Located in a residential area and close to local community facilities, Walker Lodge is registered to provide specialist care for up to eight people with an acquired brain injury. The home also provides transitional rehabilitation for people who want to move into the community in supported tenancies. The home is a purpose built facility with accommodation located over two floors. A passenger lift is available for access between the floors and the building has been designed to ensure full access for wheelchair users. There are a number of car parking spaces adjacent to the home. Eight people were living at the home at the time of our inspection.

At the last inspection, the service was rated Good. At this inspection, the service remained Good.

Our observations showed there were plenty of staff around the home to help people with their day to day needs. There were systems and processes in place to ensure that people who lived at the home were safeguarded from abuse. This included training for staff which highlighted the different types of abuse and how to raise concerns within the infrastructure of the home. Staff we spoke with confirmed they knew how to raise concerns. Medication was well manager and only administered by staff who had the correct training to enable them to do this. There was a process for analysing incidents, accidents and general near misses to determine what could be improved within the service provision. There was personal protective equipment (PPE) available within the home, and staff wore appropriate protective clothing when competing person care tasks or serving meals. Risk assessments were detailed and specific, and contained a good descriptive account for staff to follow to enable them to minimise the risk of harm occurring to people who lived at the home, these were specifically tailored to support people with brain injuries.

Menus were varied, people told us they had input into the menus and were supported to make some smaller meals themselves. Staff were suitably trained, specifically to support people with acquired brain injury. Additionally, staff were regularly supervised and appraised to enable them to provide good care to people who lived at the home. Staff told us they were well supported through the induction process, regular supervision and appraisal. Staff said they were up-to-date with the training they were required by the organisation to undertake for the job and training records confirmed this. Training was a mixture of e learning and face to face courses. Consent was also sought and clearly documented in line with legislation and guidance. The service was operating in accordance with the principles of the Mental Capacity Act 2005, and best interest processes were documented for people who required support with decision making. People had access to other medical professionals who often visited the home and were involved with people from a clinical point of view. The service was able to demonstrate good relationships with external healthcare professionals and case managers. All bedrooms were spacious and home was adapted to encourage and support peoples rehabilitation needs.

People were included in their care and support as much as possible, and there was evidence to suggest that person centred plans had been discussed with people and their relatives People were treated as individuals, and their choices and preferences were respected by staff. This was evident throughout our observations around the home, and the information recorded in people’s care plans. Staff also described how the ensured they protected people’s dignity when providing personal care. Staff spoke with people and about them with warmth and sensitivity, and told us they enjoyed helping people to rehabilitate.

There was a process to listen to and respond to complaints which was clearly displayed for people in the home and any visitors if they wished to raise a formal complaint. Staff were trained to support peopl

This unannounced inspection of Walker Lodge took place on 9 February 2015.

Located in a residential area and close to local community facilities, Walker Lodge is registered to provide specialist care for up to eight people with an acquired brain injury. The home is a purpose built facility with accommodation located over two floors. A passenger lift is available for access between the floors and the building has been designed to ensure full access for wheelchair users. There are a number of car parking spaces adjacent to the home.

Eight people were living at the home at the time of our inspection. This was the first inspection of the home since its registration with the Care Quality Commission in 2012.

A registered manager was in post. 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 said they felt safe living at the home and that staff were never unkind towards them. Staff understood what abuse was and the action they should take to ensure actual or potential abuse was reported.

Staff had been appropriately recruited to ensure they were suitable to work with vulnerable adults. People and their families told us there was sufficient numbers of staff on duty at all times.

Our review of a selection of care records informed us that a range of risk assessments had been undertaken depending on people’s individual needs. There was a culture of positive risk taking within the service.

Some of the people living at the home used bedrails and a detailed risk assessment had been undertaken for all the people who used this equipment in order to establish if it was safe for them to use.

People told us they received their medicines at a time when they needed it. Robust processes were in place to ensure medicines were managed safely and in accordance with national guidance.

The building was clean, well-lit and clutter free. The environment was suitable to the needs of the people living there. Measures were in place to monitor the safety of the environment.

Families we spoke with told us the manager and staff communicated well and kept them informed of any changes to their relative’s health care needs. People said their individual needs and preferences were respected by staff. They were supported to maintain optimum health and could access a range of healthcare professionals when they needed to. The service had access to specialist therapy services.

There was a clear person centred culture within the service. People told us they were encouraged to be involved in developing their support plans and weekly schedules. People were actively encouraged to engage in local activities and develop relationships within the local community.

People were encouraged and supported to develop their own weekly menus, participate in purchasing their own food and either fully prepare or be assisted with the preparation of their meals.

People who lived at the home and families described management and staff as caring, considerate and respectful. Staff had an excellent understanding of people’s needs, preferred routines and aspirations for the future. We observed positive and warm engagement between people living there and staff throughout the inspection.

Staff told us they were well supported through the induction process, regular supervision and appraisal. They said they were up-to-date with the training they were required by the organisation to undertake for the job.

People living at the home were consistently encouraged and supported with decision making. The registered manager and staff had an excellent understanding of the Mental Capacity Act (2005). Where people lacked mental capacity the principles of the Mental Capacity Act had been applied appropriately.

The culture within the service was and open and transparent. Staff, people living there and families said the registered manager was approachable and inclusive. They said they felt listened to and involved in how the service developed.

Staff were aware of the whistle blowing policy and said they would not hesitate to use it. Opportunities were in place to address lessons learnt from the outcome of incidents, complaints and other investigations.

A procedure was established for managing complaints and people living there and their families were aware of what to do should they have a concern or complaint. We found that complaints had been managed in accordance with the complaints procedure.

Audits or checks to monitor the quality of care provided were in place and these were used to identify developments for the service.