Archived: South Africa Lodge

South Africa Lodge is a residential care home that was providing nursing and personal care for up to 94 older people, some who may also be living with dementia. There were 89 people living in the home at the time of our inspection. The home was laid out over two floors and consists of six lodges. People are placed in the lodges according to need, presentation and specific requirements. The service provides a specialist service for people with neurological degenerative conditions.

Although the service was not a Learning Disabilities service, it did support a small number of people who had learning disabilities. Therefore, Registering the Right Support (RRS) applies to this service. The service was registered before Registering the Right Support was developed. Therefore, the service has not been developed and designed in line with the principles and values that underpin Registering the Right Support (RRS). Although the size and structure of the service was not in line with the principles of Registering the Right Support, staff delivered care in a person-centred way that offered people choice and control. The outcomes for people reflected and were underpinned by the principles and values of Registering the Right Support.

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

People and their relatives were very positive about the service and the care provided. People were cared for by staff who knew how to keep them safe and protect them from avoidable harm. People received their medicines regularly.

People's dignity, confidentiality and privacy were respected, and their independence was promoted. People's rights to make their own decisions were respected. 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.

The service continued to be effective. People's needs were assessed, and care was planned and delivered to meet legislation and good practice guidance. Care was delivered by staff who were well trained and knowledgeable about people's care and support needs.

Incidents and accidents were investigated, and actions were taken to prevent recurrence. Enough staff were available to meet people's needs and people told us when they needed assistance, staff responded promptly. The premises were clean, and staff followed infection control and prevention procedures.

People were encouraged to maintain a good diet and access health services when required. People had access to a wide range of activities and were supported to avoid social isolation.

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 21 June 2017).

Why we inspected:

This was a planned inspection based on the previous rating.

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.

South Africa Lodge provides accommodation and nursing care for up to 94 older people. At the time of our inspection there were 75 people living at the home. People living at the home have high complex support needs in relation to their diagnosis of dementia, mental health conditions, learning disabilities and physical disabilities. The home is separated into six lodges that have dedicated staff teams.

Bedrooms are single occupancy with en-suite facilities and each lodge has communal areas. There is a well maintained and secure garden area to the rear of the building that is regularly used by people with support from staff. There is also a large bird aviary in the courtyard area that is overlooked by the main lounge.

The service had a registered manager. 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.

Individual care records were stored electronically and staff had access to update records accordingly.

The provider had systems in place to respond and manage safeguarding matters and make sure that safeguarding concerns were raised with other agencies.

People who were able to talk with us and relatives said they felt safe in the home and if they had any concerns they were confident these would be quickly addressed by the staff or registered manager

Assessments were in place to identify risks that may be involved when meeting people’s needs. Staff were aware of people’s individual risks and were able to tell of the strategies’ in place to keep people safe.

There were sufficient numbers of qualified, skilled and experienced staff deployed to meet people’s needs. Staff were not hurried or rushed and when people requested care or support, this was delivered quickly. The provider operated safe and effective recruitment procedures.

Medicines were stored and administered safely. Clear and accurate medicines records were maintained. Training records showed that staff had completed training in a range of areas that reflected their job role.

Staff received supervision and appraisals were on-going, providing them with appropriate support to carry out their roles.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. At the time of our inspection applications had been submitted by the managing authority (care home) to the supervisory body (local authority) and had yet to be authorised. The registered manager understood when an application should be made and how to submit one.

Where people lacked the mental capacity to make decisions the home was guided by the principles of the Mental Capacity Act 2005 to ensure any decisions were made in the person’s best interests.

People were involved in their care planning, and staff supported people with health care appointments and visits from health care professionals. Care plans were amended to show any changes, and care plans were routinely reviewed to check they were up to date.

People were treated with kindness. Staff were patient and encouraged people to do what they could for themselves, whilst allowing people time for the support they needed.

People knew who to talk to if they had a complaint. Complaints were passed on to the registered manager and recorded to make sure prompt action was taken and lessons were learned which led to improvement in the service.