This inspection took place on 13 February 2018 and was unannounced. Drewstead Lodge is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The care home accommodates up to nine people. At the time of the inspection there was one person using the service.

At the last inspection on 18 December 2015, the service was meeting the regulations we inspected.

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 were protected from the risk of harm and abuse. Staff understood how to keep people safe and safeguarding processes were in place to support staff in reporting any allegations to the local authority. Steps were taken to mitigate any risks to people using the service.

There were sufficient numbers of staff to meet people’s needs. Staff received adequate training to support them to meet the needs of the people they cared for.

Medicines were stored, administered and managed safely. Infection control arrangements were in place to ensure that the premises were kept clean and personal protective equipment (PPE) was available. The provider had systems in place to manage any incidents, accidents or complaints.

The registered manager understood the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) and was aware of their responsibilities. Consent was sought from people before delivering care and people were encouraged to make decisions about the support they received. People were supported to access food and drink so that their dietary needs were met. Staff were aware of people’s nutritional preferences. People were supported to access healthcare professionals as and when required.

People and their relatives were involved in decisions about the care and support they received. An assessment of people’s needs took place and appropriate care plans were developed. Staff knew the people they cared for well and respected people’s likes and dislikes whilst encouraging them to maintain some independence.

Risk management plans were developed to mitigate any risk to people’s health and wellbeing. These provided appropriate guidance for staff on how to meet people’s needs and provide personalised care. The provider had a complaints policy in place.

Systems were in place to monitor and improve the service. Feedback from people and relatives was welcomed and the provider took action where needed. The registered manager spoke highly of their success in working with a number of partner agencies.

This inspection took place on 18 December 2015 and was unannounced. Drewstead Lodge provides accommodation and personal care for up to nine older people who are frail. We did not give a rating to the service because there was only one person using the service. We did not have enough information about the experiences of a sufficient number of people using the service to give a rating to each of the five questions and an overall rating for the service.

The provider was contemplating changes in the provision of care and support to people. Therefore, the provider did not consider new requests for the admission of people to the service.

At the last inspection on 27 December 2013, the service was meeting the regulations we inspected.

The service has 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 were kept safe from harm and abuse. The provider had safeguarding adults’ processes in place and had an awareness of the signs of abuse. Staff were aware of how to report an allegation of abuse to the local authority.

Staff had the relevant training, skills, experience, and knowledge to support people. There were sufficient numbers of staff to meet people’s care needs.

People gave consent to care and staff encouraged them to make choices and decisions about the way they wanted to be supported. The registered manager aware of their responsibilities under the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) to ensure people were cared for appropriately.

People had their medicines managed safely. The administration and storage of people’s medicines was safe. There were records maintained for the ordering, and disposal of medicines. Unused medicines were returned to the local dispensing pharmacy. Medicine administration records were fully completed.

People were cared for by staff who knew them well. Staff respected and understood people’s likes and dislikes and care delivered to meet these. People were encouraged by staff to maintain relationships with people that mattered to them. An assessment of people’s care needs took place and care plans developed to meet those needs. Staff identified risks to people’s health and well-being. A risk management plan was developed and implemented to manage and reduce their recurrence.

People had access to sufficient food and drink, which met their preferences. Staff had an awareness of people food preferences and nutritional needs. Meals were cooked onsite and people enjoyed them.

The registered manager and provider carried out regular monitoring and review of the service. There were systems in place to monitor and improve the quality of service delivery. People and their relatives gave feedback to the manager and the provider and action taken on them when needed.

One person who used the service told us "I am happy here and I like the staff." We saw that each person had their own private room, and had been able to bring personal items into the home. This ensured that their immediate environment was homely.

The manager told us that community nurses, chiropodists and general practitioners visited the home if required and we saw dates of these visits in the records.

We saw that the service had a copy of the current multi-agency safeguarding vulnerable people policy, along with contact details for reporting any concerns should these arise. A relative of a person who used the service told us "My mother feels safe with the staff who are very attentive."

The Registered Manager was responsible for planning the daily shifts for the service and told us that two full time members of staff lived on site. We were told no agency staff were used and the home had access to bank staff if there was a change in circumstances such as staff sickness or annual leave. One relative of a person who used the service told us "staff have good skills and the right approach."

The Registered Manager told us that an annual satisfaction survey was carried out and we reviewed written responses from relatives of people from July to November 2013. Examples included "she is extremely well cared for and in good health for her age" and "she is happy and contented and reacts very well with staff who communicate clearly with her."

This is a small service which at present has two people who use the service. We spoke to two people who use the service and they appeared relaxed and well cared for. One person told us "they were happy and well looked after".

We saw records of two people who use the service which included personal interests and preferences and were accurate and up to date.

The manager told us they had a system in place for requesting written feedback from the families of people who use the service. We saw responses ranging from 2012 and up to March 2013 - comments included "good care received", "supportive staff" and "happy in her surroundings".

We spoke to two members of staff who told us they enjoyed their work.

We reviewed records of training received by staff, examples included First Aid, fire safety, mental capacity act, food hygiene and risk assessment.

Older people like what this care setting offers, it is a small service with a friendly relaxed family atmosphere.People find that staff are attentive, and that they respond swiftly to any requests from residents. Individualised care is provided in a respectful manner, which enhances the dignity, choice and rights of residents.

Healthcare professionals find that the home has successfully supported people approaching the end of their lives to remain in the home, and that they have done this in a sensitive and compassionate manner.

Relatives and health professionals involved have confidence in the service. They find that it is run by an experienced and qualified manager that fosters a spirit of openness and respect.