We carried out a review of the data available to us about L'Arche London Gothic Lodge on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about L'Arche London Gothic Lodge, you can give feedback on this service.
About the service
L'Arche London Gothic Lodge is a residential care home providing personal care to up to 6 people. At the time of our inspection, there were 5 people using the service. The service supported people with learning disabilities and autism.
People's experience of using this service and what we found
Right Support: Model of Care and setting that maximises people’s choice, control and independence. Staff were recruited safely and had appropriate training on how to safeguard people using the service. The provider followed current best practice guidelines to effectively manage people's medicines and risks associated with infection prevention and control (IPC).
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. However, mental capacity assessments completed by the provider had not always included all the necessary information. Actions taken by the provider to address this gap will be reviewed at our next planned inspection.
Right Care: Care is person-centred and promotes people’s dignity, privacy and human rights. People were encouraged to communicate freely and accessed community for activities when they wanted to. Staff supported people to learn new skills and maintain important contacts to them. People's care records were person- centred and up to date. Staff knew people well and understood their support needs which empowered people to make decisions about their care.
Right Culture: The ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive and empowered lives. The staff team worked well together making sure people's rights and wishes were protected. The service had regular communication with the healthcare professionals which led towards good working relationships and empowering of people to choose the way they wanted to live their lives.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 10 February 2018).
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for L'Arche London Gothic Lodge on our website at www.cqc.org.uk.
Why we inspected
This was a planned inspection based on when the service was previously inspected.
This was a focused inspection and the report only covers our findings in relation to the Key Questions Safe and Well-led. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
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.
At the last inspection in November 2015 we rated the service ‘Good’ overall. At this inspection the service remains ‘Good’.
The service continued to have systems and processes in place to protect people against the risk of harm and abuse. Staff received safeguarding training that enabled them to identify report and escalate suspected abuse and keep people safe.
The service had developed risk management plans that were regularly reviewed and detailed identified risks and strategies on how to manage those risks. Staff were aware of the importance of familiarising themselves with risk management plans and these were updated to reflect people’s changing needs.
The provider demonstrated good practice in the administration, recording and storage of medicines. Medicine administration records were completed accurately and stocks and balances identified people received their medicines as prescribed.
People continued to be protected against the risk of infection, as the service had sufficient infection control plans in place. The service employed ancillary staff who ensured a deep clean of the property was undertaken twice monthly, in addition to daily cleaning. Staff were aware of the importance of ensuring Personal Protective Equipment (PPE) was used to minimise the risk of cross contamination.
People are supported to have maximum choice and control of their lives and staff do support them in the least restrictive way possible; the policies and systems in the service do support this practice. Staff had a comprehensive understanding of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). At the time of the inspection there were five people subject to a standard DoLS authorisation.
People were supported by staff that had undergone pre-employment checks to ensure their suitability. Staffing levels were flexible and ensured people’s needs were met in a safe manner. Training systems in place ensured staff had the right skills and knowledge to deliver effective care to people. Records confirmed staff training covered safeguarding, Mental Capacity Act 2005, deprivation of liberty safeguards, food hygiene, health and safety and medicines management. Where identified training had expired, the provider had booked refresher training.
People were supported to have access to sufficient amounts of food and drink that met both their dietary needs and preferences. People were supported to participate in the purchasing of food and meal preparation wherever possible. People who required specialist dietary requirements were catered for.
The service encouraged and empowered people to access healthcare services to monitor, maintain and enhance their healthcare needs. Records confirmed people had access to G.P, psychiatrists, psychologist, dentist, optician and learning disability specialists. A healthcare professional commented that the service will work with them to ensure people’s healthcare needs were met.
The service carried out adaptions to the property to ensure people’s needs were effectively met. For example, adaptions to bathrooms were made to ensure those with mobility issues and aids, could access the facilities safely and freely.
People were supported in a caring, compassionate and emphatic manner by staff. People’s right to privacy was respected and encouraged. People were treated with dignity. The service had an embedded culture of supporting people emotionally.
People continued to be encouraged to make decisions about the care and support they received and had their decisions respected. Care plans detailed people’s preferences in communicating and staff were observed supporting people to understand what was being asked of them in a manner they understood and preferred, which enabled them to make informed decisions.
