Appleton Lodge

Updated 29 November 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

We carried out an inspection at Appleton Lodge on 5 September 2018, the visit was unannounced. The inspection was undertaken by one adult social care inspector. It included visiting the service and speaking with people, visitors, the registered manager and staff.

Before this inspection, we reviewed notifications that we had received from and about the service. A notification is information about important events which the provider is required to tell us about by law. We reviewed the Provider Information Record (PIR) before the inspection. This is a form that asks the provider to give some key information about the service, and tells us what the service does well and the improvements they plan to make. We used this information to help plan the inspection. We also checked with the local authority commissioning and safeguarding teams. They informed us that they did not have any concerns about Appleton Lodge and were satisfied with the level of care provided.

During the inspection we spoke with two people who used the service and four visiting relatives. We also observed interactions between people and staff in communal areas of the home. We spoke with seven members of staff, including the registered manager, deputy manager, four care staff, the wellbeing coordinator and the maintenance man. We also spoke with a visiting healthcare professional.

We checked four people's care records which included pre-admission assessments, care plans and risk assessments. We reviewed documents relating to the assessment of mental capacity and Deprivation of Liberty Safeguards (DoLS). We checked the management and administration of people's medicines. We looked at recruitment records for three staff, staff training and supervision records, complaints, accident and incident records, maintenance records and reviewed the provider's quality assurance systems.

Updated 29 November 2018

Appleton Lodge is a purpose built care home owned by HC-One Limited. The home is registered to provide residential care and accommodation for up to 30 people with dementia, older people, younger people or people with a physical disability. On the day of our inspection there were 30 people using the service.

Appleton Lodge is a two-storey building situated next to a larger sister building on the same site. All bedroom are single occupancy and have en-suite facilities. There is an enclosed garden to the rear of the building accessed by a conservatory. Car parking is available within the grounds.

This inspection took place on 5 September 2018 and was unannounced. This meant the staff and the provider did not know we would be visiting.

Appleton Lodge was last inspected by CQC on 23 September 2015 and was rated Good.

Appleton Lodge is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The home had a registered manager in place. A registered manager is a person who has registered with 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.

The registered manager understood their responsibilities with regard to safeguarding and staff had been trained in safeguarding vulnerable adults.

People were protected from the risk of poor nutrition and staff were aware of people's nutritional needs. People had access to healthcare services and received ongoing healthcare support. Appropriate arrangements were in place for the safe management and administration of medicines.

People who used the service and their relatives were complimentary about the standard of care at Appleton Lodge.

Staff treated people with dignity and respect and helped to maintain people's independence by encouraging them to care for themselves where possible. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

Activities were arranged for people who used the service based on their likes and interests and to help meet their social needs, in the home and within the local community. The service used innovative activities to enhance people’s lives.

Care records showed people's needs were assessed before they started using the service and care plans were written in a person-centred way and were reviewed regularly. Person-centred is about ensuring the person is at the centre of any care or support and their individual wishes, needs and choices are taken into account. Care plans were in place that recorded people's plans and wishes for their end of life care.

The provider had an effective recruitment and selection procedure in place and carried out relevant checks when they employed staff. There were sufficient numbers of staff on duty to meet the needs of people who used the service.

Staff were supported to provide care to people who used the service through a range of mandatory training, supervision and appraisal. Staff said they felt supported by the registered manager.

The home was clean, spacious and suitable for the people who used the service. The provider had effective procedures in place for managing the maintenance of the premises and appropriate health and safety checks were carried out. Accidents and incidents were appropriately recorded and risk assessments were in place where required.

The provider had an effective complaints procedure in place and people who used the service and their relatives were aware of how to make a complaint.

The provider had a quality assurance process in place. People who used the service, relatives and staff were regularly consulted about the quality of the service through meetings and surveys.

The service exceeded in supporting people to reminisce by completing workbooks called ‘remembering together’ when they first arrive at the service.

The service was exceptionally skilled in helping people and their families explore and record their wishes about care at the end of their life.