Concord is registered to provide accommodation and personal care for people with learning disabilities and complex needs. The service is a residential assessment unit and provides self-contained flats for people. The aim of the service is to assess people and find them suitable long term care and accommodation. At the time of our inspection the service was providing support to four people.

At the last inspection, the service was rated Good.

At this inspection we found the service remained Good.

Why the service is rated good:

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

Risks to people were assessed and where required a risk management plan was in place to support people manage an identified risk and keep the person safe.

Staffing numbers were sufficient to meet people’s needs and this ensured people were supported safely. People told us they felt safe living at the service.

The provider ensured that new staff completed an induction training programme which prepared them for their role. Training was completed in essential matters to ensure staff and people at the service were safe. Staff were supported through a supervision programme.

People were supported to maintain good health and had access to external health care professionals when required.

Staff were caring towards people and there was a good relationship between people and staff. Staff demonstrated and in-depth understanding of the needs and preferences of the people they cared for.

Support provided to people met their needs. Supporting records highlighted personalised information about what was important to people and how to support them. People were involved in activities of their choice.

There were systems in place to assess, monitor and improve the quality and safety of the service. Staff described the registered manager as supportive and approachable. Comments from people confirmed they were happy with the service and the support received.

This inspection took place on 15 February 2015 and was unannounced. The previous inspection was carried out on 3 July 2013 and there had been no breaches of legal requirements at that time.

Concord Lodge is registered to provide accommodation and personal care and is a residential assessment unit. The service comprises of seven self-contained flats for adults who have learning difficulties and/or complex needs. People stay at Concord Lodge for around three months. However this may be longer as people stay until their assessment is completed and suitable long term care and accommodation can be found. At the time of our inspection there were six people using the service.

A registered manager was in post at the time of 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.

Staff received training to help them understand their obligations under the Mental Capacity Act 2005 and how it had an impact on their work. Staff we spoke with confirmed they had a good understanding. Within people’s support plans we found the service had acted in accordance with legal requirements when decisions had been made when people lacked capacity to make that decision themselves.

Staff had attended Deprivation of Liberty Safeguards training (DoLS). This is legislation to protect people who lack mental capacity and need to have their freedom restricted to keep them safe. One person using the service was subject to a DoLS authorisation. All documentation was appropriately completed that safeguarded the person’s human rights.

We found the provider had systems in place that safeguarded people. People we spoke with told us “Yes it is safe here. I would need to use the buzzer to go out the gate but I suppose it’s needed”.

There were sufficient staff numbers to enable them to perform their roles effectively. People who used the service told us they had no concerns with the numbers of staff on duty and felt they had sufficient one to one time and staff took them out when they needed support.

The provider had ensured that staff had the knowledge and skills they needed to carry out their roles effectively. Relevant training was undertaken and staff we spoke with were knowledgeable of people’s needs. One member of staff told us how they were supported to undertake further development training that enhanced their skills.

Systems were in place to safely manage people’s medicines. A policy was in place to guide staff through the process of ordering, stock control and the disposal of any unused medicines. One person told us how they were given their medicines by staff each day at the time expected in line with their prescription.

People were involved in reviews of their care needs to ensure that staff had up to date information about how to meet people’s needs.

People’s records demonstrated their involvement in their support planning and decision making processes. People we spoke with confirmed their involvement in the process and how staff respected their wishes.

Staff meetings and registered manager meetings took place with the service manager on a regular basis. Minutes were taken and any actions required were recorded.

Quality and safety in the home was monitored to support the registered manager in identifying any issues of concern. There were systems in place to obtain the views of people who used the service and their relatives. Satisfaction surveys were used when people left when they were asked to complete a questionnaire about the service they received.

The registered manager and senior staff were well respected was spoken of positively by staff and the people who used the service. Staff felt supported and guided in their role.

People were involved in making decisions about their care and support. We saw that people’s likes and dislikes were recorded in their care records. The environment had been adapted to meet people’s needs.

People were supported in promoting their independence and community involvement. One person told us that they visited their family regularly and was able to make regular phone calls.

People were admitted to the service stayed for a period of assessment lasting for 3 months. However, some people stayed at the service for a longer period of time whilst a suitable place was found for them.

We were told that people staying at the service were supported by a small team of staff that only worked with that person. This ensured consistency of support.

Staff were aware of how to report safeguarding adult concerns.

The service did not have a suitable policy or procedure in place around dealing with people who displayed aggressive behaviour. Risk assessments were in place for people and staff were aware of their responsibilities and only used physical intervention as a last resort.

Staff told us they were well supported by the management of the home and received regular training. We found that training in relation to physical intervention needed to be updated. The provider told us that they were currently arranging this training.

We found that the service had suitable arrangements in place to monitor the quality of the service.

We talked with four people who used the service, about the support and care they received.

We talked to three people’s relatives by telephone interview to seek their views of the care provided at Concord Lodge.

We talked with the registered manager of the service, the deputy manager, three care officers, the cook, and a domestic assistant. We talked with them about their roles and responsibilities and what how they supported people who used the service.

People had positive opinions about life at Concord Lodge. Examples of comments people shared with us, “I can go and see the manager”, “they are kind”. “I go out with the staff”.

People felt safe living at Concord Lodge. People were protected by suitable systems in the home to safeguard them from the risk of abuse.

People were being effectively supported with their needs by enough staff who were competent and caring in manner.

The overall quality of the service people received was being properly checked and monitored.

People were supported to make complaints about the service. When people were not able to make their views known they were supported by advocacy services when required.

People who use this service do so because their community support package had failed and they were admitted “in crisis”. The time limit for people living in the service is 3 – 6 months. Some of the people using the service had been resident for longer than this.

We were only able to met and speak to some of the people who were using the service when we visited. Others expressed their views that they did not want to speak to us. One person was away from the home attending their work placement.

Because of their complex learning disability, mental health or communication needs, people were unable to evaluate and discuss their care with us, but were able to make some short comments.

Staff we spoke with told us about each of the people who were using the service at the time of our visit. They were able to tell us how each person had chosen to be looked after and how they supported people and managed any challenging behaviours. They told us that each person needed different levels of support and that some people were being supported to continue with work or day care activities.

One person told us “I like it here. The staff are very kind to me and help me”. They said were happy with the care they were provided with and they were well looked after. This person looked content in the home and was relaxed in the company of the staff.

The service is non compliant with some parts of the care planning process. Health care action plans are not in place for all people who use the service, and there are no consistent measures in place to monitor the quality and safety of the service.