Chandos Lodge is a residential care home for 34 older people who may have a diagnosis of dementia. At the time of our inspection there were 27 people living at the home.

At the last inspection in November 2015 the service was rated Good. At this inspection we found the service remained Good.

People were supported to make safe choices in relation to taking risks in their day to day lives which helped people to maintain their own levels of independence. This was because staff made sure people had the equipment and aids they required to meet their needs. Staff had been trained and understood how to support people in a way which protected them from harm and abuse. There were arrangements in place to make sure staff were trained and competent in medicine administration which reduced risks to people’s safety and welfare.

Staff received regular training including dementia training, so they had the knowledge and skills to meet people's needs in an effective and personalised way.

People had regularly seen a variety of health professionals to maintain their independence, health and wellbeing.

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. Staff demonstrated their understanding of the Mental Capacity Act 2005 (MCA) and its relation to protecting people who used the service from unlawful restrictions. Records confirmed consent was sought for a variety of decisions in relation to the care people received. This confirmed people who used the service or their relatives had been consulted about and agreed to the care they received.

People who lived at the home and their relatives worked in partnership with staff to plan their care. Care records were personalised and contained detailed information about what was important to people. There was a caring, kind, staff team who knew and respected people as individuals and provided care which put people at the heart of all the care offered.

Staff treated people with dignity and respect and understood the need for people’s privacy and confidentiality.

People had access and assistance to follow their chosen religious activities.

People told us they enjoyed the food served and the dining experience offered. Staff were aware of people’s dietary needs, to help them stay well.

People were encouraged to follow their individual interests and suggest what entertainment they would like at the home.

The manager and the provider actively sought people’s opinions about the home and activities offered to enhance people’s wellbeing. People knew how to raise any concerns or complaints were managed in line with the provider’s complaints policy and brought to a satisfactory conclusion.

Regular quality audits had been performed to identify improvements and help maintain a quality service.

We inspected Chandos Lodge and spoke with the registered manager and the operations manager. We also spoke with staff these included senior care workers, care staff, a domestic and the cook. We spoke with these staff members about the support they gave to people who used the service. We also spoke with five people who used the service and four visitors. Speaking with these people helped answer our five questions about the service.

• 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. This summary is based on our observations and evidence we found during the inspection.

Is the service safe?

People who used the service told us that they felt safe living at Chandos Lodge. People told us the staff were kind and friendly towards them and provided the care and support they needed.

People told us that they were involved in their day to day decisions and could make choices about what support they needed.

People’s care records had been completed and these matched most of their individual care needs. We found that risk assessments were in place which meant people were not placed at risk of receiving inappropriate care and support.

Systems were in place to make sure that the provider learnt from accidents and incidents. We found that some piece of equipment in toilets needed to be replaced to ensure people were safe from cross infection.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberties Safeguards which applies to care homes. The provider had policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards. We found that staff had knowledge of DoL’s. This meant that people would be safeguarded as required.

Is the service effective?

People's health and care needs were assessed and care and treatment was planned and delivered in line with their individual needs.

We found from our observations and from speaking with staff that they had an understanding of most people's care and support needs.

We were told by staff who worked at the home that they received training to enable them to support people effectively. Systems were in place for staff to receive support and guidance from managers to enable them to feel supported in their role.

Is the service caring?

People we spoke with told us that staff treated them kindly and that their needs were met. We saw staff interactions were supportive and respectful and that staff assisted people sensitively, whilst at the same time promoting their independence as much as possible.

We found that people were able to make choices about their food and drink and where they spent the day.

Is the service responsive?

From our discussions with people who used the service and their relatives we found they were confident that any issues they had would be responded to in a timely way.

Records showed that people received help and support from health care professionals when required such as doctors, dentist and chiropodists.

Is the service well led?

The provider had quality assurance systems in place. These systems included obtaining the views of people who used the service and their relatives.

Staff told us they received supervision and that staff meetings had taken place. This meant that staff felt supported by the manager and senior staff.

32 people were living at the home when we visited. We talked with three of them as well as one person who was visiting a relative. We also spoke with the manager, deputy manager and two members of staff.

The people we spoke with told us they were happy with the home and the staff. One person told us: “I’m quite satisfied here. It’s a very happy place.” The visitor we spoke with said: “I’m very reassured that X is being looked after. They do a great job.”

We watched staff as they cared for people. They provided care and support that met people’s needs.

We found that staff knew about the needs of the people they were caring for. We looked at care records for three people and found that these contained guidance for staff on how to meet their needs. We saw that people’s needs were reviewed regularly.

We found that the equipment that was used in the home was maintained appropriately and that staff had been trained in its use.

We saw that staff were supported to be trained to an appropriate standard and we looked at records which showed that the provider was regularly monitoring the quality of its service.

There was a system in place for people to make complaints if they were not happy with any aspect of the service.

As part of our inspection process we spoke with three people who were using the service and a relative. Some people were unable to communicate effectively due to their health conditions. We used a number of different methods to help us understand the experiences of people who used the service.

We found that people’s privacy, dignity and independence were being respected by staff. We asked if people were able to make choices about their lifestyles, one person said:

“Oh yes, that’s not a problem. I go to bed between 9pm and half past.”

People using the service told us they were happy with the care they received form care workers. One person commented:

“They do all that I need.”

We found that people were receiving their medications as they had been prescribed for them by the doctor to promote their health and well being.

We saw that people in the home were relaxed and comfortable within their environment. Care workers interacted well with people and relatives, they were friendly and helpful. People told us they felt safe living at the home.

People said they were very satisfied with the care workers. They told us that care workers knew what their needs were and how to deliver them. One person commented that care workers responded to the call bells quickly but occasionally they had to wait a little.

The people we spoke with did not provide any opinions about the monitoring of the quality of the services provided to them. Our inspection revealed that the registered provider had systems in place for making ongoing improvements and that any complaints received were dealt with appropriately.

Chandos Lodge provides accommodation and personal care for up to 34 older people. At the time of our inspection there were 30 people living at the home.

The inspection took place on 3 and 9 November 2015 and was unannounced.

There was a registered manager in place at the time of our 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.

People we spoke with told us they felt safe living at the home. People were aware of their right to raise concerns about the service they received and these were investigated. Where the service was not to people’s expectations apologies were given and the registered manager looked at ways to resolve matters.

Staff showed an awareness and recognition of abuse and the actions they would need to take to keep people safe from harm.

Staff had knowledge of people’s changing care needs and their individual risk assessments to assist in keeping people safe. People’s needs were discussed as part of handover and care plans and risk assessments were regularly up dated to ensure staff had guidance to work to.

Staff felt supported by the registered manager and had received training and supervision. Staff were trained in order to provide them with the necessary skills and ability to meet the individual needs of people who lived at the home.

People were able to participate in events which took place in the home as well as enjoy individual interests. Staff had an awareness of people’s likes and dislikes and were seen to act upon these.

The majority of people liked the food provided and were given a choice. People were supported with their meals as needed and had a choice of drinks available to them. Sufficient staff were available to people who lived at the home to have their needs met. People had access to healthcare professionals as needed to maintain their wellbeing.

People and their relatives were involved in care planning to ensure they were up to date. People who lived at the home were able to feedback their thoughts of the care provided by means of a survey.

The registered manager and the operations manager had systems in place to monitor the quality of the service provided.