This inspection took place on 11 September 2018 and was unannounced. At our last inspection visit in June 2017 the service was rated as required improvement, but there were no breaches of the legal requirements.

Charnwood 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.

Charnwood Lodge accommodates a maximum of 17 people in one adapted building. The home was registered with the CQC prior to the CQC’s publication of ‘Registering the Right Support’ guidance for homes for people with learning disabilities and autism. This recommends that homes should cater for a maximum of six people. The provider had tried to reduce the need for people to use large communal areas by providing cooking facilities and eating and sitting areas in each person’s ‘flat’ or bedroom so they did not have to engage with a larger group of people if they do not wish to.

At the time of our visit, 16 people lived at the service.

The service had been through a challenging period. Issues related to the previous management team had resulted in staff leaving the service. Temporary management had been put in place whilst the provider sought to stabilise the staff group and make improvements.

A new manager had recently started at the service and intended to apply for registration with the CQC. 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.

A person who lived at the home, had behaviours which had become increasingly challenging to staff and to people who lived at Charnwood Lodge. This had left people and staff not feeling or being safe, as staff did not have the skills to support the person. This person had recently moved to a different service and people and staff were beginning to feel safe again.

There were enough staff on duty to keep people safe. There had been a high number of agency staff working at the service, but this was now decreasing and people had started to experience more continuity of care. Staff recruitment procedures reduced the risks of the provider employing people unsuitable to work in care.

People’s opportunities to undertake activities outside the home had been curtailed because of staffing issues; and there had been limited activities for people within the home environment. This was beginning to improve with more continuity of staff; and the appointment of a person to support activities within the home which reflected people’s interests and wants.

Medicines were managed safely and people were supported to receive healthcare when necessary. The risks related to people’s health and well-being was known by the staff group. Records informing of risks were in the process of being updated.

The premises were mostly clean but there were areas of the home which were dirty, and the laundry area did not fully comply with good practice guidance for infection control. The provider acted to put this right on the day of our visit.

Staff had not previously supported people with end of life care, but recently had received in-house training to support them in delivering this care.

The provider and new management team were improving the quality of life for people who lived at the home, and the confidence of staff in supporting people. They were addressing safety issues and improving the management of the service.

Staff understood the policies and procedures for safeguarding people from harm. They had received training to support them in their role, and were feeling more supported in their work by the new management team.

People were supported to have maximum choice

This comprehensive inspection that took place on 15 June 2017. The inspection was unannounced. We returned announced on the 22 June 2017

Charnwood Lodge provides residential care and support to up to 17 people with learning disabilities and mental illness. At the time of our inspection there were 17 people using the service.

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.

People were not always protected from abuse. We saw that incidents had occurred where people’s behaviour had negatively impacted on other people using the service. Staff understood their responsibilities to protect people from abuse and report concerns.

There were enough staff to keep people safe. Staff have been recruited following safe recruitment practices.

Staff understood how to support people to remain safe when they displayed behaviour which could harm. Risks associated with people’s support needs were assessed and action taken to minimise the risk of avoidable harm.

People usually received their medicines as prescribed by their doctor. People had access to health care professionals and were supported to meet their health needs.

The registered manager understood their responsibility to ensure people were supported in line with the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS). Consent was sought from people to provide their care.

Staff received training and guidance to carry out their role. They had a clear understanding of their role and how to support people who used the service as individuals.

People enjoyed their meals and were supported to have sufficient to eat and drink.

People were treated with kindness and respect. Their independence was promoted and they were offered choices about the things that were important to them.

People were supported to maintain links with people who were important to them. They had access to independent support if they needed it.

People received care and support that was tailored to their individual needs. People were asked for feedback about the support that they received to ensure that it was delivered in the way that they wanted it.

The registered manager and staff team were working to support people to engage in activities that were meaningful to them.

People who used the service felt they could talk to the registered manager and had confidence concerns would be acted upon. Staff were clear of their role.

There were systems in place for gathering information about the service and identifying areas of concern. These were not always effective in identifying concerns or action was not always taken in a timely way.

