Sennen Lodge

We found the following examples of good practice.

Staff had taken a pragmatic approach to encouraging social distancing. They had considered people’s needs and the impact of implementing measures which people did not understand or may find distressing. This was a balanced approach which considered both safety and wellbeing.

The provider had taken appropriate steps to help people access Covid-19 testing where possible and in their best interests. The provider had supported people to overcome barriers around understanding and apprehension to testing. There was a Covid-19 testing programme in place for staff.

There were risk assessments and contingency plans in place to mitigate the impact of a Covid-19 outbreak at the home. This included adapting areas of the home to create different communal spaces and encouraging people to isolate.

The home was clean and hygienic. The provider had implemented policies of enhanced cleaning focussing on high contact areas such as door handles. This helped minimise the risk of infections spreading. Staff had also received specific training in relation to Covid-19.

Due to the complexity of people’s needs, the service was particularly vulnerable to the impact of workforce pressures. The registered manager and staff had worked to mitigate these risks but told us it was challenging maintaining the good quality of care in these circumstances.

There was a good supply of personal protective equipment (PPE) available. We observed staff wearing appropriate PPE in the correct way.

Sennen 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.

Sennen Lodge is a care home that provides accommodation for up to eight adults with a learning disability. There were eight people living at the home when we visited. The home is based on two floors. The second floor was accessible via stairs. There were communal rooms and a garden which people could access. All rooms were single occupancy. At the time of inspection there were six people living at Sennen Lodge.

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 to help ensure people with learning disabilities and autism using the service can live as ordinary a life as any citizen.

At the last inspection August 2017, we found a breach of regulations 17, 18 and 19 of the Health and Social Care Act (Regulated Activities) Regulations 2014. This was in relation to safe recruitment practices, staff training and systems to monitor the quality and safety of the service. During this inspection we found improvements had been made and the service had met the requirements of these regulations.

The service had a registered manager in place 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 2008 and associated Regulations about how the service is run.

The registered manager started in their role since our last inspection. They had overseen the effective implementation of improvement plans, which addressed the key areas where the service required improvement. People’s relatives and professionals told us the registered manager was competent, approachable and had significantly improved the service since they started in their role.

People’s relatives told us they were kept informed about their family members care and that they were involved in making decisions where appropriate. People’s needs were fully assessed to help ensure they received an appropriate level of care. Where people had external professional input into their care, the provider implemented recommendations to help ensure appropriate plans of care were in place.

There were systems in place to ensure staff had the right training, induction and supervision in their role. The registered manager monitored staff’s working practice and behaviours, providing additional support where necessary.

Staff understood people’s needs and were confident in providing support around people’s personal care, communication and behaviour. Staff were caring and attentive to people and treated them with dignity and respect.

There were sufficient numbers of staff in place to meet people’s needs. The registered manager had successfully recruited many new staff since our last inspection in August 2017. The provider had made improvements to its recruitment processes to help ensure that only suitable staff worked with people.

The provider had made improvements to its quality assurance system to help ensure the registered manager could effectively monitor the quality and safety of the service.

Risks to people were assessed and mitigated. The registered manager analysed incidents to put measures in place to reduce the risk of reoccurrence.

Staff understood their responsibilities in safeguarding people from abuse and harm. The registered manager provided strong leadership in this area and was transparent with relatives and other stakeholders when concerns arose.

There were systems in place to ensure people’s complaints were dealt with appropriately. The registered manager welcomed people’s feedback and listened to their opinion.

People’s care plans gave detailed information about people’s preferences, routines, behaviour and communication needs. People were supported to make choices about everyday decisions in a way which they understood. People received care that was designed with their preferences and needs in mind.

People were supported to live active lives, participating in a range of activities and staff encouraged them to develop their independent skills.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

There were systems in place to help ensure the safe management of medicines. The provider was committed to working with people and professionals to reduce the amount of medicines people required where appropriate.

People had access to healthcare services. Where people were reluctant to engage in healthcare appointments, staff worked with them to reduce their anxieties about these events. No-one was currently receiving end of life care. People followed a diet in line with their preferences and needs.

The environment at Sennen Lodge was suitable to meet people’s needs. Since the last inspection in August 2017, the registered manager had made improvements to the environment to make it brighter, more homely and comfortable for people. The home was a clean and hygienic environment and the provider had effective infection control policies in place.

Sennen Lodge is a care home that provides accommodation for up to eight adults with a learning disability. There were eight people living at the home when we visited. The home is based on two floors. The second floor was accessible via stairs. There were communal rooms and a garden which people could access. All rooms were single occupancy.

The service did not have 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. The registered manager had recently resigned. A new manager had been appointed at the time of our first inspection visit on 12 July 2017, and had started work at Sennen Lodge on 31 July 2017.

People were at risk of receiving unsafe or inappropriate care because the service did not always robustly risk assess and consider an appropriate induction into the service for staff where areas of concern arose from their pre-employment checks. The provider had made changes to their recruitment policy to make the process safer and more robust, but these had only recently been introduced and therefore were not embedded within the service.

People were at risk of receiving unsafe or inappropriate care because not all staff had consistently received supervision and induction training to help their effectiveness in their role and monitor their behaviours and working practice.

There were systems in place to monitor the quality of the service. These included regular audits, competency assessments of staff and an internal inspection from the provider’s quality team. However these audits and checks were not always effective in driving or sustaining improvements.

There were systems and processes in place for identifying, reporting and recording concerns. However incomplete records meant we could not be sure all staff had completed training in safeguarding or that they put their learning into practice.

Staff we saw at the service were kind, considerate, patient and caring. There were adequate numbers of staff available.

Risks relating to people’s health and medical conditions were assessed, monitored and managed. Risk assessments looked for ways to reduce risks associated with activities, enabling people to pursue their interests. People had access to a range of different activities according to their preference. This included activities inside the home and in the community.

The environment at Sennen Lodge was busy, but the provider had made adaptations to the building to provide quieter spaces for people if they wanted. The provider had also made adaptations to the garden and kitchen which helped enable people to participate in activities in these areas.

People’s care plans were detailed and included information around effective ways for staff to provide support and respect people’s preferences. They were regularly updated when people’s needs changed and also included details relating to healthcare services and dietary requirements. The service had successfully worked in partnership with other stakeholders to enable people who were reluctant to attend healthcare appointments to access these services.

We identified three breaches of regulations. You can see the action we told the provider to take at the end of the full version of this report. Full information about CQC’s regulatory response to any concerns found during inspections is added to reports after any representations and appeals have been concluded.