This inspection took place on 14 and 17 September 2018. This inspection was unannounced.

Coneygar 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.

Coneygar Lodge is located in Bridport, Dorset. The home accommodates 22 people in four separate buildings situated around a courtyard, each of which has separate adapted facilities.

There are 22 single rooms, 21 of which are en-suite. All but three rooms are accessed from the ground floor. The three first floor rooms are accessed via stairs and there is a stair lift available. At the time of the inspection there were 22 people living at the service.

There was a registered manager in position. 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.’

The service was exceptionally well led. The service benefitted from strong leadership. The registered manager was passionate about providing person centred care and this was reflected in every aspect of the service. The registered manager worked in partnership with other organisations and had taken part in several good practice initiatives designed to further develop the service. They were enthusiastic and committed to providing the best service possible. Their focus included the promotion of dignity and valuing people's diverse needs to provide a very high standard of person centred care.

There was a 'whole team' approach which was the driving force in delivering a truly person centred service. Staff who had shown interest in specific areas, such as infection control medicines and end of life were designated 'Champions'. These champions played an essential role in developing best practice, sharing learning and acting as role models for other staff. An end of life champion told us their role was to, “Oversee what was happening and gently guide staff to what we should be doing in response to the wishes of the resident and their family".

People said they felt the service was extremely responsive to their needs. People who used the service received highly personalised care from staff who knew their background, interests and hobbies. People were encouraged to pursue individual interests and establish new community links and friendships. The registered manager listened to people who used the service and about what they wanted in regards to activities. Staff had an excellent understanding of people's needs and were imaginative in the way they provided person centred care which put people at the heart of the service. They did this by empowering people to reconnect with past interests, making people feel valued and enabling them to “live life to the full” again.

There were a range of social activities taking place. The registered manager told us, “We are proud of our activities, we take time to find out people’s individual interests so we can support them to remain as active and interested as possible. The art group are making amazing progress.” People told us they had been consulted in regards past interests and employment. They told us where they had shared their past experiences they had been encouraged to explore and “Take up” previous interests.

One initiative had been to involve people in past interests such as painting. People were introduced to a local artist and encouraged to join an art workshop. People showed us their art work and told us of their love of art and how they had, “Loved being able to take up that interest again. “I did not think I would ever paint again, it has given me a new lease of life.”

The service has taken innovative steps to m

The inspection took place on 18 and 21 March and was unannounced.

Coneygar Lodge is a residential home in Bridport which provides support for up to 22 people. They had one vacancy at the time of our inspection. The home is set around a courtyard and accommodation is in four separate buildings. All rooms are en-suite and each building has use of a communal area. People are able to use communal areas in any of the four buildings and all bedrooms have a wireless call bell in place. Most rooms are on the ground floor, rooms on the first floor have stairs and a stairlift for access. The home has a garden and a courtyard which are accessible to people.

The service had a registered manager. 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 were aware of how to keep people safe and able to explain how they would identify signs of possible abuse. The service had the local safeguarding policy and looked at the training records which showed that all staff had received safeguarding training.

Staff understood the risks affecting people and their role in reducing these risks. For example, one staff member told us about people who were at risk of falls and that they supervised them walking. They also said that “some residents request (us) to walk with them for confidence”.

People and visitors felt that there were enough staff to support people. One person told us “every time I’ve wanted something, they’ve been there”. Another said that staffing was “generally adequate, although (they are) sometimes busy at night time”. Another said “they come quite quickly when I call”.

Medicines were stored safely and given as prescribed. The service used an electronic Medicine Administration Record(EMAR) to give medicines to people. Staff with appropriate training gave medication and were able to show us how the system supported them to make sure medicines were given as per peoples prescription.

Staff were knowledgeable about the people they were supporting and received relevant training for their role. Supervisions were a mixture of face to face meetings and observational sessions where the registered manager observed staff in their role.

People were supported within the principles of the Mental Capacity Act 2005 (MCA). Staff had received training in MCA and were able to tell us how they supported people with decision making and explain the principles of the MCA and how they considered these when supporting people.

People, visitors and staff all told us that the food was good. There was a chef on the staff rota every day and we saw examples of the menu choices available for people.

Staff told us that information about people was passed to health professionals quickly when needed. One person said “if (someone was) unwell, I would speak to the shift leader to ensure it was passed to a health professional”.

People and visitors told us that the service was caring. One person said that staff were “considerate and seem to know what you want”. Another person said that they didn’t “need to ask them, they know what I need”. Staff were attentive to people and understood their individual needs.

People told us they had choices about their care. One person said “I decide when I get up and when I go to bed”. Another told us “ I go to bed early and listen to my radio and stay up for TV sometimes”. We looked at peoples care records and saw that their preferences were recorded.

People were not aware of advocacy services. We saw that the statement of purpose for the service included details about advocacy. However people, visitors and staff were not aware about these services. We spoke with the registered manager who immediately contacted the local advocacy servic

In this report the registered manager appears who was not in post and not managing the regulatory activities at this location at the time of the inspection. Their name appears because they were still a registered manager on our register at the time.

Our inspection on 15 December 2012 found that medicines were not always recorded and stored safely. The provider wrote to us on 14 February 2013 and told us that they had made improvements. During this inspection we found that sufficient improvements had not been made.

The medicines refrigerator was used to store urine samples and handwritten entries onto the Medication Administration Record (MAR) were not always signed by two members of staff to confirm accuracy. The storage and recording of

controlled drugs had improved since our last inspection.

People were treated with consideration and respect. One person told us, “They are always very kind and friendly.” Another person said, “I like the home very much, they are all very kind.”

People’s care needs were assessed and care and support was provided to meet people’s assessed needs. One person told us, “I think it’s excellent. I am not short of anything I need. If I am I ring the bell and they sort it for me.”

People were not always protected from the risks associated with the management of medicines as appropriate arrangements for the storage and recording were not made.

People were supported and cared for by skilled staff. One person told us, “They look after us well. We couldn’t do without them.”

The quality of the service was regularly assessed and improvements were made as a result. The provider had an annual program of quality monitoring activity including audit and survey.

In this report the registered manager, Natily Berry, appears who was not in post and not managing the regulatory activities at this location at the time of the inspection. Their name appears because they were still a Registered Manager on our register at the time.