The Lodge

Updated 6 September 2019

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 Care Act 2014.

Inspection team

The service was inspected by one inspector and an 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

The 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.

The service had a manager registered with the Care Quality Commission. 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.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with three people who used the service and four relatives about their experience of the care provided. We spoke with eight members of staff including the registered manager, deputy manager, senior care workers, care workers and the quality improvement lead. We observed staff interactions with people over the two days of our visit.

We reviewed a range of records. This included three people’s care records and multiple medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed. We spoke with one professional.

Updated 6 September 2019

About the service

The Lodge is a residential care home providing personal and nursing care to nine people with a learning disability at the time of the inspection. The service can support up to 12 people. The service is a large house for up to 10 people with shared communal space and two supported single occupancy flats onsite.

The service was registered before Registering the Right Support was published. This meant the number of people living at the service was higher than the number recommended by this guidance. However, the service ensures that people who use the service can live as full a lifesas possible and achieve the best possible outcomes. The service provided care in line with the principles which reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

The service was a large home, bigger than most domestic style properties. It was registered for the support of up to 12 people. Nine people were using the service. This is larger than current best practice guidance. However, the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area and the other large domestic homes of a similar size. There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home.

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

People were cared for by exceptionally kind and caring staff. All staff were employed on the basis of their values with patience and empathy being key qualities. There was a very strong person-centred culture which all members of the staff team were committed to. People were supported to make their own choices and to develop as much independence and autonomy as possible. People were supported to live as full a life as possible and staff were willing to go the extra mile to support them in this.

People were safe at the service. The culture of the service was focussed on developing a safe environment both physically and psychologically. We observed people were calm and relaxed with staff and each other. Staff were highly skilled at maintaining a safe environment by using their knowledge of people to ensure any friction or difficulty was minimised. The staff team was open and transparent and learnt from any incidents; they quickly put effective measures in place to prevent recurrence. Any concerns were shared with the appropriate professionals. Medicines were well-managed with good systems in place to minimise errors. People were supported by enough staff who had been recruited in a safe way.

People received an effective service. Their care was assessed and planned in accordance with their needs. They received support from staff who were trained and supervised. 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. People had a choice of meals and were able to shop and cook for themselves if they wished. Staff supported people to work with health professionals to improve their health and well-being.

People received a responsive service which placed their individual needs and preferences at the core of their care. Care plans were developed to maximise people’s independence and support them to live meaningful lives. Staff were passionate about doing their best for people and improving their quality of life. People were encouraged to try new things, develop new skills and consider what they would like to aim for.

The service was led by a registered manager who was passionate, had a clear vision of the direction of the service and able to implement this effectively. There was a very strong focus on the culture of the service which prioritised people who lived there. The staff team was cohesive and functioned well. Staff felt able to challenge practice or make suggestions and told us they were not afraid to admit making a mistake.

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 (report published December 2016).

Why we inspected

This was a planned inspection based on the previous rating.

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

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.