What life is like for people using this service:

People felt safe at the home. They said the quality of the care, the presence of staff, and the environment made them feel safe. The home was well-staffed and the staff responded quickly if people used their call bells. People said they had their medicines safely and at the right time. All areas of the home were clean and fresh.

People were assessed before they came to the home to ensure staff could meet their needs. The staff were skilled and experienced. We saw staff assist people in communal areas and this was always done gently and efficiently. At lunch time people were seen to enjoy their meals at their own pace. Staff assisted people who needed support to eat. People told us they had good access to healthcare services. A visiting healthcare professional said people’s healthcare needs were met at the home. The premises were well-maintained and suitable for their purpose. People chose the décor for their own bedrooms which were personalised to suit their individual tastes.

People told us the staff were ‘marvellous’, ‘very caring’ and ‘approachable and professional’. We saw many examples of staff interacting with people in a friendly manner. People told us that if they were ever worried or upset staff comforted them. The routine in the home was relaxed and flexible to meet people’s needs. People said staff consulted them about getting up and going to bed times and when they wanted their meals. People were encouraged to remain independent. Visitors were made welcome at the home at any time.

Staff knew people well and were knowledgeable about their needs. Care plans included clear instructions to staff on how to support people in the way they wanted. People had access to a wide range of one-to-one and group activities. We saw people taking part in a game of seated bowls and an armchair exercise class. People said they also enjoyed the home's visiting entertainers, coach trips, and the religious services held at the home.

People told us the home provided high-quality care and said they would recommend it to others. The home had an open and friendly culture and people said the registered manager and deputy were helpful and accessible. People shared their experiences of the home at residents’ meetings and their suggestions were acted on. For example, tea urns and a bird table were purchased at their request. The home had links with organisations in the community to support staff in meeting people’s care and social needs including dementia services, a nursery school, and local churches.

More Information is in the detailed findings below.

Rating at last inspection: Good (report published on 26 May 2016)

About the service: Egerton Lodge is a care home that provides accommodation for up to 46 older people with dementia, mental health, physical disability and old age. The home is not registered to provide nursing care. At the time of our inspection there were 43 people using the service.

Why we inspected: This was a planned inspection based on the rating at the last inspection.

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

We carried out an unannounced inspection of the service on 18 April 2016.

Egerton Lodge is registered to provide care for up to 46 older people. At the time of our inspection 43 people were using the service. There are 43 bedrooms all with an ensuite facility. Accommodation is on three floors, all of which are accessible by stairs and a lift. There are three communal lounges and a dining room, a garden and courtyard. The home is situated in Melton Mowbray next to a park and very close to many amenities.

At our last inspection on 10 February 2014 we asked the provider to take action to improve of how medicines were ordered and stored; and to improve care plans so that they contained more detail about how people should be supported with their needs. At this inspection we found that these actions were completed.

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.

There were procedures to protect people from abuse. Staff understood their responsibilities to identify and report any sign of concerns using the provider’s safeguarding procedures. The registered manager acted immediately to remind staff of their responsibilities after they learnt a care worker had not reported a concern until a few weeks after an incident involving a person using the service. People were protected from avoidable harm through risk assessments. These included information for staff about how to support people safely and without undue restrictions.

Staffing deployment was based on needs of people using the service. If people’s needs increased, additional staff were deployed. The number of people using the service had reduced but the registered manager had maintained the same staffing levels. The provider’s recruitment procedures ensured as far as possible that only people suited to work at Egerton Lodge were employed.

The provider’s arrangements for the storage of medicines were safe. Only staff who successfully completed training in management of medicines supported people with their medicines.

People using the service were supported by staff with the right skills and knowledge. Staff were supported through effective training and supervision. Staff understood and practised their responsibilities under the Mental Capacity Act 2005. They sought people‘s consent before they provided care and support. No person had restrictions on their liberty unless it had been authorised under the Deprivation of Liberty Safeguards.

People were supported with their nutritional needs. They had a choice of nutritious food and were protected from the risks of malnutrition and dehydration. People were supported to access health services when they needed. The service arranged for health professionals to visit the service to attend to people’s health needs.

Staff developed caring relationships with people using the service. They were able to do this because they understood people’s needs and their life stories. Staff were attentive to people’s needs and supported them to be comfortable.

People using the service and their relatives had opportunities to be involved in decisions about their care and support. They had access to information about the service and their individual care plans. People had `mini care plans’ in their rooms which they could refer to.

Staff treated people with dignity and respect. People were able to spend their time the way they wanted and their choices were respected. People were able to spend private time alone or with relatives in their rooms. The service was awarded a `gold award for dignity in care’ by the local authority in September 2015.

People using the service and their relatives had access to a complaints procedure

We spoke with five people that used the service, their relatives and a number of staff when we visited. People we spoke with said they felt safe, and were happy to speak with staff if they had a problem. One person said, “I would speak to (named staff) she’s my keyworker, and we get on really well.”

People felt their food and meals were good, another person said to us, “The chef is good, I always have good food here.”

We looked at the medication system and found that medicines were stored appropriately. However we found that checks were completed regularly to ensure medicines were signed for appropriately. We also found that there were not adequate supplies of medicine in place to ensure uninterrupted treatment for people.

We found care plans and risk assessments were reviewed regularly. However we found that care plans had some missing information about the emergency treatment some people may have needed. There was also other information missing from a care plan about how a person’s medicine had been administered.

There were enough qualified, skilled and experienced staff to meet people’s needs. We spoke with people using the service, their relatives and staff. One person said to us, “The staff come quickly when I ring the (call) bell, you don’t need to wait long.”

We saw evidence of a number of levels of quality assurance (QA) that was used in the home, to ensure people were safe.

Some of the people who lived at the home had limited communication; we were unable to ascertain what a number people felt about their experiences.

We have included some of the comments made in the 2012 Quality Assurance questionnaire.

“The staff are very helpful”; “The home is run very well and the staff are very good”; “The staff are wonderful and the food is excellent”; “I would like to be able to get out more often”; “We are all treated well”; “The food is wonderful” and “I can have a laugh with the staff.”

Other people stated “I feel safe here knowing there is someone to look after me all the time”; “Staff should write things down so that they don’t forget”; and I feel very contented living here”; “The activities are very enjoyable”; “I like playing bingo and bowls”; “The activities are very enjoyable.”

During our visit we used our SOFI (Short Observational Framework for Inspection) tool to help us see what people’s experiences were. The SOFI tool allows us to spend time watching what is going on in a service and helps us to record how people spend their time and whether they have positive experiences. This includes looking at the support that is given to them by the staff.

We spoke to some people and they told us they were happy at the home. One visitor told us they were very happy with the service and commented, “Since my mum’s been here she’s eating well and looks much better.”

People accommodated in the home’s high dependency unit on the first floor of the building, individual care and welfare needs were not being met. The Care Quality Commission (CQC) asked for an immediate action plan to address the shortfalls. Following on our visit managers confirmed they had started to make changes to improve the quality of life for people using the high dependency unit.