The inspection of Fixby Lodge took place on 25 and 26 April 2018. This is the service’s first rated inspection since their registration with the Care Quality Commission on 26 June 2017. Fixby 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 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.
Fixby Lodge provides care for adults who are living with a learning disability. The home has a maximum occupancy of 8 people. On the day of our inspection six people were residing at the home.
The service had a registered manager in place. 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.
There were systems in place at Fixby Lodge to keep people safe. Information regarding safeguarding was easily accessible and was provided in a suitable format. Staff were able to recognise signs of potential abuse and knew how and where to report any concerns. Care records contained a variety of risk assessments and where a risk was identified, actions had been taken to reduce the potential for harm.
The home and equipment was clean and well maintained. Staff received regular training to enable them to take appropriate action in the event of a fire.
Staff recruitment procedures were robust and there sufficient staff employed on a daily basis to enable people’s needs to be met and for people to partake in social activities both inside and external to the home.
Medicines were managed safely and staff with responsibility for administering medicines received training and an annual assessment of their competency was completed.
New staff completed a programme of induction, training and supervision were ongoing to ensure staff had the skills, knowledge and attributes to deliver effective care and support to people.
People had a choice of hot and cold drinks, snacks and fruit. Menus were varied and people received support appropriate to their needs to enable them to eat and drink.
Staff communication was effective, this included working with other healthcare professionals, ensuring people received ongoing healthcare support to meet their needs. In the event a person was admitted to hospital, a member of staff remained with them so they received ongoing support from someone who knew them well.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The home worked within the principles of the Mental Capacity Act 2005 and where people had been deprived of their liberty, the home had requested DoLS authorisations from the local authority in order for this to be lawful.
Each relative we spoke with expressed very positive feedback about the staff at Fixby Lodge. Staff told us they enjoyed working at the home and during the time we spent at the home we found the atmosphere to be consistently welcoming and homely as well as being professional. Staff involved people in their conversations; we saw staff enabled people to make choices and decisions. We also saw staff respected the choices made by people.
Relatives felt involved in all aspects of their family members care and support. Care and support plans evidenced a variety of people who had provided input into the development of peoples care and support plans.
It was clear that privacy and dignity were at the heart of the services culture and values. Discussions around this topic began at recruitment and continued through the induction process, helping to ensure this culture was embedded in all staff. This promotes staff awareness and reduces the risk of discriminatory practices.
The registered manager and staff were highly responsive to people’s individual interests and how they wished to lead their life. Staff supported people were supported to engage in a wide range of activities and people were enabled to maintain contact with family and friends, empowering people, promoting self-esteem and self-worth. Care plans were person centred and detailed people’s care and support needs, as well as their likes and dislikes. Care plans were reviewed and updated on a regular basis to ensure they were reflective of people’s current requirements.
Information regarding how to complain was available and relatives told us in the event they were dissatisfied, they would speak with the registered manager.
Relatives and staff were positive about the management of the home. There was a system of governance in place. The organisation had recently achieved external accreditation regarding their management and development of staff. Feedback was gained from people who used the service and staff on a regular basis.