The inspection was carried out on 25 June 2018, and was an unannounced.

Steven 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.

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.

Steven Lodge is registered to provide accommodation and personal care for three people who need 24 hour care who prefer to live in a small home. The people who use the service needed support to undertake life skills and be safe in the community. At the time of our inspection, the people who lived in the home were able to do somethings on their own and required support from staff to do other things.

At the last Care Quality Commission (CQC) inspection on 15 December 2015, the service was rated Good.

At this inspection we found the service remained Good.

The service did not have effective systems in place to assess, monitor and improve the quality and safety of the services provided at the time we inspected. However, a new quality audit document was being implemented which mirrored CQC key lines of enquiries. This would ensure robust monitoring of the service by the registered manager.

The registered manager had not kept their policies up to date with new developments in social care. We have made a recommendation about this.

People continued to be safe at Steven Lodge. Staff knew what their responsibilities were in relation to keeping people safe from the risk of abuse. The provider continued to follow safe recruitment practice. They had introduced new application form to rectify gaps. Medicines were managed safely and people received them as prescribed.

Staff encouraged people to actively participate in activities, pursue their interests and to maintain relationships with people that mattered to them.

People received the support they needed to stay healthy and to access healthcare services.

People and staff were encouraged to provide feedback about how the service could be improved. This was used to make changes and improvements that people wanted.

There were enough staff to keep people safe.

Each person had an up to date support plan, which set out how their care and support needs should be met by staff. These were reviewed regularly.

Staff received regular training and supervision to help them to meet people's needs effectively.

People continued to receive support to eat and drink enough to meet their needs.

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.

Staff showed they were caring and they treated people with dignity and respect and ensured people's privacy was maintained.

People said that they could contact the registered manager and staff at any time, and they felt confident about raising any concerns if they wish to. The registered manager ensured the complaints procedure was made available if people wished to make a complaint.

You can see what action we told the registered provider to take at the back of the full version of this report.

We inspected this home on 15 December 2015. This was an unannounced inspection.

Steven Lodge is registered to provide accommodation and personal care for two people who need 24 hour care who prefer to live in a small home. The people who use the service needed support to undertake life skills and be safe in the community. At the time of our inspection, the people who lived in the home appeared fairly independent; however gentle prompting had been necessary to complete everyday tasks.

There was a registered manager at the home who was also the provider. 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.

The people who used this service were protected against the risk of abuse; they felt safe and staff recognised the signs of abuse or neglect and what to look out for. They understood their role and responsibilities to report any concerns and were confident in doing so.

The home had risk assessments in place to identify and reduce risks that may be involved when meeting the people’s needs. There were risk assessments related to the people’s day to day care and details of how these risks could be reduced. This enabled the staff to take immediate action to minimise or prevent harm to the people.

There were sufficient numbers of suitable staff to meet the people’s needs and promote their independence and safety. Staff had been provided with relevant training and they attended regular supervision. Staff were aware of their roles and responsibilities and the lines of accountability within the home.

The registered manager promoted a safe recruitment practice, which ensured staff were suitable for their job role. Staff described the management as very open, supportive and approachable. Staff talked positively about their jobs.

We spoke to the people about their experiences of living at the home. It was apparent staff had developed very positive relationship with both people who used the service.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The registered manager understood the requirements of the Mental Capacity Act 2005 and Deprivation of Liberty safeguards and the home complied with these requirements.

The systems for the management of medicines were followed by staff and we found that the people received their medicines safely. They also had good access to health and social care professionals when required.

People had been involved in assessment and care planning processes. Their support needs, likes and lifestyle preferences had been carefully considered and were reflected within the care and support plans available.

People were always motivated, encouraged and supported to be actively engaged in activities inside and outside of the home. For example, the people went out to their local community most days of the week for activities, including visiting the local church for services and activities.

A health action plan was in place and the people had their physical and mental health needs regularly monitored. Regular reviews were held and the people was supported to attend appointments with various health and social care professionals, to ensure they received treatment and support as required.

Feedback was sought from the family and the people and used to improve the care. The people knew how to make a complaint and a copy of the ‘how to complain’ was available in the home. No complaints had been received but it was evident that there was a very inclusive relationship with the people’s family.

The registered manager regularly assessed and monitored the quality of care to ensure standards were met and maintained. The registered manager understood the requirements of their registration with the commission.

