Camelot Lodge

Camelot Lodge provides support to up to 9 people with long term mental health needs. At the time of the inspection the service was full. The service is also responsible for a small community support service for three people none of whom were in receipt of the regulated activity personal care so this part of the service was not inspected on this occasion.

The provider is actively involved in the running of the service and a registered manager is in place for the day to day running of the service. A registered manager is a person who has registered with CQC to manage the agency. 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 agency is run.

We last inspected the service in December 2016 and found two breaches of regulation and rated the service as requiring improvement. The identified breaches related to shortfalls in the checks made during the recruitment of staff, and also identified that existing quality assurance checks were not being conducted robustly to picked up omissions in recording. Following the inspection we asked the provider to complete an action plan to show what they would do and by when to improve the key questions Safe and Well-Led to at least Good. At this inspection quality assurance checks had improved and improvements made to records and recruitment records to show these had been carried out appropriately.

People showed that they were comfortable in each other's company and with staff; they said they felt safe living in the service and liked the staff working with them. Staff demonstrated a kind and respectful attitude towards people. Mental health professionals spoke positively about this service and the professional and caring attitudes of staff.

People lived in a safe, clean environment with all safety checks and tests routinely completed. There were enough skilled staff to support people and this was kept under review if circumstances changed. New staff were inducted appropriately into their role, they said that they felt well supported and listened to and that there was a good sense of team work. They had opportunities to meet regularly with their manager individually and within staff meetings. The registered manager and staff used handovers and email circulation to ensure effective communication about people's needs and any changes.

People understood they could report concerns and staff were trained to understand how to support those

people with diverse needs. Complaints information was displayed. People knew they could raise concerns at individual meetings or in house meetings if they chose. Staff understood their responsibilities to keep people safe from harm.

People were supported to be independent. Risks were well managed: staff took appropriate action and any learning was incorporated into practice or risk assessments. People were supported to have maximum choice and control of their lives. People's legal status meant that they were subject to some restrictions on their movement outside the service but a culture of least restrictive practice and positive risk taking ensured this was managed in a way that was acceptable to them and was reviewed with them regularly.

People were supported to keep healthy. People had regular health checks and access to healthcare professionals. Changes in health needs were incorporated into care plans to ensure staff understood how the changes impacted on the support they provided. People received their medicines safely and there were clear processes in place for the management of medicines.

Healthy eating was promoted and people were supported to gain or lose weight dependent on their needs. People could make drinks as and when they wanted them.

There was on going investment in the maintenance and upgrading of the premises to provide people with a pleasant communal and personal space to live in, servicing and visual checks and tests of equipment used was undertaken at regular intervals, to ensure this remained in safe working order. The service was clean and well maintained.

New people had their needs assessed over a lengthy period prior to admission to ensure these could be met. Care plans developed from initial assessment showed the support people needed and how they preferred this to be delivered; people said they were actively involved in their care plan development and regular review.

Activities such as a musical entertainment and art and craft activities were offered; people availed of these when they wanted to. For most people weekly activities were tailored to their specific needs, so they may have opportunities for home baking, gardening, working in a voluntary capacity in a charity shop or attending adult education if they showed an interest.

Staff demonstrated thoughtfulness in maintaining the dignity of people whose behaviour may be impacted by their mental health. Staff showed that they knew people well and had developed good working relationships with them, people and staff showed that they were able to share a laugh and a joke with each other.

People, other professionals and some relatives were asked for feedback about how the service was doing and could improve, any comments were looked into and feedback given to the person making the comment. All comments viewed were positive. The registered manager undertook regular quality checks of the service to ensure all areas were working well. The provider attended a number of external meetings and boards that provided additional opportunities for learning in regard to new best practice but also to advocate on behalf of mental health services.

The five questions we ask about services and what we found