Fitzwilliam Lodge is a ‘care home.’ People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission regulates both the premises and the care provided, and both were looked at during this inspection. The home offers accommodation for up to 16 people in single rooms or flats. Support provided includes mental health and the needs of older people. Fitzwilliam Lodge is situated close to local transport, shops and other community facilities. There were 15 people living at the home at the time of our inspection.

This inspection took place on 5 December 2018 and was unannounced. This meant no-one at the service knew we were planning to visit. At our last inspection we rated the service ‘Good’. At this inspection we found the evidence continued to support the rating of ‘Good’ and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

There was a registered manager in post. 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.

Effective recruitment procedures helped to make sure staff had the required skills and were of suitable character and background. There were enough staff available to meet the needs of people living at the home at the time of our inspection.

Staff understood what it meant to protect people from abuse. They were confident any concerns they raised would be taken seriously by the management team.

Care and support was planned and delivered in a way that ensured people were safe. People had been involved in planning their care. Support plans clearly outlined peoples’ needs and any risks associated with their care, as well as their abilities and preferences.

Medicines were stored, administered and disposed of safely.

An effective induction, plus a varied and ongoing training programme ensured staff had the right skills and knowledge for their role. Staff were supported in their jobs through regular supervisions and an annual appraisal.

People were supported to maintain good health and have access to health and social care services. They were also supported to maintain a balanced diet that met their individual needs and choices.

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

People were supported by caring and compassionate staff who respected their privacy, dignity, preferences and independence.

There was a range of social activities and events available for people to take part in, if they wished to.

The service had an open and positive culture that encouraged involvement of people using the service, their families and staff. Leadership was visible and promoted teamwork. People were encouraged to raise concerns or complaints and were asked for feedback about the service they received

The service understood their legal responsibilities for reporting and sharing information with other services.

Further information is in the detailed findings below.

The inspection was unannounced, which meant the provider did not know we were coming. It took place on 26 July 2016. The home was previously inspected in July 2014, and at the time was meeting all regulations assessed during the inspection.

Fitzwilliam Lodge is a care home for people with mental health conditions. The service can accommodate 16 people. The accommodation comprises of 13 single rooms, which share three bathrooms and three self contained flats.

The home 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. The registered manager had responsibility for a number of services in Rotherham and Sheffield. There was also a general manager at Fitzwilliam Lodge who also had management responsibilities to ensure the service was managed well.

People told us they felt safe living at Fitzwilliam Lodge. Staff had received training on how to protect people from abuse and had an understanding of their responsibilities in relation to safeguarding people and keeping them safe.

Care records demonstrated the provider had identified risks to people's health and wellbeing and how they planned to protect people and support their safety. People received their medicines from trained, experienced staff who were assessed regularly to confirm their on-going competency to give medicines safely.

Staffing levels were based on the needs of people living in the home. At the time of our inspection we found there were adequate staff to meet people’s needs. The provider's recruitment process ensured risks to people's safety were minimised. Staff received an induction, training and support from managers to carry out their roles safely and effectively.

Staff understood the requirements of the Mental Capacity Act 2005. Staff worked with people to support them in making wise decisions, and to look at the consequences of making decisions which might be harmful to them.

Staff were aware of people's dietary needs and encouraged people to eat a healthy diet which met their needs. There were regular multi-disciplinary meetings with external healthcare professionals to discuss the support needs of people who lived at Fitzwilliam Lodge.

Systems were in place which continuously assessed and monitored the quality of the service, including obtaining feedback from people who used the service and their relatives. Records showed that systems for recording and managing complaints, safeguarding concerns and incidents and accidents were managed well. Management took steps to learn from such events and put measures in place which meant lessons were learnt and similar incidents were less likely to happen again.

Our inspection looked at our five questions; is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

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

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

Is the service safe?

We found adequate quality monitoring systems were in place. This ensured the risks to people were identified and reduced, to be able to continually improve.

Appropriate arrangements were in place to protect people who used the service from the risk of abuse.

Staff supervisions, appraisals and training were up to date. Staff we spoke with told us the training was very good. One person told us, “I have been enrolled on mental health level 2, which I am really looking forward to.”

Is the service effective?

People’s health and care needs were reviewed, and people were involved in the reviews.

Audits and reviews had taken place; the audits were thorough and detailed. We saw that any shortfalls had been identified and addressed.

On the day of our visit some people went out to lunch. We observed people laughing and joking together getting ready to go out. One person told us, “I enjoy the activities.”

Is the service caring?

We observed care workers interacted positively with people who used the service. Conversations were inclusive and we observed staff and people who used the service laughing and joking together. Staff also showed patience and gave encouragement when supporting people. One person we spoke with told us, “I have to go out with staff in the community and I don’t want to, but I know why I have to and the staff are alright.”

Is the service responsive?

The manager followed a robust quality monitoring system that identified shortfalls and ensured they were rectified.

There had been a large number of notifications due to incidents between people who used the service. We saw evidence that the staff had responded appropriately to ensure people’s needs were met. We spoke with health care professionals who told us, “The service meets the needs of people who have very complex long standing care needs. They deal with the high risks very well and look after people who may otherwise need to be in secure accommodation.”

Staff we spoke with told us they felt the service required additional staff on nights to be able to meet people’s needs. We discussed this with the manager and regional manager during our visit. They agreed to look at this and increase the numbers of staff on nights.

Is the service well-led?

Staff told us they worked very well as a team. They told us they had regular meeting ensuring communication was good. Staff said, “We work well as a team, which ensures people’s needs are met.”

Staff told us they received regular supervision and could at any time raise any concerns or ideas and they were listened to.

People we spoke with told us they liked living at the service. They told us the staff were brilliant and looked after them. One person told us, “The staff treat you like you don’t have an illness and always with respect.”

People also told us that staff treated them with respect, listened to them, gave them choices, made them feel safe and supported them. One person told us, “It is the best place I have ever been.” Another person said, “We have excellent staff and they know when to keep you occupied so I don’t think about things that can make me ill.”

People told us it was sometimes difficult to maintain hygiene needs as there was lack of bathrooms. The management were looking at this to determine what improvements could be made.

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines safely. One person told us, “I am able to self-administer my medication, but I know staff can check my medication to make sure I am taking it properly and safely.”

We found there was an effective recruitment and selection processes in place. Staff received appropriate professional development. Staff we spoke with told us they were supported and had access to training opportunities.

There was an effective system to regularly assess and monitor the quality of service that people received. There was a complaints policy that took account of complaints and comments to improve the service

People we spoke with told us they liked living at Fitzwilliam Lodge and a number of people told us it was the best care home they had ever lived in. One person told us, “The staff help you, not against you.”

Another person we spoke with told us, “Every member of staff is fantastic, great personalities and they all put their hearts into the job.”

People told us that staff treated them with respect, listened to them, gave them choices and supported them in activities they liked.

People who used the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. Staff we spoke with were very knowledgeable on procedures to follow.

Staff received appropriate professional development. A training programme was in place to provide staff with the training and support they needed.

There was an effective system to regularly assess and monitor the quality of service that people received. There was a complaints policy that took account of complaints and comments to improve the service.