Garland Lodge

Updated 19 February 2022

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

A single inspector visited the service on 09 December 2020 and an expert by experience made phone calls to people and their relatives to seek their views about the service. 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

This service provides care and support to people living within three ‘supported living’ settings. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

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

We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 09 December 2021 and ended on 15 December. We visited the office location on 09 December 2021.

What we did before the inspection

Before the inspection we reviewed the information we held about the service. This included details about incidents the provider must tell us about, such as any safeguarding alerts that had been raised. 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 sought feedback from commissioners and the local authority safeguarding team. We took this into account when we inspected the service and made the judgements in this report. We used all this information to plan our inspection.

During the inspection

We spoke with three people and six relatives of people who used the service about their experience of the care provided. We spoke with four members of care staff, the registered manager, and the area manager. We reviewed a range of records. This included six people’s care records, four staff files in relation to recruitment and a variety of records relating to the management of the service, including policies and procedures.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at staff rotas, staff recruitment and training records, medicine administration records, risk assessments, and quality assurance records, including policies and procedures were reviewed.

Updated 19 February 2022

Garland Lodge provides care and support to people living in a supported living setting so that they can live as independently as possible. At the time of the inspection, 11 people were using the service. CQC does not regulate premises for supported living; this inspection looked at people’s care and support.

The service consistently applied the principles and values of Registering the Right support, right care, right culture and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

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

Improvement was required to protect people from the risk of avoidable harm. Pre-employment staff checks were not satisfactory. The quality assurance process was not robust to identify these concerns and to make improvements in a timely way.

We made four recommendations about assessing staff dependency levels and deployment, comprehensive staff guidance in care plans on how to support people, promoting privacy, dignity and independence, and care records in easily accessible formats in line with Accessible Information Standards.

People and their relatives gave us positive feedback about their safety and told us staff treated them well. The service had systems and processes in place to administer and record medicines use. People’s care plans reflected their current needs; however, some care plans were not detailed with sufficient guidance for staff. People were protected from the risk of infection. The provider had a system to manage accidents and incidents.

Staff received support through training, supervision and staff meetings to ensure they could meet people’s needs. Staff told us they felt supported and could approach the management team members at any time for support. The provider worked within the principles of Mental Capacity Act (MCA). Staff asked for people’s consent, where they had the capacity to consent to their care. 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.

An assessment of people’s needs had been completed to ensure these could be met by staff. The management team and staff worked with other external professionals to ensure people were supported to maintain good health. People and their relatives were involved in making decisions about their care and support. People were treated with dignity, and their privacy was respected, and supported to be as independent in their care as possible.

Staff showed an understanding of equality and diversity. Staff respected people’s choices and preferences. People knew how to make a complaint. The registered manager knew what to do if someone required end-of life care.

There was a management structure at the service and staff were aware of the roles of the management team. They told us the management team members were supportive and approachable. The management team members and staff worked as a team and in partnership with a range of professionals and acted on their advice.

Rating at last inspection and update

This service was registered with us on 27/07/2020 and this is their first inspection.

Why we inspected

This was a planned comprehensive inspection.

Enforcement

We have identified breaches in relation to safe care and treatment, fit and proper persons employed, and good governance.

Please see the action we have told the provider to take, at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk