At the last inspection on 28 and 30 October 2014, the service was rated Good. At this inspection we found the service remained overall Good. However, we did find some areas of practice which needed improvement which had not been consistently maintained. People and relatives and observations during the day told us people had access to drinks during their stay in the service. But the recording of fluid charts had not always been fully maintained to ensure there was an accurate record of people’s consumption. Staff told us they felt well supported, managers were accessible and they had access to a range of training opportunities. But not all staff had undertaken updates of their essential training or received formal supervision which had been recorded.to meet the provider’s policy and procedures. These are areas of practice in need of improvement.

People and their relatives told us people felt safe. One person told us, “I have been here five days. It is lovely so far. My daughter says they are doing up my house, but I think I couldn’t be in a safer place. I could stay here forever.” They knew who they could talk with if they had any concerns. They felt it was somewhere where they could raise concerns and they would be listened to. There were systems in place to assess and manage risks and to provide safe and effective care. People were supported by staff who had been through robust recruitment procedures.

Sufficient numbers of suitable staff had been maintained to keep people safe and meet their care and support needs. Staff told us they were supported to develop their skills and knowledge by receiving training which helped them to carry out their roles and responsibilities effectively. Training records were kept up-to-date, plans were in place to promote good practice and develop the knowledge and skills of staff.

People's individual care and support needs were assessed before they moved into the service. Care and support provided was personalised and based on the identified needs of each individual. People’s care and support plans and risk assessments had been maintained and were detailed and reviewed regularly. People told us they had felt involved and listened to. Where people were unable to make decisions for themselves this had been considered under the Mental Capacity Act 2005, and appropriate actions continued to be followed to arrange meetings to make a decision within their best interests.

The service continued to have a relaxed and homely feel. People were supported by kind and caring staff who treated them with respect and dignity. They were spoken with and supported in a sensitive, respectful and professional manner. One person told us, “I would recommend this place to anyone.” A member of staff told us, “We build up a rapport and loving and caring relationships and put them in the centre. We look at the personal outlook like their hair and treat them as individuals. For example, one lady loved sprays and crosswords so we bought her some impulse sprays and crosswords in her room. It’s the little things, knowing her interests and what makes them smile and we encourage that.”

People told us the food was good and plentiful. One person told us, “The food is lovely and you can choose what you want to eat. You can even change your mind. The portions are good but you are always asked about everything, before it is served.” Staff told us that an individual’s dietary requirements formed part of their pre-admission assessment and people were regularly consulted about their food preferences. Healthcare professionals, including speech and language therapists and dieticians, had been consulted with as required.

Staff told us that communication throughout the service continued to be good and included comprehensive handovers at the beginning of each shift and staff meetings. They confirmed that they felt valued and supported by the managers, who they described as very approachable. The registered manager told u

There were 21 people who used the service at the time of our inspection. We used a number of different methods to help us understand the views and experiences of these people, as not all of the people who used the service were able to tell of their experiences. We spoke with the registered manager who is referred to as manager in the report, the duty officer, two care workers one of who was one of the organisations bank staff, a domestic assistant, an agency cook, three people who used the service, and three relatives. We observed care workers supporting people and looked at care/staff documentation and documentation in relation to the running of the service.

This told us people had been asked for their consent for any care or treatment, and that care workers had acted in accordance with their wishes. People or their representatives had been involved in making decisions about their care and treatment. People’s care needs had been assessed, planned, reviewed and delivered in line with their individual care plan. One relative commented, “I think it’s wonderful. The staff are lovely and very friendly. I feel more relaxed that my mum is here. From what I see I am very pleased.”

People were provided with a choice of suitable and nutritious food and drink. Comments received included, “The food is very good. I would have said if I did not get to choose. I get a cup of tea when I want,” and “The food is quite nice.”

All feedback received confirmed that the service was clean.

There were sufficient numbers of staff with the right skills and qualifications to meet the needs of the people who used the service.

Systems were in place to review and monitor the quality of the care provided.

Some people were unable to communicate with us about the service they received at Ireland Lodge. We therefore reached views about the delivery of the service through observation, information from other people, and viewing care records to assess compliance.

We spoke to two people using the service individually who told us that they were happy with the care provided and one person told us that they were involved in the discussions about the care that was to be provided.

We used the Short Observational Framework for Inspection (SOFI) tool during this visit in one of the three lounge areas after people had had their tea.

Staff members we spoke to told us that they were happy working in the home, that the team worked well together and that they had received the training and support they needed to meet individual people’s care needs.

This inspection took place on 28 and 30 October 2014 and was unannounced. We last visited the service on 13 December 2013, where no concerns were raised.

Ireland Lodge in run by Brighton & Hove City Council and provides personal care and support for up to 23 people. Care is provided to adults over 50 years of age, but predominantly older people who are living with dementia. This was for a period of respite care, or for a period of assessment. for people living in the community or people discharged from hospital to give an opportunity to ascertain their care and support needs and for these to be put in place. The service has a high level of admissions and discharges due to people only staying for short periods of care and there are no long term placements in the service. There were 22 people living in the service on the day of our inspection.

The service had a registered manager, who was present throughout the inspection, who has been in their current post for a number of years and knew the service well. 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's individual care and support needs were assessed before they moved into the service. Care and support provided was personalised and based on the identified needs of each individual. People’s care and support plans and risk assessments were detailed and reviewed regularly. People told us they had felt involved and listened to.

Where people were unable to make decisions for themselves the service had considered the person’s capacity under the Mental Capacity Act 2005, and had taken appropriate action to arrange meetings to make a decision within their best interests.

People were treated with respect and dignity by the staff. They were spoken with and supported in a sensitive, respectful and professional manner. One person told us, “I had a look around and chose to come here. It’s the best place.” Another person told us, “Being in this place is beautiful.” A visitor told us, “My relative has been here since mid-September. I can’t speak highly enough of the home. The relatives talk to each other and they all say it is good. I come in at all times of the day. Overall there is nothing to criticise.”

People and their visitors told us they felt safe. They knew who they could talk with if they had any concerns. They felt it was somewhere where they could raise concerns and they would be listened to. There were systems in place to assess and manage risks and to provide safe and effective care.

People said the food was good and plentiful. Staff told us that an individual’s dietary requirements formed part of their pre-admission assessment and people were regularly consulted about their food preferences. Healthcare professionals, including speech and language therapists and dieticians, had been consulted with as required.

People had access to health care professionals. All appointments with, or visits by, health care professionals were recorded in individual care plans.

There were sufficient numbers of suitable staff to keep people safe and meet their care and support needs. Staff told us they were supported to develop their skills and knowledge by receiving training which helped them to carry out their roles and responsibilities effectively. Training records were kept up-to-date, plans were in place to promote good practice and develop the knowledge and skills of staff.

Staff told us that communication throughout the service was good and included comprehensive handovers at the beginning of each shift and regular staff meetings. They confirmed that they felt valued and supported by the managers, who they described as very approachable.

People were asked to complete a satisfaction questionnaire at the end of their stay, and had the opportunity to attend residents meetings. The registered manager told us that senior staff carried out a range of internal audits, and records confirmed this. The registered manager also told us that they operated an 'open door policy' so people living in the service, staff and visitors could discuss any issues they may have.