The service had an embedded culture of delivering personalised care tailored to the individual. Care plans were regularly updated to reflect people’s changing needs. Where possible people were encouraged to develop their care plans with support from staff.
People were able to express their discontent and share their concerns with staff. The service had a complaints system in place; and staff were aware of how to respond to, report and escalate complaints in line with the provider’s policy.
The service was aware of the importance of supporting people at the end of their lives. At the time of the inspection the service were in the process of developing support circles for people, which meant they would be able to share their wishes in line with the end of life care they received.
Staff and relatives spoke positively about the registered manager, saying she was approachable, compassionate and supportive. The registered manager was a visible presence within the service and operated an open door policy, which enabled people to approach her at any time convenient to them.
The service notified the Care Quality Commission of safeguarding and statutory notifications in a timely manner.
The service had an embedded culture of ensuring people’s views were heard, listened to and where appropriate acted on. This was done through regular keyworker and house meetings. People were supported to access advocacy services should they wish. Relatives and healthcare professionals were encouraged to give feedback on the service through quality assurance questionnaires.
The registered manager actively encouraged partnership working with other healthcare professionals to drive improvement and enhance people’s lives where possible.
Further information is in the detailed findings below
This inspection took place on 25 August 2015 and was unannounced. L'Arche Lambeth Gothic Lodge is a residential care home providing accommodation, care and support for up to five people with a learning disability. At the time of our inspection five people were using the service.
The L’Arche Lambeth Gothic Lodge has 22 staff , that work across three services, of which this is one.
The service had a registered manager. At the time of the inspection the registered manager was not at work and a manager from another service and a senior manager were providing cover for her role.
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 provided with care that kept them safe from harm and injury. Staff supported people to identify any risks to their safety and helped them to manage these risks. Staffing levels ensured people received the support they required. People knew the staff team well and got to know new members of staff before they started supporting them. Staff undertook regular health and safety checks to maintain a safe environment for people.
Staff were knowledgeable and had skills to meet people’s care needs. They attended relevant training courses to ensure that people were provided with individual support. Staff assessed people’s capacity on a daily basis and provided them with informed choices to ensure that they were involved in their care planning. People were supported to eat and drink what they liked and were encouraged to cook meals for themselves. Staff obtained additional professional support to meet people’s health needs.
People liked their home and had good relationships with the staff. Staff knew people’s preferences and supported them to make choices according to what they wanted. People had support to maintain relationships in the community and were encouraged to have visitors in their home. Staff used people’s preferred communication methods to ensure that their wishes were heard and acted on. People were supported to access advocacy services.
People were provided with support to make decisions for themselves whenever possible. People had one-to-one meetings with staff and were encouraged to discuss their care needs and how they wished to be supported. Staff supported people to plan their personal goals and supported them to achieve those goals. People were provided with support to make a complaint if they wished to. Families and advocates provided feedback about the service and felt that issues raised were addressed.
The management team monitored the quality of care provided and made changes to improve it. The management team had good communication with staff and advised them where required. Staff were supported to question practice and make suggestions when they felt improvements were required. We saw that some medicines errors did not have follow-up actions identified to prevent this happening again. The management team was updating the medicines management procedures to ensure that people received the support they required with safe medicines management. Staff shared information amongst the team to ensure that people were consistently supported in line with their needs.
Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. People's care was personalised to include their needs and preferences. People had been supported to maintain their physical health.
People were protected from the risks of inadequate nutrition and dehydration, and had a choice of meals and an opportunity to take part in shopping and meal preparation. One person told us they liked to have fish and chips each Friday and records showed that this was done.
People who used the service, staff and visitors were protected against the risks of unsafe or unsuitable premises as Gothic Lodge was well maintained and homely.
There were enough qualified, skilled and experienced staff to meet people's needs and we saw kind and respectful interaction between staff and people who used the service.
There was an effective complaints system available and this was adapted to the needs of people with a learning disability so it was easier for them to understand and use. We found that people had been given opportunities to raise any concerns they had.
Staff told us how they worked with people to aid their communication and to help them to make choices. This had enabled people to contribute their views and ideas.