Bethany Lodge is a residential care home for people who may have learning disabilities and or have an autistic spectrum condition. At the time of our inspection 7 people were living at the home. The home has lounge, dining room, activity room, and multi-sensory room for relaxation, art room for activities, five individual bedrooms, and two apartments.

At the last inspection in November 2015 , the service was rated Good.

At this inspection we found the service remained Good.

Why the service is rated Good.

People and their relatives told us they continued to receive care which protected them from avoidable harm and abuse. Risks to people’s safety were identified and measures were in place to help reduce these risks. When people required support to take their medicines this only happened when staff had received the training to do so. Regular checks on staff practices were undertaken to support people’s safety. There was enough staff to provide support to people to meet their needs.

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

People were provided with care which continued to be effective in meeting their particular needs. Staff had received training to provide them the skills and knowledge they needed to provide the right care and support people required.

People enjoyed spending time with the staff that cared for them and were treated with dignity and respect. People were encouraged to maintain their own personal interests and take part in activities.

People’s care was planned in ways which reflected their preferences and wishes. Relatives’ and health and social care professionals’ views and suggestions were taken into account when people’s care was planned. People knew how to complain. The complaint procedure was available in Easy Read Format so everyone could access.

People living at the home and their relatives were encouraged to give feedback on the service provided. The registered manager and provider regularly checked the quality of the care people received. Where actions were identified these were undertaken to improve people’s care further.

The inspection took place on 2 October 2015 and was unannounced.

The provider of Bethany Lodge is registered to provide accommodation and personal care for up to eight people. On the day of the inspection there were six people living there. A manager was in post who had applied to become the registered manager with the Care Quality Commission to manage the service. 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 responded positively to staff looking after them and communicated with them in a friendly manner. Relatives told us they had no concerns and that staff knew what to do to keep their family members safe.

People received care from staff who understood their individual health needs and how to manage risks when caring for them. People were supported to take their medicines. People received their medicines at the correct time and medicines were safely administered and stored. The manager made regular checks to ensure people received their medicines correctly. The manager told us they would make sure the information about people’s ‘when required’ medicines was reviewed.

People received care and support from staff who were regularly supervised and could discuss aspects of people’s care they were unsure of. People received care from staff that understood their needs and knew their individual requirements. Staff received regular training and understood well how to care for people.

People’s consent was appropriately obtained by staff. People who could not make decisions for themselves were supported by staff so that people’s best interests were always considered.

People enjoyed their food and were supported to prepare drinks and meals. People were offered choices at mealtimes and were supported with special dietary requirements. Staff understood people’s needs and preferences and ensured people received the food they liked.

People’s health needs were assessed regularly and staff understood how they should care for people. Staff kept relatives informed about their family members care and appropriately involved them in any decision making. People accessed other health professionals as appropriate.

People liked the staff who cared for them and responded positively to them by seeking reassurance through appropriate comforting touches. People’s privacy and dignity were respected and people were supported to make choices. People’s individual circumstances were considered when caring for people.

People were supported to take part in activities they liked or had an interest in. Staff understood each person’s interests and encouraged people to make their own choices about what they wanted to do.

People were involved in making decisions about their care and how they received services. People were kept updated by the manager and provider about issues which affected their care.

People were relaxed around the manager. Staff enjoyed working with the manager and felt part of a team who understood people who lived there and their roles and responsibilities.

People’s care was regularly checked and reviewed by the manager. The quality of care people received was routinely reviewed to ensure it could be monitored and improvements made were effective in providing people with better care.

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask;

Is the service safe?

Is the service effective?

Is the service caring?

Is the service responsive?

Is the service well led?

This is a summary of what we found-

Is the service safe?

People living at Bethany Lodge were cared for in a clean and hygienic environment. Equipment was well maintained and serviced regularly which kept people safe. During our inspection, we observed staff who treated people with dignity and respect.

