We carried out a review of the data available to us about Shenley Lodge on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Shenley Lodge, you can give feedback on this service.
Shenley Lodge is a residential care home providing personal care and support for up to seven people with learning disabilities. At the time of our inspection there were six people using the service.
People’s experience of using this service and what we found
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.
The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.
The model of care and setting maximised people’s choice, control and independence. People and their relatives told us they were encouraged to do as much as they could for themselves. People told us they could make decisions about their day to day lives.
Care was person-centred and promoted people’s dignity, privacy and human rights.The ethos, values, attitudes and behaviours of the registered manager and care staff ensured people using the service lead confident, inclusive and empowered lives. Staff were kind and caring and treated people with respect. Relatives said their loved ones were supported by staff who were compassionate and understanding.
People were safeguarded from the risk of abuse. Staff had completed appropriate safeguarding training and people told us they felt safe. Medicines were managed safely, and several checks were in place to help ensure they remained safe. Risks to people were assessed and managed safely. Risks were reviewed regularly, and routine checks were made to ensure people were receiving the care they needed.
There were sufficient numbers of staff in place and recruitment was ongoing. Support was provided by staff who had received the required training and supervision from the registered manager.
People were supported to be as independent as possible. People’s dietary needs were documented and met. Healthcare services were accessed on a regular basis.
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 19 September 2018)
Why we inspected
The inspection was prompted in part due to concerns related to the management of medicines, staffing, training, supporting people with choice, respect and dignity and nutrition and hydration. A decision was made for us to inspect and examine those risks.
We found no evidence during this inspection that people were at risk of harm from these concerns.
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.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Shenley Lodge on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Shenley 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. Shenley Lodge provides care and support for up to seven people with learning disabilities. At the time of our inspection there were seven people using the service. 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.
There was a registered manager at the service at the time of our inspection. 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 and associated Regulations about how the service is run.
Relatives and health and social care professionals told us they felt the service was safe and there were enough staff to meet people’s needs. Staff were trained in safeguarding and knew how to safeguard people against harm and abuse. People’s risk assessments were completed, regularly reviewed and gave sufficient information to staff on how to provide safe care. Staff kept detailed records of people’s accidents and incidents. Staff wore appropriate protection equipment to prevent the risk of spread of infection. Medicines were stored and administered safely. The home environment was clean.
Staff undertook training and received regular supervision to help support them to provide effective care. Staff we spoke with had a good understanding of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). MCA and DoLS is legislation protecting people who are unable to make decisions for themselves or whom the state has decided need to be deprived of their liberty in their own best interests. We saw people were able to choose what they ate and drank. People told us they enjoyed the food. The home was well decorated and adapted to meet their needs of the people.
People and their relatives told us the staff were caring. We found that care records were in place which included information about how to meet a person’s individual and assessed needs. People’s cultural and religious needs were respected when planning and delivering care. Discussions with staff members showed that they respected people’s sexual orientation so that lesbian, gay, bisexual, and transgender people could feel accepted and welcomed in the service. People had access to a wide variety of activities. People’s end of life wishes were explored.
The management of people’s finances was not robust. We have made a recommendation about the management of people’s finances.
The service had a complaints procedure in place and we found that complaints were investigated and where possible resolved to the satisfaction of the complainant. However, the service had not formally responded to people’s complaints.
Staff told us the service had an open and inclusive atmosphere and the registered manager was approachable and listened to concerns. The service had various quality assurance and monitoring mechanisms in place.
This inspection was carried out on 1 December 2015 and was unannounced.
During our inspection on 22 April 2014 we found that there were inadequate staffing arrangements and there was no evidence that staffing rotas were completed. A follow up inspection on 4 September 2014 found this area to be compliant.
Shenley Lodge provides accommodation and support with personal care for up to seven people with a learning disability.
The service did not have a registered manager. However, the manager told us that they were in the process of applying for registration. 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 legal requirements in the Health and Social Care Act 2008 and the associated regulations on how the service is run.
Due to risks to their safety people living at the home were not allowed to go outside without staff or relatives accompanying them. Deprivation of Liberty safeguards (DoLs) applications were not made for these people. The manager told us after the inspection that applications had been submitted and provided evidence to support this. The Mental Capacity Act and DoLS is a law protecting people who are unable to make decisions for themselves or whom the state has decided their liberty needs to be deprived in their own best interests.
