The inspection took place on 5 March 2018 and was unannounced. Bonehill Lodge is a care home that provides accommodation with personal care and is registered to accommodate 26 people. The service provides support to older people who may be living with dementia. The accommodation at Bonehill Lodge is on the ground and first floor and there are two lounge areas, a conservatory and a dining room. The home is on the outskirts of Tamworth and has a car park for visitors to use. Public facilities and transport services are within easy reach of the home.

Bonehill Lodge is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. At the time of the inspection there were 24 people using the service.

At this inspection we found the evidence 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. However, we found the service had improved their rating to outstanding in Responsive by demonstrating they provided tailored, flexible support that consistently met people’s individual needs and preferences.

People were supported to live full lives and received care that reflected how they wanted to be supported. The staff were motivated and committed to provide people with personalised experiences that exceeded their expectations. The registered manager encouraged staff to be imaginative in the way they provided care which recognised that people were at the heart of their service. Staff worked collaboratively with other professionals to ensure people received care based on best practice. The care planning focused on people’s individual needs and preferences. People were central to deciding how care was planned and staff recognised the elements which were most important to them. The support plans were reviewed when their needs changed to ensure it reflected their wishes. Staff recognised how information needed to be provided to ensure people’s understanding, including the use of information technology to help with communication. People’s diversity was fully recognised and promoted by the staff; people were supported to follow their religious beliefs and to maintain important family relationships. People could raise any concerns or complaints; people were confident their concerns were acted on as the staff and registered manager were approachable listened to what they wanted to say.

People continued to receive safe care. There were enough staff to support people and staff were recruited to ensure that they were safe to work with people. People were protected from the risk of harm and received their prescribed medicines safely. Lessons were learnt from when mistakes happened.

The care that people received continued to be effective. They 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. Staff received training and support to be enable them to care for people well. People were supported to maintain a diet that met their requirements and they received support from health care professionals to ensure their well-being was maintained. Health concerns were monitored to ensure people received specialist health care intervention when this was needed. The environment met people’s needs.

There was a strong management team and people were included in developing the service and found the registered manager approachable. There were processes in place for people to express their views and opinions about the service provided. There were systems in place to monitor the quality of the ser

This inspection took place on 28 January 2016 and was unannounced. At our last inspection on 9 August 2013 the provider was meeting the legal requirements we looked at.

Bonehill Lodge provides personal care for up to 26 people. There were 26 people living in the home on the day of our inspection.

There was a registered manager 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.

Staff understood their role in protecting people’s risk of harm and assessing avoidable risks. There were a sufficient number of suitably recruited staff to provide care to people. People received their prescribed medicines to keep them well as there were processes in place to ensure medicines were administered, recorded and stored correctly.

Staff were provided with training and support to enhance their skills and knowledge to improve people’s care. The provider understood the principles of the Mental Capacity Act 2005 and supported people to make decisions which were in their best interest.

People were supported to eat a meal of their choice in a pleasant sociable environment. People’s health and wellbeing was monitored and the support of healthcare professionals was sought whenever specialist advice was required.

People were treated politely by kind and considerate staff who knew them well. Staff ensured that people were supported to maintain their dignity and respected their right to privacy. People were able to stay in touch with people who were important to them as visitors could come to the home at any time.

People’s preferences were considered and incorporated in to the plans for their care. There were regular reviews of people’s care to ensure it accurately reflected their needs. People had opportunities to socialise together or independently inside and outside of the home.

When people or their relatives raised concerns or complaints there was an investigation followed by a detailed response.

People, their relatives, staff and external professionals were happy with the way the home was managed. The provider took an active interest in the home which they were refurbishing to improve the environment for people.

We visited Bonehill Lodge on 9 August 2013. This was our first inspection since the service had been taken over by the new provider, Oaktrees Healthcare. We spoke with three people who lived there. One person told us: “I’ve got a lovely room and the carers are kind. The meals are very, very good.” Another person said: "I love every minute here. I’m trying to think if there’s anything to complain about but I can’t.” A third person said: “It’s a homely home, a nice place to be. I feel genuinely well-cared for.”

We saw that the people who lived at Bonehill Lodge were treated with consideration and respect. When we looked at people’s care plans, we found that people’s individual needs and preferred routines were clearly recorded. Care workers had clear guidance about meeting people’s needs. The people we spoke with told us their needs were met. Two professional visitors confirmed that staff worked with them to ensure that people’s specific needs were met.

We spoke with the registered manager and two care workers during our inspection. We observed other care workers as they went about their work. We saw that there were enough staff on duty through the day to provide care for people. Staff told us about their training which enabled them to care for people safely.

We saw that quality assurance at Bonehill Lodge was monitored through questionnaires for the people who lived there and their families. We saw evidence that processes in the home were audited by the manager.