocks and balances evidenced that medicines were recorded, administered and recorded in line with good practice.

Staff received on-going training to effectively meet people’s needs. Staff training covered safeguarding, Mental Capacity Act 2005, Deprivation of Liberty Safeguards (DoLS), health and safety and behaviours others may find challenging. Staff confirmed they could request additional training to enhance their skills and knowledge.

Staff were supported to reflect on their working practices through supervisions, appraisals and regular staff meetings. Staff confirmed supervisions aided their performance to deliver effective care.

People were supported to access sufficient amounts to eat and drink to meet both their dietary needs and preferences. Staff encouraged people to make healthy choices and supported people with their daily living skills.

People continued to have access to a wide range of healthcare professionals to meet their health and wellbeing needs. Records confirmed staff supported people to attend healthcare services to maintain and enhance their wellbeing. Where guidance and support was given, this was then implemented into people’s care plans and the care they received.

People received support from staff that were described as ‘caring’, ‘friendly’ and ‘a good laugh.’ Staff developed positive relationships with people and treated them with dignity and respect. People confirmed they were encouraged to maintain their independence with support and guidance from staff.

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 support this practice. People continued to be encouraged to make decisions about the care and support they received. People’s consent to care and treatment was sought prior to being delivered.

The service continued to deliver personalised care that was responsive to people’s needs. Care plans documented people’s preferences and gave staff clear guidance on how to support them in line with their wishes. The service encouraged and empowered people’s diversity.

The service had robust systems in place to monitor and respond to people’s complaints in a timely manner. People were supported to share their concerns through regular one-to-one meetings.

The registered manager was a visible presence within the service. People spoke positively of the registered manager and told us she was supportive and approachable. Staff also confirmed the registered manager was receptive to their views and ideas.

The service continued to develop relationships with other healthcare professionals to enhance the delivery of care. Healthcare professionals’ guidance and support was sought and then implemented. The service actively sought feedback from people who used the service, through regular discussions and one-to-one meetings. People’s views were considered and where appropriate actioned and implemented into the service provision.

Further information is in the detailed findings below.

People's privacy, dignity and independence were respected. Their views and experiences were taken into account in the way the service was provided and delivered in relation to their care. Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare.

People told us they enjoyed the meals served and their cultural dishes and personal preferences had been included in the menus.

People who use the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

People who use the service, staff and visitors were protected against the risks of unsafe or unsuitable premises.

People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard.

A community psychiatric nurse (CPN) told us that staff looked after people well and that people had experienced good outcomes after being placed at Ambleside Lodge.

A psychiatrist told us "the manager is committed and thorough. They take the time to get to know people and understand their personal histories and care and support needs. They carry out a thorough assessment of these needs and produce good reports. The service is small and homely. Staff are attentive and they know where people are and how they are doing. The manager works well with us and understands the need to work with other mental health professionals to ensure that people receive extra care or treatment if they become unwell. They understand and recognise possible triggers that can precede a relapse and they contact us quickly if someone's mental health shows any sign of deterioration. Ambleside Lodge is one of the best services."