This inspection took place on 11 May 2017 and was unannounced. We returned on 12 May 2017 announced to complete the inspection.

The Ark Care Lodge provides residential care for up to 18 people with a learning disability and/or autistic spectrum disorder and who may present behaviours that challenge services. People lived in two private dwellings adjacent to each other in a residential area. At the time of our inspection there were 18 people using the service.

At our last inspection on 9 February 2016 the service was rated as requires improvement. We found two breaches of regulations in relation to the safe staff recruitment process and systems to effectively monitor the quality of service provided and the service had also no registered manager. We asked the provider to send us an action plan setting out how they would be compliant with the regulations. However, no action plan was sent to us and no registered manager application was received.

A registered manager was not in post. The provider had appointed managers. The provider told us the managers were in the process of applying to the Care Quality Commission to be the next 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 responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

At this inspection we found the provider had made improvements. They along with the managers collectively provided leadership and worked with professionals to ensure people were safe and their needs were met. Improvements were found to the provider’s governance systems in place monitor the quality of service. Some audits had been completed. Further action was needed to ensure that the audits were robust and drove improvements to the quality of care people received.

We found improvements had been made to the staff recruitment process. Staff had undergone a robust recruitment process and relevant checks had been carried out before they commenced work. Staff received appropriate induction and training for their role and understood their responsibility to protect people from avoidable harm and provide safe care to people. Staff were supported through supervisions and appraisal.

The provider had taken action to improve the premises. People lived in a clean and well maintained service. Regular checks were carried out and actions taken to maintain a safe environment.

Risks were managed so that people were protected from avoidable harm whilst promoting their choices and independence. Sufficient numbers of staff were on duty to meet people’s needs both at home and to support people to access the wider community.

People were supported by trained staff in all aspects related to their medicines. People had enough to eat and drink and were involved in meal preparations. Staff supported people to access relevant health care support and services to meet their health needs. People’s rights were protected and respected. Advocacy support was made available to people. Staff understood the importance of seeking people's consent prior to providing care and support.

People's care needs were met and their lifestyle choices respected. People maintained contact with family and friends and took part in social events and activities that were of interest to them.

People’s privacy and dignity was respected. Staff helped to maintain and promote people’s independence. Staff used the knowledge gained from supporting people to continually review and update people’s care plans so that they were able to respond to people’s changing needs.

People and their relatives were involved or had opportunities to be involved in the development of the service. A complaint process was in place and staff knew how to respond to complaints.

The provider had appointed two managers. Collectively the

This inspection took place on 9 February 2016 and was unannounced.

The Ark Care Lodge is registered to provide residential care and support for up to 18 people who have an autistic spectrum disorder or a learning disability and who may present behaviours that challenge. People live in two houses adjacent to each other with no internal access that blend in with other private dwellings in a residential area. The accommodation has two lounges with dining rooms. The bedrooms are over two floors and the upper floor is accessible using the stairs. Most bedrooms have an ensuite shower facility and are close to a bathroom. At the time of our inspection there were 18 people using the service.

The service has a manager who was registered with Care Quality Commission (CQC). A registered manager is a person who has registered with the 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. However, they no longer work for the service and have not yet cancelled their registration. We spoke with the provider representative about this and advised us that the registered manager has been informed to cancel their registration.

The provider had appointed two managers that had been in post for two months at the time of our inspection. The provider told us that they intend to have two managers to manage the service. The provider advised us of their intention to submit an application to the Care Quality Commission to become registered. We will monitor this situation to ensure that a registered manager is in post to ensure that the service is managed well.

People told us they felt safe at the service and with the staff that looked after them. Staff understood the safeguarding procedure (protecting people from abuse) and knew how to keep people safe.

People’s care needs were assessed including risks to their health and safety. Care plans developed from the risk assessments lacked guidance and information for staff as to how to support the person safely. Despite this staff were aware of people’s needs and knew how best to support them. Further action was needed to ensure care plans and risk assessments were reviewed regularly to ensure people received the safe and appropriate care and support. The provider assured us they would take action and ensure people’s needs and records were reviewed.

Staff were recruited in accordance with the provider’s recruitment procedures and further action was needed to ensure records were kept of the pre-employment checks carried out. The service had sufficient staff to meet people’s needs and support people to live independently and access community amenities.

Staff received an induction and training for their role and responsibilities. Further action to the ongoing support, training and records would help ensure staff’s knowledge; skills and practice were kept up to date.

People received their medicines at the right time from trained staff. People had access to health support and referrals were made to relevant health care professionals where there were concerns about people’s health.

People told us that staff sought consent before they were helped and that staff always respected their choices and decisions. Staff were aware of their responsibilities to ensure people’s rights were promoted and new care plan format would help ensure decisions made were recorded.

People told us staff were caring and had developed positive relationships with them. People’s privacy and dignity was maintained, their choice of lifestyle was respected and their independence was promoted.

People spent time doing things that were of interest to them such as activities, accessing community’s amenities and doing household chores to promote their independence. Records showed people went out, maintained contact with family an

All the people we spoke with at Ark Care Lodge said they liked living at the home. One person told us, “This is a very friendly home.” Another person said, “I’m happy here and I love it to bits.” Those who were unable to give their views verbally appeared content and settled and took an active part in the inspection.

We observed that the people who used the service got on well together. They were caring and supportive of each other and helped each other with tasks. One person told us, “We are a big family here.” Staff told us there were strong bonds between the people who used the service, some of whom had lived at the home for many years.

People said the food was good at Ark Care Lodge and they had plenty of choice. One person told us, “The food is delicious. I like it best when we have pasta.” Another commented, “We have lovely meals here.”

People told us they liked how the home looked and thought it was clean and tidy. One person said, “I’ve got a nice room which is all mine and I love it.”

People got on well with the staff. One person said, “I like all the staff here.” Another person told us, “The staff are very kind. They never shout and are ever so friendly.” The staff team was established, knew the people who used the service well, and were able to provide continuity of care.

This service does not currently have a Registered Manager. CQC are working with the Provider to ensure one is put in place.

We saw that people appeared to be happy about the way they were supported and cared for. We saw that people appeared to be relaxed and happy in their home. People told us they were happy living at Ark Lodge and that there were lots of activities to take part in. One person told us "I like it here". One person told us that they enjoyed going to the day centre but if they did not want to go, then they did not have to go. We saw that people were given choices in all aspects of daily life and that staff talked to the people who used services about what each choice meant to them. We saw that staff respected the choices made. We saw that some activities were undertaken by individuals and other activities were carried out as a group.

People were protected against the risks associated with medicines because there were appropriate arrangements in place to manage medicines. There were enough qualified, skilled and experienced staff to meet people’s needs. People who use the service, their representatives and staff were asked for their views about their care and treatment and they were acted on.

The manager of Ark Lodge told us that she had not yet registered as the manager with us, however she said that she would be registering within the next three months.

People told us that they were happy living at Ark Care Lodge and that staff supported them to take part in activities within the home and the community.

One person told us whilst they were having their nails painted by a member of staff, that they were going to a local school that afternoon as a volunteer. They told us that they go every week to help look after the children in the nursery. They went on to tell us about their planned shopping trip the following week, that they were going to Nottingham on the train and that they were looking forward to going on a tram. They also told us that they were going to bake cakes the following morning with a member of staff.

One person told us that they sometimes help with housework but it’s not something they enjoy. Whilst someone else told us that they enjoy helping prepare meals and on the evening of our visit would grate the cheese for the cheese and potato pie.

We were told by someone that they go to a variety of clubs in the evening and that they play pool and football, whilst someone else told us that they go dancing and sometimes play games.