About the service:

Jasper Lodge is a residential service, which provides accommodation and personal care for up to 11 adults living with learning disabilities and autistic spectrum disorders. Jasper Lodge provides accommodation for people in individual flats. At the time of our inspection there were 11 people using the service.

People’s experience of using this service:

People received care and support from a staff team who knew them well. People had a core support team, which meant there was consistency in who supported them, and this allowed for trusting and close working relationships to be formed.

People received their medicines safely, and staff understood people's individual support needs in that regard.

People received effective care that was in line with good practice. 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.

People's independence was encouraged as much as possible. People received person-centred care, which was tailored around their individual preferences, needs and wishes. People were encouraged to enjoy their hobbies and interests.

The staff team felt valued, motivated and positive about the running of the service. This helped to create a harmonious working and living environment, which benefited people living at Jasper Lodge. The provider's and registered manager's vision for the service were known and shared by the staff team.

The registered manager and provider routinely monitored the quality and safety of the care provided at Jasper Lodge, with feedback and complaints used as a way of making continuous improvements.

Rating at last inspection:

Good (report published 31 August 2016).

Why we inspected:

This was our scheduled, planned inspection based on previous rating

Follow up:

We will monitor all intelligence received about the service to inform the assessment of the risk profile of the service and to ensure the next planned inspection is scheduled accordingly.

More information is in detailed findings below.

The inspection took place on 6 and 8 July 2016 and was unannounced. Jasper Lodge provides accommodation for people unable to live in a shared home by offering individual flats. They provide accommodation and personal care for 10 adults with a learning disability or an autistic spectrum disorder. The people living at Jasper Lodge had a range of support needs.

There was no registered manager in post. A senior manager had been responsible for the service since March 2016 and a new manager had started the previous week that had been employed to be 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 responsibilities for meeting the requirements in Health and Social Care Act 2008 and associated Regulations about how the service is run.

The service was the subject of on-going monitoring by the local authority. This was because when they visited earlier in 2016 they found that the service required improvement. An action plan was put in place with specific actions required and a timeline for this. This was almost completed when we arrived for our inspection.

People were receiving care that was responsive and tailored to their needs. Care plans were in place that clearly described how each person would like to be supported. People had been consulted about their care and support. The care plans provided staff with information to support the person effectively. Other health and social care professionals were involved in the care of the people living at Jasper Lodge.

Safe systems were in place to ensure that people received their medicines as prescribed; however, not all medicines given had been signed for. The manager had devised an action plan to make sure this would not happen again.

We found the service was not always effective. Staff were not receiving regular supervision or support. Two appraisals had been carried out for any staff within the last 12 months. Staff received appropriate training which was relevant to their role. The service was adhering to the principles of the Mental Capacity Act 2005 (MCA) and where required the Deprivation of Liberty Safeguards (DoLS).

People using the service were positive about the care they received. We observed staff supporting people in a caring and patient way. Staff knew people they supported well and were able to describe what they like to do and how they like to be supported.

The service was well led. Quality assurance checks and audits were occurring regularly and identified actions required to improve the service; however there are still some improvements to be made. A senior manager explained to us how things will be improved. Staff, people and their relatives spoke positively about the changes in management.

From looking at the accident and incident reports, we found the registered manager was reporting to us appropriately. The provider has a legal duty to report certain events that affect the well-being of the people who live there or affects the whole service.

We used a number of different methods to help us understand the experiences of people using the service. Because people using the service had complex needs which meant they were not all able to tell us their experiences. We observed some staff interacting with people and spoke with staff about aspects of people's needs and examined their care records. Nine people were using the service at the time of the inspection and all required one to one support from staff due to their complex needs. Two people were able to tell us about activities they enjoyed.

We examined the care of two people in detail and we found they had comprehensive care and support plans in place. These were all individual to each person and contained text and pictures. Staff we spoke with about aspects of people's care demonstrated a very good knowledge. Where people were able they were encouraged to become involved in the planning and delivery of their care and support.

People had access to nutritious food that met their needs and personal choices.

The provider had an effective system in place to identify, assess and manage risks to the health, safety and welfare of people who used the service and others.

This inspection took place on 11 and 12 November 2014 and was unannounced. Jasper Lodge provides support for people unable to live in a shared home by offering individual flats. They provide accommodation and personal care for nine adults with a learning disability or an autistic spectrum condition. The people living at Jasper Lodge had a range of support needs. Some people could not communicate verbally and needed help with personal care and moving about. Other people were physically able but needed support when they became confused or anxious. Staff support was provided at all times and most people required the support of one or more staff away from the service.

There was a registered manager employed by the company but they were not available during our inspection. The person currently managing the service was the acting 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.

We found some breaches of our regulations. People’s rights under the Mental Capacity Act 2005 were not being consistently met although we did not find evidence people were being harmed as a result. People were at risk of receiving inappropriate care as some key records, including risk assessments, best interest decisions and support plans were not being routinely reviewed. Some staff required training identified as mandatory by the provider and training specific to the needs of the people they supported. We had not received relevant notifications from the service. Services tell us about important events relating to the service they provide using a notification. Until recently, quality audits had not been effectively used to identify areas for improvement, such as the storage of medicines. New quality checks were now being undertaken by the staff and the provider and the acting manager was open with us about elements of the service that still needed improving. You can see what action we told the provider to take at the back of the full version of this report.

Staff supported people in a caring and patient way. They helped people to become calm if they got anxious and helped people to do what they could independently. They knew people well and respected their preferences. Staff adapted their approach to suit people’s personalities and communication needs. They actively engaged people in conversations and were attentive to them at all times.

The staff and relatives told us the responsiveness of the service had improved since the acting manager had come to post. Staff felt more able to share concerns and were confident they would be listened to. The acting manager told us about changes she had made following feedback from people and staff. This included using agency staff until a full staff team had been recruited.