The inspection took place on 28 March 2017. The inspection was unannounced. Freda Gunton Lodge is a residential home, which provides accommodation and personal care for up to 40 older people. There were 39 people living at the home on the day of our inspection.

At the last inspection on 23 July 2014, we rated the service as 'Good' overall but found improvements were required. People who used the service were being put at risk because the arrangements for the recording and safe administration of medication were not managed safely. We found the service in breach of Regulation 13 HSCA 2008 (Regulated Activities) Regulations 2010 Management of medicines.

Following our last inspection the registered provider sent us information, which detailed the action they would take to make improvements at the service. At this inspection we found that the team had worked collaboratively to ensure the previous breach of regulation had been addressed. They had recently introduced an electronic medicine management system, which demonstrated their commitment to continual improvement in this area.

The service had 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.

People told us they felt safe and secure. Staff understood the process they should follow to keep people safe and could describe the different ways people may experience abuse and the correct steps they would take if they were concerned that abuse had taken place.

There were sufficient numbers of care staff on shift with the correct skills and knowledge to keep people safe. There were comprehensive pre-employment checks of staff in place.

Arrangements were in place to ensure that newly employed staff received an induction and received opportunities for training. Records also showed that staff received regular supervision and an annual appraisal in line with the service’s policy and procedures.

The registered manager and senior staff team supported care staff to provide safe and compassionate care. Risks to people's safety were recognised and staff took action so people were able to do things they enjoyed in a safe way.

People’s health and social needs were managed effectively with input from relevant health care professionals and people had sufficient food and drink that met their individual needs.

The service regularly used community services and had links with the local community. People told us they were supported to take part in meaningful social activities.

The provider had systems in place to check the quality of the service and take the views of people into account to make improvements to the service. There were systems in place for people to raise concerns and there were opportunities available for people to give their feedback about the service.

The service was led by a registered manager and supported by the provider who was open, supportive and approachable. Systems and processes were in place to check on the quality and safety of the service; audits of the service were taking place to monitor and review the service. People benefited from receiving support from care staff who were motivated and enthusiastic.

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service.

The inspection was unannounced. This meant the provider did not know we were going to inspect. The last inspection took place on 4 February 2014, during which, we found there were no breaches in the regulations.

Freda Gunton Lodge Residential Home is a purpose built care home that provides accommodation for up to 40 older people and older people living with dementia related care needs. At the time of our inspection there were 38 people living at the service.

The provider is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider. At the time of our inspection a registered manager was employed at the service.

People told us that they were happy with the care and support provided at the service. We saw that staff provided good levels of care and staff were able to demonstrate that they knew the needs of the people they supported.

Medication practices at the service were not robust and did not ensure that people’s medicines were managed safely.

The CQC is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA), Deprivation of Liberty Safeguards (DoLS) and to report on what we find. We found that people who used the service had their capacity to make day-to-day decisions formally assessed. At the time of our inspection, DoLS referrals to the supervisory body (Local Authority) were being considered.

We found that appropriate systems were in place to ensure that there were sufficient numbers of suitable staff employed at the service. Arrangements were in place to ensure that newly employed staff received an induction and received opportunities for training. Records also showed that staff received regular supervision and an annual appraisal in line with the service’s policy and procedures.

The care needs of people living at the service were assessed and recorded. Risk to people’s health and wellbeing were clearly identified so as to minimise these and ensure people’s safety. We found that people’s healthcare needs were considered and access to healthcare professionals provided where appropriate.

Our observations throughout our inspection showed that people’s privacy and dignity were respected and upheld.

The provider had responded to people’s complaints and concerns in line with the complaints procedure. We found that people had been listened to and the issues raised had been acted upon. People told us that they felt confident and able to raise issues.

We found that people’s nutritional needs had been recorded and the dining experience for people living at the service to be positive.

The provider was able to demonstrate that there were effective systems in place that assessed and monitored the quality of the service provided. The views of the people who used the service, their relatives, staff employed at the service and visiting healthcare professionals had been sought and the majority of comments were positive.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. This referred specifically to the management of medicines and assessing and monitoring the quality of service provision. You can see what action we told the provider to take at the back of the full version of the report.

During our inspection we observed staff supporting people in a warm and relaxed manner.

People we spoke with said they were happy and that staff were:” Very good”. One person told us:”Staff were always very helpful.”

We saw that people’s care had been planned and was individual to their needs.

We saw that people were asked for their consent to receive care and treatment.

We reviewed the provision of food and drink. People told us the food was good and that there was: “A good range.” of food.

There were recruitment processes in place to ensure staff were suitable to fulfil their role.

We saw there were procedures in place to respond to people’s complaints appropriately.

We saw that records were maintained efficiently.

People that we spoke with told us that they were comfortable living at Freda Gunton Lodge and felt safe being there. They told us that they felt well supported by the staff who they said were kind and caring.

People that we spoke with told us that they were happy with the accommodation provided and were particularly happy with their own rooms. One person told us 'Living here is like home from home.'

People receiving care that we spoke with told us that they believed that staff understood their care needs well.

People that we spoke with also told us that the food provided was always good and that they were always provided with at least two choices from the menu.

People living at Freda Gunton Lodge with whom we spoke told us they were very happy living there and made many positive comments to us including: “Everybody’s so kind here”, “I am so happy here, I can’t find anything to fault” and “I am very happy here, quite the most contented person, I am singularly lucky to be here”.

A visitor to the home on the day of our visit said “It always seems to be very clean here” and “The care they give to (relative) is really excellent”. Another person visiting the home told us “It’s like a hotel isn’t it? It’s been many years now and we’ve had no complaints”.

Staff working at the home told us: “Very, very good team here and we are well supported” and “I have worked in other care establishments but this is by far the best place to work”.

People living in the home had mixed views about the food. Some people told us they found the food was, on the whole, good whilst others said they were not satisfied.

The management team were aware that people were not completely satisfied with the food provision. A residents’ meeting had been arranged specifically to discuss the menu and the quality of food provided.

People told us that they felt safe whilst living at Freda Gunton Lodge and that it was always clean and tidy. People told us that they were happy to raise any concerns and that they discussed any minor issues at their regular residents’ meetings.