People’s relatives expressed concern about the high turnover of staff. The registered manager was working on a recruitment and retention plan to address this.

The registered manager was aware of their responsibility to report events that occurred within the service to CQC and external agencies.

We carried out our inspection on 17 March 2016. The inspection was unannounced.

Charnwood Lodge provides accommodation for up to17 adults who require personal care and support. People who use the service live with a mental health diagnosis and/or learning disability.

The service had a manager who had applied to the Care Quality Commission to become the 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 and associated Regulations about how the service is run.

People felt safe at Charnwood Lodge. Staff had a good understanding of the provider’s procedure to keep people safe from harm and abuse. Staff told us they would report any concerns firstly to the manager and deputy manager. The managers referred concerns to relevant authorities. Staff also knew the external agencies that they could contact if they were concerned about people’s safety.

People had the appropriate level of staff support to meet their assessed needs. The provider completed relevant pre-employment checks which assured them that staff were safe to work with people.

We reviewed people’s records and carried out observations which showed that people received their medicines as prescribed by their doctor.

Staff had effective training and support that equipped them with the skills they required to look after people.

Staff understood the Mental Capacity Act (MCA) 2005 and how they would practice it in their role. They supported people in accordance with relevant legislation and guidance.

People were supported with their nutritional and health needs. They had access to a variety of healthy meals that they enjoyed. They also had prompt access to healthcare services when they needed them.

People were complimentary of the caring attitudes of the staff that supported them. Staff treated people with respect and promoted their dignity and human rights. They also promoted people’s right to privacy.

Staff provided the information and support that people required to make their own choices. They worked collaboratively with other professionals to enable people to make decisions about their own care and support.

People’s care plans reflected their individual needs. Their care plans included comprehensive details of how they would like to receive their care and support. Staff supported people as they had requested stated in their care plans.

People and their relatives have various opportunities to raise any concerns they had about the service they received. We saw that staff actively encouraged people to do so.

People that used the service, their relatives and the staff all had confidence in the manager and how the service was run. Staff had a shared commitment to provide an inclusive service to people.

The provider had quality assurance systems to monitor the quality of the service.

We spoke with three people who use the service. Although the people we spoke to had limited verbal communication they were all able to indicate that they were happy with the care and support they received at Charnwood Lodge. We also spoke to four staff members.

We found people were able to make informed decisions about their care and support. One person told us, ”It’s good here. I have a key to my room, so I can lock my room when I go out.”

We found people experienced care and support that met their needs and protected their rights. We found people’s care needs had been assessed. Care and support was delivered in a way that met people’s needs and ensured their safety and welfare.

People were protected from the risk of abuse and staff knew how to raise any concerns. We found the provider had up to date policies in place relating to the safeguarding of vulnerable adults, and whistle blowing.

We found there was a clear and up to date recruitment procedure in place that was followed by the service. This meant that people were cared for, or supported by, suitably qualified, skilled and experienced staff.

We found systems were in place to regularly obtain people's views about the care and service they receive. We found the provider had an effective system in place to identify, assess and manage risks to the health, safety and welfare of people using the service.

Some people living at Charnwood Lodge had limited communication and were unable to answer direct questions about some of the essential standards we reviewed. We did speak with two people and asked some questions. They told us they liked the home and staff. One person said” I am doing well in my life and staff help me. I am going on holiday next week with my keyworker” Another person told us, “I am treated respectfully.”

We saw people in the lounges dusting and polishing surfaces. Some people told us they cleaned their own bedrooms and were assisted with their laundry and trying to be independent.We observed staff interacting with people in a professional, positive and respectful way. Staff involved people and offered people choices about their care, treatment and support provided.

Some of the people we saw during or visit were unable to give their views about the service verbally due to their disabilities. However we observed them taking part in activities, and interacting with staff.

We saw staff working calmly with people offering one to one support. The number of staff and hours required to work with people was set out in their care plans.

One staff member was seen prompting a person to tidy their apartment. Another person was playing board games with a staff member.

People are consulted through the “Your Voice” which encourages people to represent their views and make decisions about the running of the home.

There are other projects people can get involved in. A farm project, an allotment and a Japanese garden.