We found that Shenley Lodge provided personalised person centred care, which people contributed in decision-making on the support they received. People were encouraged to be independent and there was a homely type culture that promoted independence.
Medicines were stored and administered correctly. Staff administering medicines was trained to ensure they were competent and safe.
Staff were trained in safeguarding adults and had a good understanding in keeping people safe. They knew how to recognise abuse and who to report to and understood how to whistle blow. Whistleblowing is when someone who works for an employer raises a concern about harm, or a risk of harm, to people who use the service.
Care plans were personalised to the people. Both the people and their relatives were involved in planning of care and the care plan was then signed by people to ensure they were happy with the care and support listed on the care plan.
Risk assessments were recorded and plans were in place to minimise risks.
People enjoyed the food and were given choices on what they would like to eat during mealtimes.
People had access to healthcare services such as the GP and dentists. People were supported to make healthcare appointments and visits were made with the assistance of staff. A GP also visited the home to undertake health checks. We saw individual hospital passports were not updated. The manager told us after the inspection, the hospital passports had been updated.
Systems were in place to ensure staff received regular supervision and appraisal. Staff received induction training and also received regular training to ensure that people were safe and the care provided was effective.
Complaints had not been made by people or relatives about the service. People were aware on how to make complaints and staff knew what to do in the event a complaint was made.
People had a weekly activities timetable and enjoyed a number of activities such as going to the daycentre, holidays, parks and shopping.
People's privacy and dignity was maintained. People were encouraged to be independent and we saw people moving freely around the house and were able to go to their rooms without interruption.
Systems were in place for quality assurance and continuous improvements. The manager conducted regular audits, which included spot checks to ensure quality and used the findings for continuous improvement.
We identified breach of regulation relating to Deprivation of Liberty safeguarding. You can see what action we have asked the provider to take at the back of the full version of this report.
During this inspection we found that the service had taken appropriate action to ensure that there was a written staff rota and staff informed us that the staffing levels were adequate.
People who used the service had learning difficulties. When we spoke with them, they did not provide us with any views or comments regarding the staffing levels. The home appeared clean and well furnished. Four people who used the service had gone out to a day centre. The two people who used the service who were in the home appeared comfortable and were appropriately dressed.
We were provided with night risk assessments carried out on each of the people who used the service. We noted that none of them presented any potential care problems for night staff. The manager stated that staff who had been consulted by them indicated that there were no significant problems during the night shift. The two day staff on duty informed us that the staffing levels were adequate and they were able to perform their duties.
During the inspection the home had six people who used the service. All of them had a learning disability. Two of them were able to express their views verbally. A third person communicated by making gestures, and with facial expressions. The rest of the people who used the service did not express their views to us when we communicated with them.
We observed the care provided and the interaction between staff and people who used the service. We also spoke with two care staff and the registered manager. Two relatives and a social care professional also provided us with feedback regarding the care provided to people who used the service.
Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at.
If you want to see evidence that supports our summary please read the full report.
This is a summary of what we found:
Is the service safe?
People who used the service moved about freely in the home and some went out accompanied by staff. We observed that staff were constantly supervising people to ensure that they were safe. Care records contained risk assessments which provided guidance to staff on action to take to keep people safe. Health and safety checks and audits had been carried out on the premises to ensure that any risks to people were identified and minimised. A recent report by the fire authorities indicated that fire safety arrangements were satisfactory.
Safeguarding procedures were in place and staff had been provided with safeguarding training. They were aware of action to take in response to safeguarding incidents or allegations. Staff had an understanding of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS). The manager told us that no applications for deprivation of liberty needed to be submitted and staff were able to gain the co-operation of people. However, we saw people living in the home needed continuous
supervision and control and staff told us that due to risk to their safety people were not free to leave without staff or family members accompanying them. This may mean that deprivation of liberty authorisations were required. The registered manager agreed that he would contact the local authority with regard to this issue.
Is the service effective?
Feedback from relatives and a social care professional indicated that the service was effective and responsive to the needs of people. People's care needs had been fully assessed with the help of their relatives and representatives. Their likes and dislikes were documented and staff we spoke with were aware of these. Care plans had been prepared and these were up to date and had been regularly reviewed. There was evidence that people's needs had been attended to by healthcare professionals such as psychiatrist, dentists and their GP. Staff were knowledgeable regarding how to care for people with behavioural problems and gain their co-operation. We noted that people co-operated well with staff who assisted them to get ready when they were going out.
Is the service caring?
We observed that people were well dressed. Staff were gentle and pleasant towards people. We noted that people were able to approach staff freely and came to them when they needed help. Staff were seen offering people food and drink. Some people informed us that they were provided with food they liked. Staff were aware that all people who used the service should be treated with respect and dignity. We noted that people who chose not to go out could remain in the home. Arrangements had also been made to ensure that people religious and cultural needs were responded to. A social care professional and a relative stated that they observed that care staff were caring towards people.
Is the service responsive?
We observed that staff were attentive towards people and when people needed help or attention, staff responded immediately. Staff gave us examples of what they did in response to suggestions made. This included buying a computer game that a person asked for and enabling a person to have more contact with their relative. We noted that the bedrooms of people had been personalised with pictures and ornaments they liked.
One relative informed us that when they had any concerns regarding their relative, staff responded promptly and took appropriate action. When information was needed regarding the care of people or the running of the home, the manager was able to provide the required information.
Is the service well-led?
The home had a registered manager who was knowledgeable regarding his role and responsibilities. There were arrangements for monitoring the quality of care provided. A satisfaction survey had been carried out. The results indicated that people who used the service and their representatives were on the whole satisfied with the care provided. An action plan had been prepared in response to suggestions made. Monthly monitoring visits had been done by the nominated individual to check on the condition of the home and the care of people. Checks on medication arrangements, the cleanliness of the building, and Health and Safety audits had been carried out.
Staff meetings took place two monthly. The minutes of meetings indicated that staff had been updated regarding the management of the home and the care of people. Staff we spoke with informed us that they had been provided with appropriate support to enable them to take good care of people. Staff had received essential training and were knowledgeable regarding their roles and responsibilities.
People's care needs were identified and clearly set out in care plans for staff to follow. Staff were knowledgeable about people's needs and we saw them being proactive in assisting and encouraging people to take up activities.
There had been careful consideration about the food provided. Each person had their dietary needs identified as part of their care plan and we saw that the food provided was plentiful and based on people's wishes. Staff knew each person and their food preferences well. Medication was stored safely and there were checks to make sure medicines were administered and handled properly.
Staff told us they felt supported. One member of staff told us that the team meetings, 'give us opportunities to bring up ideas.' Another staff member said that a good thing about the service was that, 'we work as a team.' There were regular team meetings and staff supervision as well as the provision of relevant training.
The service is provided in a large detached house which provides a family style setting. There had been regular safety checks of the premises including a premises risk assessment and fire safety checks.
However we were able to observe people who used this service and their interaction with staff.
The home was clean and had a relaxed atmosphere. We observed that people who used this service were treated with respect and dignity. We saw evidence that people were able to have an input into all areas of their daily lives and that their independence was respected.
We observed staff supporting people in a friendly and professional way and saw that
people were being offered choice with regard to menus, activities and care preferences.
People who use the service seemed positive about the care and treatment they received at the home. Interviews with staff and care plans indicated that they had good access to health care professionals such as doctors, district nurses, dentists and speech and language therapists.
We asked people who use the service what they thought about the care and treatment they receive at the service. They responded positively and said they felt supported by the staff team and that they were included in decisions about their care as far as possible. One person commented, 'Nice staff'.
There are lots of opportunities for people to follow their own recreational activities and to be part of the local community.
People who use the service indicated that they enjoyed the food provided by the home. One person said, 'Lovely' when we asked about the food. We saw people eating lunch which looked appetising and was of sufficient quantity.
People who use the service indicated to us that they felt safe with the staff at the home.
People receive the medication they need and medication procedures were being followed appropriately.
Although recruitment procedures were generally being followed, the service was not always maintaining staffing files appropriately.
When we asked people who use the service if there were enough staff at the home one person commented, 'No worries'. Peoples' dependency levels were not being routinely assessed, in order that staffing levels could be reviewed and adjusted to ensure there were enough staff on duty at all times.
The views of people who use the service were being sought regarding the quality of care provided at the home. However there were no formal procedures to monitor health and safety, maintenance and the quality of service provision.
The home was decorated and furnished to a very good standard and peoples' rooms had been individualised to reflect their own personalities.