Dunheved Lodge

Dunheved Lodge is a residential care home providing personal care and accommodation to people with a learning disability and autistic people in one adapted building. The service provides support to a maximum of 12 people. At the time of our inspection 12 people were living there.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

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

Right Support

People were supported to live active lives over which they had choice and control. People chose the activities they wanted to do, and staff supported their participation. Timely referrals were made to healthcare professionals to ensure people’s needs were assessed and met.

Right Care

People received kind and compassionate care from staff. People and staff knew each other well and over time and relatives were welcome at the service. People’s communication needs were assessed and individually met. The providers procedures and staff training ensured that people were protected from foreseeable harm.

Right Culture

Dunheved Lodge is a larger than usual service for people with a learning disability and autistic people. However, the provider maintained a person-centred culture by focusing on people’s individual needs and preferences. The service gathered people’s views and acted on them. The quality of care being delivered was audited in order to drive improvements. 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.

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 21 February 2019).

Why we inspected

We undertook this inspection to assess that the service is applying the principles of right support, right care, right culture.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

We found the following examples of good practice.

Staff had received infection prevention and control training, including how to put on and take off personal protective equipment and dispose of it safely and hand washing.

The visiting arrangements for the service were in line with government guidance. People were also able to keep in touch with family and friends using video and telephone calls.

People and staff were tested for COVID-19 in line with government guidance and all staff had been vaccinated. Staff checked the vaccination status of professionals visiting the home.

The provider kept people and their families informed about COVID-19 and the arrangements for the home. Staff supported people in the home and in the community to reduce the risk of COVID-19 infection.

The service had enough staff and had measures in place to deal with any staffing difficulties arising from COVID-19.

At our last comprehensive inspection of Dunheved Lodge in July 2016 we rated the service ‘Good’ overall. At this inspection we found the service continued to be ‘Good’.

The service is registered to accommodate and support 14 people. At the time of our inspection 12 people were living in Dunheved Lodge. The care service has 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. 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 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.

People living at Dunheved Lodge continued to be safe. Staff were trained to safeguard people by recognising signs of abuse and reporting concerns appropriately. People’s risks were assessed and reduced and there were enough suitable staff available to keep people safe. Medicines were administered in line with the prescriber’s instructions. The home was clean and staff followed the provider’s infection control and food safety procedures.

People participated in their assessments and staff made referrals were necessary for people’s specific needs to be assessed by healthcare professionals. Staff were trained and supervised and the registered manager evaluated their performances. People ate well and were supported to access health and social care services whenever they needed to. The registered manager ensured people were treated in line with the Mental Capacity Act 2005 and care records were in place to show that restrictions in place were lawful and in people’s best interests.

Staff and people knew each other well and in some instances shared positive relationships for decades. Relatives were made to feel welcome when they visited family members and people were supported to maintain friendships. Staff respected people’s privacy and promoted their dignity.

Detailed care plans were in place to provide staff with guidance on meeting people’s needs and preferences. People’s autistic spectrum, behavioural support and communication needs were met and people were active. The service recognised the need to increase the quality and quantity of activities for people who were at home and did not attend the provider’s day service and had created the role of activity coordinator to lead this. Complaints were dealt with appropriately.

There was an established leadership and good governance at the service. The service worked cooperatively with external agencies to meet people’s needs. Staff felt supported and thought an open culture existed at the service. The provider gathered and acted on the views of people, relatives and staff. The registered manager oversaw quality assurance processes which monitored care and support and drove improvements at the care home.

The home had 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.’

We carried out an unannounced comprehensive inspection of this service in August 2016. A breach of legal requirements was found. After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breach.

We undertook this focused inspection to check that they had followed their plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements. We found improvements had been made and relevant notifications had been sent to the Commission and we have revised our rating to good for the Well led section

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Dunheved Lodge on our website at www.cqc.org.uk.

Dunheved Lodge is a residential care home that provides 24 hour care and support for up to 14 adults. The home specialises in caring for adults with a learning disability. At the time of our visit, there were 12 people using the service, two people were using the service for respite care.

The home had 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.’

At this inspection we found that the service had not sent the CQC notifications in relation to the outcomes of Deprivation of Liberty (DoLS) applications. This was a breach of Regulation 18 of CQC (Registration) Regulations 2009.

People liked staying at Dunheved lodge and found staff who supported them were caring and kind towards them. There was a relaxed and friendly atmosphere when we visited.

There were systems and processes in place to protect people from the risk of harm and staff were aware of safeguarding procedures. People received assistance to stay safe from potential harm and injury. Appropriate recruitment procedures were followed and staff were fully vetted before they started work. There were sufficient numbers of qualified staff to support people and meet their individual needs.

People were supported to have their health needs met. Staff worked with the person to access the GP and other local health services as appropriate to help make sure the individual’s health needs were met. People requiring assistance with taking their medicines received their medicines safely. Prescribed medicines were stored securely and managed safely.

Staff received training which gave them the knowledge and skills to support people effectively. Newly recruited staff received induction and foundation training to prepare them for the role. Staff received training in the Mental Capacity Act (MCA) 2005 and the Deprivation of Liberty Safeguards (DoLS). Staff worked within the principles of the Mental Capacity Act 2005 (MCA). People were asked for their consent to the care and support they received.

There was a system in place for responding to people’s concerns and complaints. People told us they knew how to complain and felt confident that staff would respond and take appropriate action.

The registered manager understood their role and responsibilities and positive feedback was received from staff about their leadership and management. There were effective systems in place to identify areas for improvement and to help ensure the safety and quality of the service provided.

People experienced safe and appropriate care and support that met their needs. One relative we spoke with said ''I see them once a week and whenever I go to the home they are always dressed appropriately, that tells me a lot. I don't usually tell them (the staff) I am coming so I know it isn't done to please me.'' Risk assessments had been completed for each person and the records we saw stated how the risks would be managed and reviewed. There were arrangements in place to deal with foreseeable emergencies.

The premises and grounds were adequately maintained. The premises were warm, well lit and secure. We saw records that showed essential maintenance and safety checks had been carried out such as testing of emergency lighting and water temperatures.

People received care from staff that had been properly trained supervised and appraised. Records were accurate and fit for purpose and kept secure to ensure confidentiality.

We were able to speak to three people briefly before they went to the day centre and two others throughout the course of the day.

Everyone we spoke to liked living at Dunheved Lodge. One person told us, 'like it here, friendly'. Someone else said 'like staff, like it when everyone comes back' (from day centre).

One person who uses the service gave us a tour of the building, including showing us their bedroom.

The home provides respite care for people who need to be away from their permanent home for short period. The respite care provided is usually for a two week period, although can sometimes be extended by the funding authority.