Background to this inspection
Updated
18 May 2023
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.
Inspection team
The inspection team consisted of 1 inspector, 1 specialist advisor who was a nurse and 1 Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
Arthur Lodge is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection
Registered Manager
This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
At the time of our inspection there was a registered manager in post.
Notice of inspection
This inspection was unannounced. We visited the location on 17 April 2023.
What we did before the inspection
We reviewed information we had received about the service since it was last inspected. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make.
During the inspection
We met 3 people who lived in the home. Some people could not use words to tell us about their experience, we observed interactions between people using the service and staff. We spoke with 2 staff and the registered manager. We reviewed 5 people’s care records including risk assessments and 2 staff files in relation to recruitment. We also reviewed a range of management records including staff training, quality audits, medicines, and service user feedback. We also spoke to 2 relatives of people who used the service.
Updated
18 May 2023
We expect health and social care providers to guarantee people with a learning disability and autistic people respect equality, dignity, choices and independence and good access to local communities that most people take for granted. 'Right support, right care, right culture' is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
About the service.
Arthur Lodge is a care home for adults with learning disabilities, including those with a dual diagnosis of a
mental health condition. The maximum number of people the service can accommodate is 11. At the time of our inspection 9 people were using the service.
People's experience of using this service and what we found
Right Support:
Staff supported people to access health and social care support in the community. They supported people being involved in maintaining their own health and wellbeing where possible. Staff communicated with people in ways that met their needs. The service gave people care and support in a safe environment. However, people were not always supported to have maximum choice and control of their lives as up to date mental capacity assessments had not been completed. Staff knew people well and supported them in the least restrictive way possible and in their best interests. However, the policies and systems in the service did not always support this practice. Risks to people were assessed, monitored, and managed. Staff had the necessary skills, knowledge, and experience to provide safe and effective care. There were enough staff to meet people's needs.
Right Care:
Medicines Administration Records (MAR) did not contain sufficient information and some people were receiving medication that was not prescribed. Staff were recruited safely.People's needs were appropriately assessed before they moved to the service. The service worked together with healthcare professionals and relatives to ensure people's needs could be met. Care was person-centred and promoted people's dignity, privacy, and human rights. Staff understood how to protect people from poor care and abuse. Staff were appropriately trained on how to recognise and report abuse and they knew how to report safeguarding concerns. Care records contained risk assessments with clear guidance for staff to follow. Medicines were not always managed safely. Medicines Administration Records (MAR) did not contain sufficient information and some people were receiving medication that was not prescribed. Staff were recruited safely. The premises were clean. People had a choice about their living environment and were able to personalise their rooms. Some aspects of the home needed refurbishment and the provider was taking action to address this.
Right Culture:
The registered manager promoted a person-centred environment and people experienced good outcomes. However, the providers quality monitoring systems were very informal and had failed to mitigate the risks in relation safe medication management and lack of mental capacity assessments. People spoke positively about the management team and staff. Staff understood people’s needs in relation to their strengths, impairments, or sensitivities people with a learning disability and/or autistic people may have. This enabled people to receive compassionate and empowering care that was tailored to their needs. Staff knew and understood people well and were responsive, supporting their aspirations to live a quality life of their choosing.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
At the last inspection we rated this service as good. The report was published on 28 July 2017.
Why we inspected
We carried out a focused inspection of this service on 17 April 2023, this inspection was prompted by a review of the information we held about this service. This report only covers our findings in relation to the Key Questions Safe, and Well Led. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.
Enforcement and Recommendations
We have identified one breach in relation to safe care and treatment.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our inspection programme. If we receive any concerning information, we may inspect sooner.