London Borough of Greenwich - 169 Lodge Hill

Updated 21 April 2020

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 inspection was carried out by one inspector.

Service and service type

London Borough of Greenwich - 169 Lodge Hill is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a 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

Before the inspection, we reviewed any information we had about the service since the last inspection. This included an action plan, details of incidents the provider had notified us about and the monitoring report we had received from the local authority. 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

People were not always able to verbally express their experiences of living at the home with us. Therefore, we observed people as they engaged with staff and the support provided in communal areas. We spoke with four members of staff including the registered manager, assistant manager and two care workers. We also spoke with four visiting healthcare professionals. We reviewed a range of records including three people’s care plans, risk assessments and medicines records. We reviewed two staff files including induction, training and supervision records. We also reviewed a range of records including a staff training matrix, activities planner, surveys, audits, health and safety reports and minutes of meetings.

After the inspection

We spoke with two relatives on the telephone to gather their views about the service. We also contacted the local authority that commissioned the service and other health and social care professionals including advocates for their feedback about the service. We received further feedback from four professionals.

Updated 21 April 2020

About the service

169 Lodge Hill is a residential care home providing care and support for up to six people with multiple learning and physical disabilities. At the time of this inspection six people were living at the home.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles 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.

People’s experience of using this service

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible to gain new skills and become more independent.

The management of the home had improved but this was not consistently maintained in all areas. Care and support were planned and delivered to meet individual needs; however, a relative said their loved one’s needs were not always met because the service was not well managed.

People were supported to participate in activities that interested them. At the time of this inspection, the service was looking for new activities to ensure people were kept stimulated and engaged at all times.

The hygiene levels at the home had improved, and people were protected from the risk of infections. There were enough staff available to support people’s needs. People were safe living at the home and were supported by staff to take their medicines as prescribed by healthcare professionals. Risks to people had been identified, assessed and with appropriate risk management plans in place.

Staff had been supported with induction, training, supervision and appraisal. People were supported to eat and drink healthy amounts for their wellbeing. People were supported to access healthcare services when required. At the time of this inspection, some parts of the home had been redecorated; however, there were further plans in place to carry out refurbishment work to bring the home’s design and decoration up to standard.

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 were supported by staff that were caring, kind and respectful. People, their relatives and advocates were involved in planning their care. People’s privacy and dignity were respected, and their independence promoted. Relatives knew how to make a complaint if they were dissatisfied about the service. People were supported to maintain a relationship with those important to them.

The home had systems in place to assess and monitor the quality of the service and feedback had been gathered from people, their relatives, staff and professionals to improve on the service. Staff worked in partnership with key organisations and health and social care professionals to plan and deliver an effective service. Feedback we received from all professionals was positive.

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 requires improvement (published 12 March 2019).

Why we inspected

We carried out an unannounced comprehensive inspection of this service on 16 and 17 January 2019. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when they would improve infection prevention and control, staffing levels, supporting staff with training and good governance.

We undertook this comprehensive inspection to check they had followed their action plan and to confirm they now met legal requirements.

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.