Our inspection team was made up of an inspector, during this visit we were able to answer our five questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with the staff supporting people who used the service and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

One person we spoke with at the home told us “I feel safe here, the staff are kind and they look after me well”

We saw that people who lived in the home were treated with respect and dignity by the staff. Systems were in place to make sure that the manager and staff team learn from events such as accidents and incidents. There were risk assessments and instructions for staff on how to reduce risk in place which were reviewed regularly. This reduced the risks to people and helped the service to continually improve.

The home had policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards. We found that staff had received training and understood their responsibilities in regard to this.

The service was safe, clean and hygienic.

The home was clean and well maintained and there were systems in place to monitor the cleaning of the home. Policies and procedures such as infection control and bodily fluid spillage were available to staff, these gave instructions to staff about how to keep people safe and reduce the risk of infection.

Staff had received training to help them keep people safe, they included safeguarding vulnerable adults, infection control and food hygiene.

Is the service effective?

People’s health and care needs were assessed with them, and they were involved in writing their plans of care. We spoke with staff and they had a very good understanding of peoples agreed needs and the support that they were to provide. People’s needs were taken into account when organising outings and other in house activities.

We spoke with the people who lived in the home, they confirmed that they received the care and support that they had asked for and that was in their care plan. One person said that they were involved in the care plan with their family and care manager, they said “Staff always ask me before they help me, and I get to say what I want help with”. This showed the care planning system was effective.

The home also had systems in place to ensure the day to day running of the home, for example all items in the fridge were labelled when they were opened and when they needed to be disposed of by. Staff completed a schedule each week which also checks for example food in tins and packets to ensure they are in date and safe for people to eat.

Is the service caring?

We spoke to the two people who lived in the home at the time of our visit. One person said, "I am happy here, the staff help me a lot”. The other person also told us they liked to live in the home, they said “Staff are all nice to me, they look after me, they make sure I am ok”.

People were supported by kind and attentive staff. We saw that care workers showed patience and gave encouragement when supporting people.

People’s preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people’s wishes. For example one person said, “I do like to go to church sometimes, I don’t go every week but the staff never mind taking me when I want to go”.

Is the service responsive?

We found that staff listen to the people they cared for, for example one person said they would like a Chinese meal as they had not had one for a long time. The staff member arranged a Chinese take away on the menu for the following week.

We also saw in the daily records that when people who lived at the home were not well they made appointments with the persons GP, and followed the instructions they were given.

Is the service well-led?

The staff and the manager listened to the people who lived in the home and what they liked to do and there capabilities. The people were put first in the way the home ran day to day.

The service worked well with other agencies and services to make sure people received their care in a joined up way.

The service has a quality assurance system, records seen by us showed that identified shortfalls were addressed promptly. As a result the quality of the service was continuingly improving.

Staff told us they were clear about their roles and responsibilities. Staff had a good understanding of their role within the home and the quality assurance processes which were in place. This helped to ensure that people received a good quality service at all times.

We visited the home and found that there were two people who lived there, with one vacancy. We looked at documents, records, spoke to one person who lived in the home and a staff member. People were asked for their consent before care and support was provided.

We found the people care and support needs had been assessed and there was a detailed plan and risk assessments in place. People and other health professional had been involved in the care and support plans.

The home was clean and systems were in place to reduce the spread of infection.

There was a complaints policy and procedure in place. The person we spoke with was happy that if they had concerns, these would be taken seriously and acted upon.

People said they liked living at Steven Lodge. They said there were different activities to do and that they could join in with activities if they wanted to. They said they were happy with the support they received, and that the staff looked after them well. People said they liked the food, there was a choice of menu and that they were able to choose where to eat. They said they knew who to speak to should they have any concerns, but said they had no complaints.

We observed that people living at the home were relaxed and comfortable, for example by choosing whether to sit in the lounge or their room, or by approaching staff if they wanted something. We saw that people living at the home were able to express their choices verbally or non-verbally to show whether they wanted to join in an activity and what their choice of food and drinks were.

We saw that support plans were individually tailored to each person’s needs, and were reliably updated and maintained.

We looked at staff recruitment procedures, and found that these were carried out appropriately.

We viewed all areas of the home during the inspection visit and saw that they were visibly clean and well maintained.

The person using the service said that they liked living at the home, they liked the staff and enjoyed the activities they took part in.