Colwill Lodge provides accommodation and personal care for people living with and/or a learning disability/ physical disability for up to 15 people on a respite basis. People live at the service usually for short arranged periods on a regular basis or for longer whilst suitable permanent accommodation is sought. People carry on their weekly activities during their stay therefore there are rarely people at the service during the day. The service is owned and operated by Plymouth City Council and at the time of our inspection approximately 75 people accessed the respite service. We looked at records relating to the 62 people who received personal care. There are 10 beds for respite care and 5 independent living flats.

At our last inspection in February 2016, we rated the service good overall with the area of responsive rated as requires improvement. We carried out a focussed responsive inspection in July 2017 and found the area of responsive was still rated as requires improvement. During this inspection in April 2018 we looked at whether the areas noted in responsive had been addressed. We had found in July 2017 that some people still did not always have care plans in place to help

provide guidance and direction to staff about how to meet their needs. We found in April 2018 that there had been a lot of work carried out to ensure all care plans had been devised so that staff could follow individualised information and meet people’s needs consistently.

At this inspection we found the evidence relating to other areas continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Further information is in the detailed findings below.

We carried out an unannounced comprehensive inspection of this service on 19 February 2016. A breach of a legal requirement was found so we issued a requirement notice. This was because the provider had not ensured people’s care plans were effectively reviewed, met their needs and preferences and were reflective of the care being delivered. After the comprehensive inspection the provider submitted an action plan to tell us what they would do to meet the legal requirement in relation to the breach.

We undertook this focused inspection on 25 July 2017 to check that they had followed their plan and to confirm that they now met legal requirements. This report only covers our findings in relation to these topics. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Colwill Lodge on our website at www.cqc.org.uk

Colwill Lodge is a respite service providing care and support for up to 15 people who have a learning disability. The service is owned and operated by Plymouth City Council and at the time of our inspection 75 people accessed the respite service.

The service had 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.

Some people had care plans in place which helped provide guidance and direction to staff about how to meet their individual needs. Since our last inspection, some care plans had been re-created. Staff had worked alongside each person to draw up new documents called ‘personal planning booklets’ which helped provide staff with up to date information about each person’s needs. People’s care plans were devised in a format that they could easily understand. However, there were still a large number of care plans outstanding which meant staff did not always have up to date information about the people staying at the service.

The local authority service improvement team told us they had a good relationship with the registered manager, and that they had carried out a quality review of the service in 2015.

You can see what action we told the provider to take at the back of the full version of the report.

We inspected Colwill Lodge on 19 February 2016, the inspection was unannounced. The service was last inspected in January 2014, there were no concerns at that time

Colwill Lodge is a respite service providing care and support for up to 15 people who have a learning disability. The service is owned and operated by Plymouth City Council.

There was a registered manager in post at the time of this inspection. 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.

We spent time with people seeing how they spent their day and observing the care and support being provided. Some people were able to talk to us, but most people had limited verbal communication. People were treated with care and respect by the staff team. We observed people laughing and smiling and having friendly conversations with each other and the staff supporting them. Relatives said; “She definitely enjoys going there, she tells us constantly when she’s going!” and, “She really likes it and if she likes it, I like it.”

Recruitment practices helped ensure staff working in the home were fit and appropriate to work in the care sector. Staff had received training in how to recognise and report abuse, and all were confident any concerns would be taken seriously by the manager and organisation. New employees undertook an induction before starting work to help ensure they had the relevant knowledge and skills to care for people. Training was regularly refreshed so staff had access to the most up to date information. An external healthcare professional told us; “I can only praise the professionalism, care and support provided by Colwill Lodge.”

Care plans contained information about a wide range of areas. However, some people’s care plans had not been regularly reviewed and did not accurately reflect their current care needs. One person, who had been living in the service for over two months, still only had a draft care plan. You can see what action we told the provider to take at the back of the full version of the report.

The service was well led by the registered manager who was supported by five assistant managers. There was also a keyworker system in place. Keyworkers are members of staff with responsibility for managing and arranging care for a named individual. There were sufficient numbers of staff to meet people’s needs.

Staff and relatives told us they considered the service to be well managed. Staff referred to an “open door” policy and told us they were able to approach managers with any concerns. Staff meetings were held regularly and were an opportunity for staff to voice any views or concerns they had.

Staff recognised people’s rights to make everyday choices and supported them to do so. People chose what time they got up and went to bed, when they ate their meals and how they occupied their time. Staff supported people to take part in activities both in the service and in the local community. A relative told us; “They always ask him what he wants to do.”

There was a strong stable staff team in place and many had worked at the service for several years. They knew the people they supported well and had a good understanding of their needs and preferences. A relative told us; “He knows them very well and they know him.”

Regular audits and quality checks were carried out to monitor the standards of care provided. People were regularly asked for their views on the care and support they received.

We carried out an unannounced inspection on 7 October 2012. On the day of our visit we were told that there were 14 people staying on respite care at Colwill Lodge. Some of these people were staying for a longer period until suitable placements could be found for them. Due to the complex needs of some of the people staying in the home in the home not all were able to communicate effectively with us. We spoke with 8 people staying in the home, one relative, five staff members, two agency staff, and the duty assistant manager and looked at three people’s care files. We saw that staff treated people with consideration and respect. For example, we saw that staff responded to people’s care needs to ensure that they were kept comfortable and informed about what was happening, such as discreetly assisting people with eating their lunch. Care plans that we saw reflected people’s health and social care needs and demonstrated that other health and social care professionals were involved. We spoke with staff about their understanding of what constituted abuse and how to raise concerns. They demonstrated a good understanding of what kinds of things might constitute abuse, and knew where they should go to report any suspicions they may have. We had received one concern about a possible theft in the home. During our visit we saw that the home had changed their policy and procedure in how to manage people finances.

People were treated with dignity and respect was shown to them at all times whilst we were present at the home. We saw that staff were courteous when interacting with people. We observed respectful practice by staff when entering people's rooms of knocking and waiting to be invited into their room. We saw that people were able to remain in their rooms during the day if they chose to, and were able to get up later in the day if they wished. This showed privacy and respect was afforded to people.

Staff and the manager were knowledgeable about people in their care, and spoke warmly and sincerely about the people using the service. We observed staff interaction with people during our visit. Staff were polite, respectful and friendly without exception. We spoke with three people using the service, and they each told us they were happy staying there and with the support they received from staff. One told us, "I like all the staff" and another added "it's nice".

People's needs were assessed with care and treatment planned and delivered in line with their individual plans to ensure people's safety and welfare. For example we saw that there were detailed mental health assessments in place which detailed the person's condition, symptoms and behaviours. This meant the service was able to make sure that they could meet people's needs.