The inspection took place on 6 October 2015. It was unannounced. During our last inspection of the service in May 2013, the provider was compliant with all of the regulations we assessed.
Christmas Lodge provides care and personal support for up to 15 people. It does not provide nursing care. The service specialises in providing support for people who have enduring mental health difficulties. The home is situated near to York racecourse and is close to many shops and amenities.
The home has a 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.
People consistently spoke of the outstanding care delivered by staff. They told us that staff went above and beyond to ensure they received a person centred service. Staff maintained people’s privacy and dignity ensuring that any care or discussions about their care were carried out in private. Interactions between staff and people were caring and respectful, with staff being consistently patient, kind and compassionate. We observed the interactions between staff and people living at the home. It was clear that staff knew and understood the people they cared for. People’s care remained the focus for staff and people knew that they mattered. It was evident that people were involved in all decisions regarding their care. Care records were detailed and person centred, and we saw people were involved in the development and review of their care records.
People were encouraged and supported to be as independent as possible. The home was innovative in the way it provided person centred care to people, for example getting people to determine what values they thought the staff should display or writing their own care records. It was clear that the support people received meant that they were supported to have an enriching and empowering lifestyle. We saw numerous examples of this during our visit. Examples included each person being supported or independently choosing their own meal, attending meaningful and fulfilling activities with the staffing allocated accordingly or the way in which people had made the home their own in terms of personalisation. The home was run in a way that people using the service remained the focus. It was evident that Christmas Lodge was ‘Their home.’
People told us that their ideas and suggestions were responded to. Staff had a ‘can do’ approach and they really made the most of opportunities to support people in taking risks so that they could participate in things which were important to them. A range of social, leisure, occupational and educational activities were provided. People’s interests were evident throughout the home. People were encouraged and supported to remain autonomous and the service was run in a way which encouraged and support people’s individual aspirations and dreams.
People told us they felt safe; they told us they could approach staff if they had any problems or concerns. We saw that people were encouraged and supported to take risks and there were no restrictions on people’s freedom.
People spoke positively about the staff who worked at the home. It was clear that staff knew and understood people’s needs well. Staff went through a robust recruitment process before starting work. Staffing ratios were responsive to people’s changing needs and preferences which enabled people to lead busy and fulfilled lives. It was evident that staff knew the people they supported and went out of their way to provide a flexible and tailored service.
People received their medication as prescribed by their GP. They were encouraged and supported to manage their own medicines where possible. Regular reviews took place and staff received training and support so that medicines could be administered safely.
The home was clean, smelt fresh and was well decorated and maintained. People had personalised the environment to make it more homely. It was warm and welcoming.
Staff received induction, training and supervision which supported them to carry out their roles effectively. People spoke highly of the staff employed and we observed warm, caring and encouraging support throughout our visit.
People had care records in place which they had contributed to. People were supported to make their own decisions and when they were not able to do so, meetings were held to ensure that decisions were made in the person’s best interests. If it was considered that people were being deprived of their liberty, the registered manager was clear that the correct authorisations must be applied for.
People spoke positively of the meals and we saw that specialist diets were catered for. People were able to choose what they wanted to eat and to be involved in the shopping and preparation of their meals where possible. People could access the kitchen at any time and were able to help themselves to meals, drinks and snacks.
People had access to a range of health care professionals and staff were able to support people with both their physical and emotional health needs. There were clear records of this within people’s care files. Staff knew and understood the people they supported and were able to respond quickly to any changes in health. This was re-iterated by the health professionals who provided feedback on the service.
The home had appropriate adaptations to make it accessible to people living there. The registered manager and staff regularly reviewed the premises so that any required adaptations could be made.
People’s views and opinions were sought and their ideas and suggestions were responded to. People living at the service were able to bring about change. Staff spent time with people both on a one to one basis and in group discussions so that individual aspirations could really be considered. People did not have any complaints but consistently said they would have no issue raising them if they did.
People living at Christmas Lodge spoke highly of the registered manager and staff. The support from senior management was also said to be consistently good. There was a warm friendly atmosphere and staff spoke of a positive culture. People were encouraged and supported to express their views. There were good links with the local community.