This inspection took place on 6 November 2018 and was unannounced.

New 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. New Lodge is registered for up to four people with either a learning disability and/or autistic spectrum disorders. At the time of the inspection four people were living at the service. The service was provided from a domestic-style house over two floors, each person having their own personal room. There were shared communal areas such as a lounge and dining area and kitchen and there was also a wet room on the ground floor.

At our last inspection in January 2016 we rated the service ‘good.’ At this inspection we found the evidence continued to support the rating of ‘good’, there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last 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.

There was a registered manager in post. 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.

Systems were in place to keep people safe and they were protected from abuse. People’s risks were identified and measures put into place to avoid harm, risk assessments were in place to ensure people’s safety and to support staff. Lessons were learnt as a result of incidents, accidents or feedback and improvements had taken place.

Staff had the knowledge, training and skills to effectively support people. People’s care needs were individually assessed and documented well. People were given choices and the service had made adaptations to meet people’s individual needs. The service was meeting the requirements of the Deprivation of Liberty Safeguards (DoLs). People received appropriate nutrition and hydration support to maintain their health and wellbeing. People had adequate access to health professionals. The home was appropriately adapted and decorated for people living there.

People were provided with individual care packages and regular reviews took place, involving people and their representatives. People’s interests were considered and there was a range of activities that took place within the community, promoting inclusion. People received person-centred care. People were not nearing the end of their life however consideration had been given to those who wanted to plan.

Staff knew people well and were compassionate and treated people with dignity and respect. People were given privacy at appropriate times and staff encouraged people’s independence as far as possible. People’s individual needs were considered and catered for.

We saw that the registered manager was visible and approachable in the home. They worked closely with the provider to ensure that the quality and continued improvement of the home was monitored.

Systems were in place to support practice and there was clear leadership at the service and plans in place to further improve the provision and overall experience for people who live there. The last CQC rating was being displayed and notifications were being submitted as required.

Further information is in the detailed findings below.

This inspection took place on 22 January 2016 and was unannounced.

The service provides accommodation and personal care for four people with learning disabilities. There were four people using the service at the time of the inspection. People who used the service were unable to communicate with us verbally due to their disabilities.

The registered manager had recently left the service and a new manager was due to start the following week. 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 safeguarded from abuse as staff knew what constituted abuse and who to report it to. Incidents of alleged abuse had previously been referred for further investigation when the staff had suspected abuse had taken place.

People were supported to be as independent as they were able to be through the effective use of risk assessments and the staff knowledge of them.

There were enough suitably qualified staff who had been recruited using safe recruitment procedures available to maintain people’s safety and to support people in hobbies and activities of their choice.

People medicines were stored and administered safely by trained staff.

Staff had a good knowledge of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). The MCA and the DoLS set out the requirements that ensure where appropriate decisions are made in people’s best interests where they are unable to do this for themselves. People’s capacity had been assessed and staff knew how to support people in a way that was in their best interest and was the least restrictive.

People and their representatives were involved in decisions relating to their care, treatment and support. Care was planned and delivered based on people’s preferences and regularly reviewed.

People were supported to have a healthy diet dependent on their assessed individual needs. People were given choices and asked what they would like to eat and drink.

People had access to a range of health professionals and staff supported people to attend health appointments when necessary.

People were treated with kindness and compassion and their privacy was respected. Staff supported people to be independent as they were able to be.

People had opportunities to be involved in the community and to participate in hobbies and interests of their choice.

Staff felt supported to fulfil their role effectively through regular support and supervision and training applicable to their role.

The provider had systems in place to monitor the quality of the service and an ongoing improvement plan.

On the day of our inspection four people were living at the home. People who used the service were not able to verbally communicate with us so we observed the support that people received. People appeared happy and comfortable in their surroundings. We spoke with two relatives who were happy with the care and support provided. We sampled care records and spoke with staff. They helped us to answer the five questions we always ask:

Is the service safe?

Is the service effective?

Is the service caring?

Is the service responsive?

Is the service well led?

This is a summary of what we found-

Is the service safe?

