Faldonside Lodge provides accommodation and care for up to 15 people, many of whom are living with dementia. At the time of our inspection there were 13 people living in the home.

There was a registered manager in the home. 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.

At the last inspection, the service was rated Good. At this inspection we found the service remained Good.

Why the service is rated Good

People were treated in a kind and caring way at Faldonside Lodge and were consistently involved in the planning and reviewing of their care. People’s privacy and dignity was consistently upheld and there were no restrictions placed on when people could have relatives or friends visit them.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Individual risks to people and within the environment were consistently assessed and steps had been taken to mitigate these risks. There were consistently enough staff to support people.

People’s medicines were managed and stored in a safe way and people received their medicines as prescribed.

Staff were supported through regular supervisions and by having access to a variety of courses which would develop their skills and knowledge within their role. Staff ensured that people maintained a healthy dietary intake and people had their preferences catered for. People were able to access relevant healthcare professionals when needed.

There were regular quality satisfaction surveys to gain people’s feedback about their care and treatment. The registered manager involved people living in the home and the staff in discussions about how the service could be improved.

Further information is in the detailed findings below

We inspected Faldonside Lodge on the 28 November 2014. This was an unannounced inspection.

Faldonside Lodge provides care for up to 15 older people who require nursing or personal care. The home is registered with the Care Quality Commission by Mrs J. Soobrayen. There were eight people living in the home when we inspected.

At the time of the inspection the home had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (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 2008 and associated Regulations about how the service is run.

The CQC is required by law to monitor the operation of the Mental Capacity Act (MCA) 2005, Deprivation of Liberty Safeguards (DoLS), and to report on what we find. The DoLS are a code of practice to supplement the main MCA 20015 Code of Practice. They are put in place to protect people where they do not have capacity to make decisions and where it is considered necessary to restrict their freedom in some way, usually to protect themselves or others. No applications had been made relating to people who lived at the home and we found that the requirements of the MCA 2005 had been complied with.

People told us they felt safe at the home. Staff were aware of how to identify abuse and what to do if they suspected abuse was taking place. Staff had received training in safeguarding adults and refresher training was about to be undertaken.

The home undertook safe and robust employment checks when recruiting new employees. This helped to achieve and maintain the recruitment of staff that were qualified, trained and of good character. The provider and registered manager were maintaining staffing levels which contributed to protecting people from harm.

Medicines were managed, stored and administered safely by staff who had been properly trained.

Any accidents or incidents were recorded appropriately and timely. Learning from such experiences was shared with staff so as to help prevent recurrences.

At the time of the inspection the home was clean and tidy and free from hazard. Staff were trained in infection prevention the home was equipped with hand sanitizers and relevant information posters about the need for good hand hygiene.

Staff undertook regular training, supported by refresher training where relevant. Staff were empowered and supported to progress their careers by taking National Vocational Qualifications in care (NVQ). This contributed to ensuring they had the skills and knowledge necessary to support people well.

People’s choices in relation to their food and drink and times that they took breakfast were flexible to meet their needs.

Hot and cold drinks were to hand in all areas of the home and people told us they never went without a drink or snack if they wanted one. We observed this to be the case during the inspection.

People were supported to see health professionals where this was needed for rehabilitation or treatment. When necessary GP visits, nurse visits and chiropody visits were arranged. The registered manager would take people to see their own GP or dentist if they wished.

Staff were caring and attentive towards people who lived at the home. At all times staff were respectful and courteous. People were encouraged, where possible, to maintain independence. No pressure was placed on anyone to do anything they did not wish to. Staff were fully aware of people’s personal choices as to how they wished to spend their time.

People and staff were encouraged to be open about any concerns they may have had and the registered manager was seen to respond in a kind and compassionate way at all times, answering questions, re-assuring people and instinctively knowing what was needed.

Assessments of people’s needs took place before they went to live at the home. Any changes to a person’s needs or requirements were immediately acted on and, where appropriate or relevant, family were involved in discussions about changing needs. Individual likes and dislikes, hobbies and interests were noted and acted upon.

People and family members told us how well managed the home was. In particular, they told us about the ‘extra lengths’ the registered manager went to, to make sure people were safe and well cared for. The provider complied with their responsibilities to notify the Care Quality Commission (CQC) of specific events happening within the home in a timely manner.

One person told us, “I reckon it’s one of the best in the district.” Another person said, “They look after me very well.” We also spoke with relatives of three people, all of whom were complementary about the care and support their family member received. One relative told us that the staff couldn’t possibly do any more to look after their family member.

Before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes. Where one person was unable to consent verbally, staff were able to explain to us how they were satisfied that the person had consented to receive the 'flu jab'. This demonstrated that the home understood the requirements of the Mental Capacity Act and respected the person's rights.

We reviewed care records for four people, each of whom had different needs. Each record held a comprehensive pre-admission assessment which enabled the home to determine whether they could meet the person’s individual needs. Monthly reviews were done promptly.

People were supported to be able to eat and drink sufficient amounts to meet their needs. Two people received direct assistance from staff to eat and required a soft diet. Adapted cutlery had been provided for one person.

The provider had robust procedures in place for staff recruitment and a complaints process was available should people living in the home or visitors wish to make a complaint.

The people using the service said they were well looked after. One person said, “I am really settled here. The carers do an excellent job and look after us all well”. One person visiting someone in the home said, “I wouldn’t hesitate for one of my parents to live here when the time arrives”.

Care plans showed that people were involved in making decisions about how they wished to be cared for. They were regularly asked what they would like to do and staff supported their independence. The care given by staff reflected what was documented in people’s care plans, and care plans were regularly reviewed and updated.

During the visit we observed staff speaking with people in a caring and respectful manner. We noted that people had different communication needs and these were met by staff. We saw that there were enough suitably trained and experienced staff to meet the needs of people using the service. Staff were well supported and one member of staff said, “I feel really well supported and the management are very good”.

This home had various methods that were used to ensure the quality of the care was assessed. Meetings, reviews and senior management audits were in place and records were available.

At the time of our inspection, we were told by visitors in the home, that ‘Faldonside Lodge has a very relaxed and homely feel at all times and never has any unpleasant odours’. The people living in the home were happy to speak to us and visitors also chatted and told us they are welcome at any reasonable time and staff are always helpful and caring.

People who live in the home told us that if they have any problems ‘I just push the emergency bell and staff are always there’. When we asked if they feel they would be listened to if they have a worry at all, we were told that staff always help and they would feel confident talking to staff about any problems.

People with whom we spoke told us that the one area they would improve is the opportunity to get out a bit more. For example, one person said ‘I cannot complain about anything, staff are wonderful and I love it here. The only thing I would say is that we do not get a chance to go out as much as I would like. Just a short walk or trip to the sea and have an ice cream more often would be rather nice.’

The building itself has been extended and now has a larger lounge area with windows onto the garden and people told us they enjoy this space and love sitting looking at the garden, which is tended to some degree by people living in the home during the summer months.