Copthorne Lodge provides personal care for people, living in a purpose built scheme where there are 30 individual flats with shared facilities, such as a dining area and lounge areas. Staff provide personal care and support to people at pre-arranged times and in emergencies. Some people live at the scheme permanently whilst others live at the scheme on short term basis, whilst receiving care and support. There were 20 people receiving personal care when we inspected.

At the last inspection in March 2015, the service was rated as Good. At this inspection we found the service remained Good.

There was a registered manager in place. 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 continued to receive care and support from staff who understood how to keep them safe. Staff were available to meet people’s needs and understood how to best support people and the risks to their health. Staff understood how to protect people from abuse and were clear about the steps they would need to take if they suspected someone was unsafe. People were supported by staff to have their medicines as prescribed and checks were made to ensure staff supported people with their medicines appropriately.

The service continued to be effective. Staff said training helped them do their job and gave them the right skills to meet the needs of the people they supported. They were supported by the management team through regular supervisions and staff meetings. Staff understood they could only care for and support people who consented to being cared for. People enjoyed choices in the meals and drinks they were offered and told us staff responded when they were unwell and staff arranged health appointments on their behalf if they asked.

The service remained caring towards people. People said staff were caring and treated them with dignity and respect. People were involved in how their care and support was received; they were given choices and said their wishes were respected by staff.

The service remained responsive. People received care that met their needs. Staff provided care that took account of people’s individual needs and preferences and offered people choices. People said staff listened to them and they felt confident they could raise any issues should the need arise and action would be taken.

The service remained well led. Staff felt supported by the management team to provide good care. The registered manager and provider had systems in place to review and update people’s care and to assure themselves of the quality of care being delivered. Where areas had been identified for improvement, actions had been taken.

Further information is in the detailed findings below

Copthorne Lodge provides housing with care. The unit consists of 30 flats, four of which are double occupancy. People live in their own home and have a tenancy agreement with Whitefriars Housing. Staff provide personal care and support to people at pre-arranged times and in emergencies. At the time of our visit 25 people used the service.

We inspected Copthorne Lodge on 31 March 2015. The inspection was announced so people could give consent for us to visit them in their flats to talk with them.

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.

People told us they felt safe at Copthorne Lodge. Staff were trained in safeguarding and understood the action they should take if they had any concerns people were at risk of harm. There were processes to minimise risks to people’s safety; these included procedures to manage identified risks with people’s care and for managing people’s medicines. Staff understood the requirements of the Mental Capacity Act (MCA) and knew they could only provide care and support to people who had given their consent.

Staff received training in areas considered essential to meet people’s care and support needs safely and consistently. People told us they received care from a regular team of staff who understood their likes, dislikes and preferences. There were enough suitably trained staff to meet people’s individual support needs. People told us the care staff were kind, caring and respected their privacy, dignity and independence.

Care plans and risk assessments contained relevant information for staff to help them provide the personalised care people required. Care plans were updated regularly and people and their relatives had been involved in reviews. Staff referred people to other health professionals when their health needs changed and supported people to follow the health professionals’ advice.

People were encouraged to share their views and opinions about the quality of the service and all the people we spoke with were happy with the service they received. People knew how to complain and information about making a complaint was available for people. Staff were confident they could raise any concerns or issues with the managers and this would be listened to and acted on.

There were processes to monitor the quality of the service provided and understand the experiences of people who used the service. This was through direct feedback from people, returned surveys, tenant and staff meetings and a programme of checks and audits.

Copthorne Lodge provides housing with care. People live in their own flats and staff provide support at pre- arranged times. We visited the service on Wednesday 3 April 2013. There were 25 people using the service on the day of our visit. During our visit we spoke with six people who used the service, the assistant manager and four members of staff.

We looked at the care records of three people who used the service. We were satisfied people were receiving the care they had consented to. We found care plans provided staff with sufficient information about people’s support needs and how staff were to provide support safely. We found staff supported people to maintain independence. One person told us, “I do everything for myself other than my medication. I like to be independent; the staff respects my wishes and don’t interfere.” People spoke positively about the care provided. One person said, "All the staff are very friendly. I feel very fortunate to live here, its lovely.”

We looked at medication management and the recruitment procedure. We found people received their medication at the times prescribed. There were processes in place to safely recruit staff and provide staff with the training and support to meet people’s needs.

We looked at how complaints were managed. There was clear information for people about how to make a complaint. People we spoke with said they had no need to complain about the service but would speak to someone if they needed to.

When we visited the Copthorne Lodge on 11 April 12 we found that the procedure for monitoring and managing pressure area care did not ensure peoples welfare and safety and this could place people at risk.

We asked the provider to send CQC a report to say what action they were going to take to achieve compliance with this essential standard. The report told us, “Following CQC inspection all areas of concern were immediately addressed and rectified.”

We visited Copthorne Lodge again on 14 June 2012 to review the improvements made to the management of pressure area care. We did not talk to people who use the service during this follow up visit. Peoples experience of the service can be found in the report dated 11 April 12.

We requested to see the care files for the two people where concerns had been identified on our last visit. We found that risk assessments had been completed for pressure area management. This information had also been recorded in their care support plans. We saw from records we looked at that staff were checking pressure areas and reported concerns to the senior staff on duty. The senior staff then referred this to the district nurse.

We looked at the call schedules for the two clients whose pressure area care we were looking into. We found that the information on schedules was not detailed in relation to what staff should do to manage pressure care. We asked a member of staff about pressure area management for one of the people concerned. We were told that she knew the client well and that staff always checked pressure areas during personal care routines. The senior carer who supported our visit added the additional information required to the call schedules. This should ensure any staff not familiar with the people who use the service will have sufficient information about how to manage individual’s pressure area care.

We found that people were now having their pressure area care managed and monitored to ensure their welfare and safety.

People told us that they were consulted and involved in decisions about the care they received and were involved in care plan reviews.

People we spoke with told us that staff were polite and treated them with respect. We were told carers were helpful and friendly. One person said “I couldn’t wish for better staff”. Staff we spoke with said they encouraged people to maintain their independence. One staff member said “We always encourage tenants to do things for themselves wherever possible.”

The files we looked at contained care plans and risk assessments. Plans we looked at provided staff with sufficient information about the care support required. We saw that assessments and support plans were being reviewed and updated as needed. We found that pressure area management should be improved to make sure people remain safe and well.

We looked at a sample of staff work schedules. These showed calls are allocated consistently and that staff were given sufficient time to carry out all the tasks required. One person said "All the carers here are really good they always make sure I have everything I need before they leave”.

Staff we spoke with knew what they would do to keep people safe. Staff spoken with knew about the whistle blowing procedure and said that they would have no hesitation reporting poor practice to the office. Staff we spoke with said they had regular training and felt well supported to do their job.

People we spoke with said they were asked for their views and opinions of the service. People told us that they would talk to the managers if they were unhappy about anything. Care staff we spoke with said they had confidence that any concerns they reported to the staff in the office would be dealt with promptly.