Recruitment procedures were robust and included relevant security checks on staff. Ongoing training was undertaken by all staff which helped ensure they had the required skills, experience and qualifications. This meant people living at the home had their needs met.

The Care Quality Commission monitors the use of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. Although no recent applications had been made by the provider, appropriate policies and procedures were in place. Relevant staff had been trained to understand when an application should be made, and how to submit one.

Is the service effective?

Where able, people living at Bethany Lodge had their care needs assessed with them and/or their representatives. This meant they were involved in writing their care plans which helped ensure their needs and wishes were being met.

When we spoke with people they told us, "The manager goes above and beyond to help us" and "I love it here - the staff help us with all we need." During our observations we found that there were enough staff on duty, with the correct skills that ensured people received care and support that met their needs.

Is the service caring?

People living at the care home had their needs met by caring and patient staff. We observed good interaction during our inspection. Staff members took their time to understand people who had limited verbal communication. This meant that staff showed respect for the people they were caring for.

One person told us he had attended college for several years and commented "Staff encourage me to carry on, but I don`t know yet." Another person said, "It`s the best thing that has happened to me coming here - I feel so much better now." This meant that people`s interests and wishes were being listened to.

Is the service responsive?

People living at the care home took part in a range of activities. This included art and cooking sessions, horse riding and visits to a local hydro-pool if they wished. They were supported by staff members if they chose to partake in any activity of their choice. On the day of our inspection we noted one person who helped prepare the lunch.

The provider had a complaints procedure in place. People we spoke with told us they knew who to talk to if they had any problems. We saw the last complaint had been recorded and logged appropriately and had been resolved. This meant that people living at the care home could be assured their complaints would be listened to, and responded to, within an acceptable time-scale.

Is the service well-led?

The provider had both internal and external quality checking procedures in place. Any identified issues or concerns were addressed without delay which meant the quality of service continued to improve.

Staff members we spoke with were fully aware of their roles and responsibilities at Bethany Lodge. One staff told us, "If we think we need any training we just ask and it gets sorted for us." Another staff member told us, "We have regular meetings and talk about anything we feel is important." We were told by the provider, that if any changes were proposed around the care home, staff and people living at the care home were consulted with for their thoughts before any changes were made.

We inspected Bethany Lodge and spoke with two members of staff on duty. We spoke with the newly appointed manager. We were unable to hold conversations with the people who lived at the home due to their communication difficulties. We spent time and observed the care and support people received.

We saw that people were respected by staff. We saw that people appeared comfortable with the staff that supported them.

People’s needs had been assessed and care and treatment was planned and delivered in line with their individual care plan. We saw that staff were aware of each person’s needs and how to give care and support to meet those needs. We saw that staff were kind and caring in their approach to people who lived in the home.

People were supported with access to additional medical services as necessary to make sure their health and social welfare was protected at all times.

Recruitment procedures were in place and these had been followed to make sure that suitable people were employed to work at the home. Staff we spoke with told us they: “Enjoy working here, we have a great team and everyone works well together”.

The provider had a complaints procedure in place. Staff told us: “If we have any concerns we can talk to the manager and X will listen”.

In this report the name of the registered manager appears who was not in post and not managing the regulatory activities at this location at the time of the inspection.

We inspected Bethany Lodge and found that people were supported to make everyday decisions by staff at the home. People’s views and experiences were taken into account in the way the service was provided and delivered in relation to their care.

Records showed that people’s needs had been assessed and care and treatment was planned and delivered in line with their individual care plan.

We found that people who used the service were protected from the risk of abuse. People told us they liked living at Bethany Lodge and that they felt the staff gave them the help they needed. We saw that staff had a kind and caring approach towards people they supported.

Staff received regular training and support so that they were able to give people the care they needed. Staff told us they were given many opportunities to do training and were well supported by the registered manager and the deputy manager.

The provider had sent us a copy of the report of the review of the service that had been carried out during 2012. This report showed that people’s views of the service had been obtained and taken into account in the way the service was provided.