Arthur Lodge Residential Care Home

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.

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 eleven. At the time of our inspection 9 people were using the service.

People’s experience of using this service

People told us they were happy with the care and support they received because they felt safe and all their needs were met by kind and caring staff.

People praised the manager of the service and agreed that they were approachable, knowledgeable, fair and did their job well. The staff team worked well together and supported the registered manager.

The staff team was committed to providing a high-quality service and keeping people safe. They had undertaken training so that they were skilled and knowledgeable to effectively meet people’s needs. Staff understood their responsibilities to report any concerns.

Staff encouraged people to be as independent as possible and respected people’s privacy and dignity. Staff knew people well. Staff managed the risks to people’s health and welfare.

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.' Registering the Right Support CQC policy. 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.

As part of thematic review, we carried out a survey with the registered manager at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people. The service used positive behaviour support principles to support people in the least restrictive way. No restrictive intervention practices were used.

People were given choices about the way in which they were cared for. Staff listened to them and knew their needs well. Care plans contained information about each person’s individual support needs and preferences in relation to their care and we found evidence of good outcomes for people.

Recruitment practices were safe and relevant checks had been completed before staff worked at the service.

People told us staff were able to meet their needs and were respectful of their individual preferences.

People received care and support from a small group of staff, which provided consistency.

The managers of the service actively sought the views of people and their relatives about the running of the service and they dealt promptly with any concerns that people raised.

The provider had systems in place to monitor and improve the quality and safety of the service provided.

More information is in the full report.

Rating at last inspection

At the last inspection we rated this service Good. The report was published on 28 March 2017.

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor this 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.

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.

People told us they were well treated at the home and risks to their safety had been identified and ways to mitigate these risks had been recorded in people’s care plans.

Relatives were positive about the family who ran the home and the domestic nature of the accommodation. Everyone we spoke with told us the service was very homely and relaxed. Staff turnover was low and everyone knew each other very well.

Staff were aware that the people they supported were vulnerable and they understood their responsibilities to keep people safe from potential abuse.

There were systems in place to ensure medicines were handled and stored securely and administered to people safely and appropriately.

Staff turnover was low and staff were positive about working at the home and told us they appreciated the support and encouragement they received from the registered manager.

Staff understood the principles of the Mental Capacity Act (MCA 2005) and knew that they must offer as much choice to people as possible in making day to day decisions about their care. This included making sure people who had difficulty communicating verbally were as involved in their care and decision making as everyone else.

People told us they enjoyed the food provided and that they were offered choices of what they wanted to eat.

People had regular access to healthcare professionals such as doctors, dentists, chiropodists and opticians.

Staff treated people as unique individuals who had different likes, dislikes, needs and preferences.

People told us that the management and staff listened to them and acted on their suggestions and wishes.

Both people using the service and their relatives told us they were happy to raise any concerns they had with any of the staff and management of the home.

People were included in monitoring the quality of the service and we saw that their suggestions for improvements and preferences about how they wanted to live their lives were respected and acted on.

During the last inspection, the provider had previously failed to notify us of incidents of injuries and deaths in a timely manner. We saw that the home now has systems in place to ensure we are notified appropriately and promptly.

We found that care plans and assessments of risks to people who use the service were regularly reviewed. Staff demonstrated the knowledge and skills needed to protect people from abuse. One person told us "yeah, feel safe here." We found that staff received appropriate training to work with people who use the service in relation to their individual care needs. The provider had a system in place to regularly assess and monitor the quality of service that people receive.

The provider might like to note that one person's care plan did not identify the steps staff should take in an emergency situation.

Care plans reflected people's current needs. We found that care plans and assessments of risks to people who use the service were regularly reviewed. The provider was managing safeguarding in line with it's own procedures.

Recruitment processes were robust. There was an effective complaints system available. The provider had failed to notify us about injuries and incidents.