Queens Lodge is a care home located in Eyres Monsell, Leicester. It provides support for up to four people who have a learning disability or autistic spectrum disorder. At the time of our inspection there were four people living at the service. At the last inspection in August 2015, the service was rated Good. At this inspection we found that the service remained Good.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 told us they felt safe living at Queens Lodge. Relatives agreed that people were safe living there. People remained safe from avoidable harm because the staff team knew their responsibilities and the actions to take if they suspected someone was at risk of abuse or harm. Risks associated with people’s care and support had been assessed and these were being monitored on a regular basis. Appropriate recruitment processes had been followed when new members of staff had been recruited. There were sufficient numbers of staff deployed to meet the care and support needs of the people living there. People continued to be supported with their medicines safely and in a way they preferred. There were appropriate systems in place to audit the management of medicines.

The staff team were appropriately trained and were supported by the management team through supervisions, appraisals and staff meetings. They were aware of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS) ensuring people’s human rights were protected. People had access to relevant healthcare services and were supported to attend appointments when required. People had been involved in developing menus to include their own likes and preferred choices and their dietary requirements had been identified.

The staff team were kind and caring and treated people with dignity and respect. People’s independence was promoted and they were supported to make choices about their care and support.

People were supported in a way they preferred because plans of care had been developed with them and with people who knew them well. The staff team knew the needs of the people they were supporting well because they had read their plans of care. People knew what to do if they had a concern and they were reminded of this through meetings and conversations with the staff team.

Staff members felt supported by the management team and told us there was always someone available to talk with should they need guidance or support.

People's views of the service were sought through meetings and informal chats. Surveys were also used to get gather people’s thoughts and suggestions of how the service could be improved. Systems were in place to monitor the quality of the service being provided.

Further information is in the detailed findings below

This inspection took place on 10 August 2015 and was unannounced.

Queens Lodge is registered to provide residential care and support for four people with a learning disability who present behaviours which challenge people us and who have complex needs. At the time of our inspection there were four people using the service.

The service is purpose built and provides accommodation over two floors. The ground floor comprises of a kitchen and an open plan lounge and dining area that provides access to an enclosed patio area. The first floor which is accessible via a stairwell or passenger lift leads to four bedrooms all with en-suite facilities.

Queens Lodge had 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.

Staff told us that training had helped them to understand the needs of people, which included their right to make decisions about their day to day lives. Staff were confident that if they had any concerns about people’s safety, health or welfare then they would know what action to take, which would include reporting their concerns to the registered manager or to external agencies.

People were supported by knowledgeable staff that had a good understanding as to people’s needs. Staff provided tailored and individual support to keep people safe and to provide support when their behaviour became challenging.

People received their medicines in a timely manner and the medicine they were prescribed was regularly reviewed by a doctor.

People were in the main protected under the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). We found DoLS were in place for two people and that applications had been submitted to the appropriate supervisory body for consideration. We found that mental capacity assessments had not been carried out for one person where restrictions had been placed on them. The registered manager confirmed these would be undertaken as a matter of urgency.

People were supported to have sufficient to eat and drink and recommendations from health care professionals were followed. People were supported to access a range of health care appointments by staff to ensure their health was monitored and maintained. Staff were proactive in responding to people’s health care needs and liaising with health care professionals effectively.

The attitude of the registered manager and staff showed they were enthusiastic about their work and committed to providing the best possible care for all those who used the service. All were aware of each person’s individual needs. Staff appeared caring, friendly and talked about their work and were well informed about those using the service.

There were effective systems in place for the maintenance of the building and equipment which

ensured people lived in an environment that was well maintained and safe. Audits and checks were effectively used to ensure people’s safety and needs were being met, as well as improvements being made as required. People’s representatives and staff had the opportunity to influence the service, which enabled the provider to review and develop the service.

We haven't been able to speak to people using the service because of their complex needs. We gathered evidence of people's experiences of the service by reviewing people's records, observing people's daily life experiences and by speaking with staff.

We saw people being supported by staff to make decisions about their daily lives, which included encouraging them to take part in household chores. People were supported by care staff to go out into the local community and to take part in activities within the home. One person helped a member of staff to dry the pots following breakfast and later had a game of cards; they also enjoyed singing along to music before in the afternoon going out to have their hair cut. A second person spent time with a member of staff having their hair styled and make up put on.

People’s needs and the support they required were recorded within care plans. People were supported by a range of health and social care professionals in the monitoring of their health and wellbeing. Staff we spoke with had a good understanding of the needs of people and supported them to ensure their rights were upheld. This included using legislation to ensure people’s best interests were promoted and maintained.

Records we viewed confirmed staff had undergone an effective recruitment and selection process. We viewed records which showed the service had effective systems for the maintenance of the property.

We haven’t been able to speak to people using the service because of their complex needs. We gathered evidence of people’s experiences of the service by reviewing people’s records, observing people’s daily life experiences and by speaking with staff.

We saw people being supported by staff to make decisions about their daily lives, which included encouraging them to take part in household chores. People were supported by care staff to go out into the local community and to take part in activities within the home.

People were supported to understand important information which included the fire procedure and complaints procedure along with the menu and organised activities by producing the information using large print, pictures and symbols.

People had a range of comprehensive assessment and care plans which detailed the care and support they needed. Records showed people were supported to access health care services where required and that their health was monitored by care staff.

Records showed people using the service were supported by staff who underwent regular supervision, appraisal and training which meant staff were able to meet their care and welfare needs.

The provider had an effective quality assurance system which monitored the day to day running of the service which included environmental and health and safety checks, along with systems to ensure records were used effectively.