People were treated with respect and dignity by the staff. Care plans identified people’s needs and were reviewed regularly. Staff demonstrated a good understanding of people’s needs. People were given choices and supported to make decisions themselves. Risk assessments were in place and control measures identified. This meant that people’s needs were met and people were kept safe. Relatives we spoke with felt that people were safe at the home.

Documented procedures were in place for The Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). Relevant staff had been trained to understand when an application should be made and how to submit one. This meant that systems were in place to safeguard people as required.

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines. Only staff who had been trained administered medication.

People received care and support from staff who had the skills, experience and knowledge to meet people’s needs. Relatives we spoke with told us, staff were excellent.

Systems were in place to make sure that managers and staff learned from events such as accidents and incidents, complaints and concerns. Relatives we spoke with knew how to make a complaint and were confident their views would be listened to. This reduced the risks to people and helped the service to continually improve.

Is the service effective?

People experienced care and support that met their needs. People were supported to access the community. One relative said, “X is alright if they are able to access the community and participate in activities”. Another relative said, “I’m perfectly happy with the service now that teething problems have been resolved”. Records showed people, their relatives and professionals were involved in care reviews. One relative said, “They always let me know what is happening”. This meant that people’s relatives were encouraged to be involved in their care.

People who were able to, could move around the home freely and safely. Regular audits and checks took place. Any issues identified, which might affect people’s safety, were acted on. This meant the service had effective systems in place to identify improvements and continually meet people’s needs.

Is the service caring?

People were supported by kind and attentive staff. We saw that support workers showed patience and gave encouragement when supporting people. We saw people responded positively to staff. One relative said, “Staff do care”. Another relative said, “The staff are brilliant”.

People’s preferences, likes, dislikes and diverse needs had been recorded and care and support had been provided in accordance with people’s wishes. People were involved in their day to day care and were supported to maintain relationships that were important to them. People’s diversity and individuality were promoted and respected.

Is the service responsive?

We saw staff responded quickly to meet people’s needs and ensure people’s safety and dignity was maintained. For example, one person was prompted to adjust their clothing to maintain their dignity. We saw that people were supported to express their views and these were acted on. People had the opportunity to engage in activities both within the home and local community.

A copy of the complaints procedure was readily available. Relatives told us they were aware of how to make a complaint. We were told that no formal complaints had been received since our last inspection.

Is the service well-led?

The service worked well with other agencies and services to make sure people received their care in a joined up way. Staff felt supported in their roles and felt their views were listened too. Staff we spoke with told us it was a good staff team. A relative told us that the immediate staff team and manager were approachable.

The service had a quality assurance system. Quality audits were undertaken monthly and annually. These included environment checks. The service was due to undertake some interior painting. In addition to this a meeting was due to take place to ensure the home was meeting updated guidance related to The Deprivation of Liberty Safeguards. This meant the quality of the service was continually improving.

During our inspection we spoke with three members of care staff, the registered manager and the locality manager. People who used the service were unable to verbally communicate with us, so we observed the support that people received.

We saw that communication aids were used to enable people to be involved in making decisions about their day to day care. Staff respected people’s decisions, promoted people’s independence and enabled people to access their local community.

We saw staff were responsive to people’s needs and staff provided support in a caring, compassionate and professional manner.

Staff understood the systems in place to keep people safe and effective systems were in place to ensure that staff were suitable to work with the people who used the service.

The service was well led as systems were in place to continually assess and monitor quality, and plans were in place to ensure the service continually improved.

We spoke with the relatives of two people using the service and five members of staff. Relatives told us they were happy with the care being provided. One relative said, “Its important for X that he gets consistency. At the moment that’s what X is getting at New Lodge”. Another relative said, “Y is very settled now. Staff are brilliant with Y”.

During our inspection we saw that people were encouraged to make day to day decisions. We saw that where people were unable to make decisions for themselves the provider was acting in accordance with legal requirements.

We saw that people were supported to engage in appropriate community activities and purposeful activities around the home. People had access to health and social care professionals to ensure that there health and well being needs were addressed.

We observed people receiving care and treatment by staff who had the required knowledge and skills to provide the level of care that people needed. Care records were accurate and up to date.

We saw that medicines were stored, recorded and disposed of safely and that there was an effective complaints system in place to support people using and visiting the service.