About the service: Courtland Lodge is a residential care home that can provide residential and nursing care for up to 60 older people including people living with dementia, physical disabilities, sensory impairments. At the time of inspection 54 people were living at the service.

People’s experience of using this service:

¿ People we spoke with confirmed they were happy living at Courtland Lodge. Staff were kind and caring and had developed good relationships with people who lived there. People received the care and support that met their needs.

¿ Staff promoted people’s independence; people were involved in the home’s day to day life and formed friendships with each other and staff working in the home. There were plenty spaces where people could choose to be alone, sit with other, or join in activities.

¿ Staff promoted people’s privacy and dignity and their choices were respected. Care and support were delivered in a personalised way by staff who knew people and their preferences.

¿ Risks to people’s well-being and health were managed and regularly reviewed to ensure people were safe and protected from the risk of harm. Staff received training and had their competencies assessed to ensure they had the skilled and knowledge to meet people’s needs effectively.

¿ The environment was homely, clean and welcoming. Staff used effective infection control measures to protect people from the risk of infections. Appropriate equipment was in place where needed for people to receive support in a safe way.

¿ People had opportunities to take part in organised group activities or pursue their hobbies and interests. Staff had a genuine interest to keep people involved and occupied. There were also a group of staff who volunteered their free time to provide activities and fun for people who lived at Courtland Lodge.

¿ People and relatives confirmed there were enough staff in the home to meet people’s needs. The manager monitored people’s needs to ensure good staffing levels. People felt listened to and they told us they were happy living at Courtland Lodge.

¿ Everyone we spoke with, people, relatives and staff praised the manager for being visible, supportive and placing people at the centre of the care and support delivered.

¿ Complaints and feedback from people and relatives were used in a constructive way and lessons were learned to ensure improvements were made.

¿ The manager and the provider used a range of effective audits and governance systems to check the quality and safety of the care people received.

Rating at last inspection: Good (report published 29 July 2016)

Why we inspected: This was a planned inspection based on the rating at the last inspection. At this inspection the service remained rated Good overall.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

The inspection took place on 26 April 2016 and was unannounced. At our last inspection on 4 April 2014, the service was found to be meeting the required standards in the areas we looked at. At this inspection we found that they had continued to meet the standards.

Courtland Lodge provides accommodation and personal care for up to 60 older people. At the time of our inspection 57 people lived at the home. Some people at the home were unable to verbally communicate with us so we observed how care and support was provided in communal areas such as the lounge and dining area.

There was a manager in post who had registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the CQC 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 and associated Regulations about how the service is run.

People told us that they felt safe, happy and well looked after at the home. Staff received training in how to safeguard people from abuse and knew how to report concerns, both internally and externally. Safe and effective recruitment practices were followed to ensure that all staff were suitably qualified and experienced. Arrangements were in place to help ensure there were sufficient numbers of suitable staff available at all times to meet people’s individual needs.

Plans and guidance had been drawn up to help staff deal with unforeseen events and emergencies. The environment and equipment used were regularly checked and well maintained to keep people safe. Trained staff helped people to take their medicines safely and at the right time. Identified and potential risks to people’s health and well-being were reviewed and managed effectively.

Relatives and healthcare professionals were positive about the skills, experience and abilities of staff who worked at the home. They received training and refresher updates relevant to their roles and had regular supervision meetings to discuss and review their development and performance.

People were supported to maintain good health and had access to health and social care professionals when necessary. They were provided with a healthy balanced diet that met their individual needs.

Staff made efforts to ascertain people’s wishes and obtain their verbal consent before providing personal care and support, which they did in a kind and compassionate way. Information about local advocacy services was available to help people and their family access independent advice or guidance.

Staff had developed positive and caring relationships with the people they cared for and clearly knew them well. People were involved in the planning, delivery and reviews of the care and support provided. The confidentiality of information held about their medical and personal histories was securely maintained throughout the home.

Care was provided in a way that promoted people’s dignity and respected their privacy. People received personalised care and support that met their needs and took account of their preferences. Staff were knowledgeable about people’s background histories, routines and personal circumstances.

People were supported to pursue social interests and take part in meaningful activities relevant to their needs, both at the home and in the wider community. They felt that staff listened to them and responded to any concerns they had in a positive way. Complaints were recorded and investigated thoroughly with learning outcomes used to make improvements where necessary.

Relatives, staff and professional stakeholders were complimentary about the manager and staff on how the home was run and operated. Appropriate systems and processes were in place to monitor the quality of services provided, reduce potential risks and drive improvement.

The inspection team was made up of one inspector. We set out to answer our five key questions; Is the service caring, responsive, safe, effective, and well led?

When we inspected Courtland lodge in July 2013 we found that they were not meeting three of the regulations we reviewed, so we checked to make sure they had made the required improvements. We found that they had made the improvements and were now meeting all the regulations we inspected. During the course of our inspection we followed up to make sure there were no mal odours that were identified during our last inspection. Overall these had been addressed and improved. We observed people being cared for in the four units in the home, where people had differing needs and abilities. We observed staff assisting people in the communal areas and in their individual bedrooms. People were assisted with patience and understanding and staff displayed a good knowledge and understanding of people’s needs.

Below is a summary of what we found. The summary is based on our observations during the inspection, discussions with people using the service, their relatives, and the staff supporting them and looking at records.

If you wish to see the evidence supporting our summary please read the full report.

Is the service safe?

People who lived at Courtland lodge told us they were well looked after and felt safe. We observed people looked at ease in their surroundings and through their interaction with staff. The provider had a robust safeguarding policy and procedure in place and made appropriate referrals when required.

Is the service effective?

We observed people in a variety of situations in the home. We found that care was provided at a time when people required it. There were systems in place to ‘manage’ the home effectively.

Is the service caring?

We found that staff were very kind and attentive to people who used the service. Although during a meal time we observed staff were busy serving food and did not spend much time interacting with people. However at other times when they were less busy they were seen to be very caring and patient when supporting people.

Is the service responsive?

We noted that the staff and managers responded quickly and appropriately to situations that occurred. People who used the service told us "The staff were very helpful, and they did as much as they could for you”. We observed staff demonstrated a clear understanding of people’s needs.

Is the service well-led?

The service is well managed and the management team had a good overview and knowledge of all aspects of the service. There were systems in place to ensure a consistent approach to policies and procedures. We found that there were well developed relationships with other professionals and appropriate referrals were made, in this regard.

A relative of a person who used the service told us “Staff know people by their first names.” and “I am absolutely happy with my relative being here. Staff are brilliant.”

We found that the provider did not have sufficient information in people’s care records. We found the provider did not have sufficient processes in place to ensure people’s personal and cultural preferences relating to food were met.

We saw the provider had systems in place to ensure medication was managed safety. We noted that staff felt they were well supported and they were equipped with the tools and training they needed to perform their job roles.

The provider had processes in place to monitor the quality of the service they provided to people. However the findings of these monitoring processes were not always acted upon. We saw the provider had suitable complaints procedures in place.

When we visited Courtland Lodge on 5 February 2013, we visited two of the four units in the home, and spoke with eight people who lived there. We found that most people were satisfied with the care and support they received. People looked at ease in the company of staff and told us the staff were friendly and supportive. One person said, "I've been here a while, and I've found the staff are all lovely."

We observed that people were offered support at a level which encouraged independence and assured that their individual needs were met. People were supported to make choices about their every day lives and we observed staff were friendly and polite in their approach and interacted confidently with people. We noted the midday meal service was relaxed and people were given assistance in an unhurried way.

We found most peoples' care needs were documented in a way which promoted personalised care and continuity of care delivery, although we did identify some inconsistencies across the two units we visited. People were encouraged to express their views, and personal preferences and choices were integrated into care plans. Within the care files we saw care documents had been signed by the individual or a representative to confirm their involvement and agreement with their care plan.

We found there were sufficient staff on duty to meet peoples' needs. The staff were knowledgeable about the people they cared for and they had completed a wide range of training.

People who use the service told us during our visit on the 20 June 2011 that they are satisfied with the care and service provided. A person we spoke to said “I am very happy here” and another person remarked that the staff “are very helpful and kind; I have no complaints.” However, one person expressed that staff are “generally friendly and helpful” except for "one or two who could be more caring.” The same person added that the manager “is very helpful and always sorts things out for me.”

People in the dementia units were not able to give us feedback but their family members spoke on their behalf and commented that the person is “well looked after” and added that the staff are “caring and helpful” and that they have “no complaints so far”.