Amethyst Lodge

People who used the service had their own bedrooms with a separate communal kitchen and lounge. There was also a shared garden area people had access to.

Right Support: Amethyst Lodge is based in a residential building. It is close to local facilities and externally, there was nothing to indicate it was a registered care home which helped to promote the concept of community living.

Improvements were required to ensure that the premises were designed and decorated in a way that supports autistic people and people with a learning disability, and we have made a recommendation about this.

Staffing levels had sometimes fallen short. There had been a high use of agency staff to cover some shortfalls, but people told us they preferred staff they knew well. The provider had recently recruited five new staff and hoped the use of agency staff would reduce as a result, meaning people will receive care from a consistent staff team. Recruitment processes needed to be more robust to ensure staff were suitable for their roles. The provider had begun implementing more detailed checks and were reviewing all previous recruitment files.

Care records did not always reflect what people's aspirations or longer-term goals were. Some goals were not person-centred. There was limited evidence that people had been involved in creating their care plans.

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 support this practice. However, documentation in relation to decisions that had been made in people's best interests required review to ensure that people continue to have maximum choice and control over their lives and that the least restrictive option was always considered.

Right Care: People were taking part in activities of their choosing, including in the community, and with family or friends. Staffing levels sometimes impacted on how long people could be out for as staff needed to return to attend to other clinical duties.

We observed caring interactions between staff and people. Staff told us they cared about the people at the home. The core staff team knew people well and had established positive relationships with them.

Although we observed staff to be effective in supporting people, some staff were overdue refresher training in several subjects.

People received their prescribed medicines by staff who had completed relevant training. People's hydration and nutritional needs were met, and people received a varied diet of their choosing.

Right Culture: More robust monitoring and auditing checks were required to ensure all aspects of people's care needs and their quality of life were being measured effectively. Several audits which monitored the quality and safety in the service had not been completed in the timeframes set by the provider.

The previous registered manager had left, and there was a new manager in post. However, they had been covering staffing shortfalls, impacting on their time to complete the usual quality checks. As a result, opportunities to identify shortfalls had been missed, such as infection control procedures. Staff told us they liked the new manager and considered that they would be good for the service going forward.

There was no formal feedback documented around people's views about the service they received. Improvements were needed to ensure that people were consistently supported to provide feedback and to ensure people were fully involved in shaping their support.