This inspection took place on 12 December 2016 and was unannounced. Furze Hill Lodge care home is a 29 bedded purpose built facility in Kingswood, Surrey. The home provides accommodation and personal care for up to 29 older people, including people with dementia. On the day of our inspection 23 people were using the service. The service was last inspected in November 2013 and was found to be meeting all the regulations we reviewed at that time.

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.

Prior to this inspection we received a monitoring report by a local authority contract monitoring team. This had identified a few areas which required some improvements. At this inspection, we noted that improvements had been made.

Staff knew how to recognise abuse and how to respond to concerns. Risks in relation to people's care were assessed and planned for to minimise the risk of harm. Concerns regarding people's safety had been appropriately managed and staff displayed a good knowledge of safeguarding principles.

There were sufficient numbers of staff on duty to meet the needs of people who used the service. Staff underwent pre-employment checks including enhanced Disclosure and Barring Service (DBS) checks.

Staff supervisions, appraisals and meetings all happened regularly. Staff spoke highly of the support they received from management and were confident they could raise any issues or concerns, knowing they would be listened to and acted upon.

People received their medicine safely. They received their medicines in a way they chose and preferred. The medicines administration records (MAR) were signed and up to date. Staff kept an on-going record of how much medicine was administered and how much was left, to make sure medicines were always available when people needed them.

People were cared for in a clean and safe environment. We saw infection prevention and control policies and procedures were in place.

New staff commenced an induction to ensure they developed the skills and knowledge needed to support people safely. The induction included the opportunity for new staff to shadow more experienced staff until they felt confident.

Staff were encouraged and supported to undertake training. We saw records which showed staff had received training in various aspects of care delivery. There was a comprehensive training programme that was delivered to staff as part of the mandatory induction.

Staff understood the principles of the Mental Capacity Act 2005 (MCA). MCA provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. This ensured that people's right to be involved in decisions about their own care was consistently upheld and respected.

People had access to a range of health care professionals such as GPs, district nurses, speech and language therapist, dieticians and occupational therapists. Immediate referrals were made with appropriate follow up meetings when staff had any concerns about people's health.

People were supported to have food and drink of their choice. The home operated a ‘protected’ mealtime system. This ensured staff were available to serve food and assist people if necessary so they could enjoy their food in a more relaxed environment.

People were supported with care and compassion. People told us they were treated with dignity and respect. Staff understood the need to protect people's privacy and dignity.

People received a personalised service which was responsive to their individual needs. Care records were person centred and developed to meet people's individual needs and reviewed if there we

We visited Furze Hill Lodge to look at the recruitment process that had been carried out on staff before they were employed. We did this because we had received information of concern that the service was not meeting the requirements of the regulations.

During the visit we found the service had completed all the checks to ensure staff were of good character. We saw that records of qualifications, criminal record checks and reference checks were complete. The service had met the requirements of the regulations.

We visited Furze Hill Lodge to look at the safety, care and welfare of people using the service.

We spoke with seven people about their experience of life at the home. Also with a visitor, the registered manager and four staff. We looked around the home and grounds and spent time sitting with people in bedrooms and a lounge.

People were happy with the home and their care. They had access to health care services. Their comments included, "The home is well managed. Staff are kind”. “Staff sit and talk with me about my care plan. They keep it up to date and check if I want it changed. We have entertainment and various activities. We go out to the library and enjoy tea at a garden centre”.

We found that people or others on their behalf had agreed their care plans. The provider had acted within legal requirements to promote the rights of people without capacity to make complex decisions. We observed staff to be friendly, skilled and professional in their interactions with people. The activities coordinator engaged people in stimulating activities.

Staff were suitably trained and supported, ensuring delivery of safe and appropriate care. Emergency procedures minimised risk of people's care needs not being met in the event of emergencies. Risk assessment, risk management and maintenance arrangements ensured the safety and security of the environment. Quality checking systems assured the safety, health and welfare of people.

We spoke with six people about the service. We spoke with two staff and the registered manager, reviewed records and made observations throughout the inspection.

People expressed high levels of satisfaction and we received a number of positive comments. One person told us that they “Cant fault the care,” another person said that “Care is extremely good”.

People told us that they were treated with dignity and respect and that they were involved in their care plan. We were told that people enjoyed the activities available, although one person wanted more exercise classes.

We asked people if they felt safe and each person we spoke with confirmed that they did. We were told that staff were “Always kind and helpful.”

Staff had received recent safeguarding training and were aware of their role in safeguarding vulnerable adults.

People told us that staff seemed well trained and equipped in their role. We saw appropriate recruitment checks took place which meant that staff were suitably skilled.

People were made aware of the complaints system and we saw that complaints had been investigated and resolved to people’s satisfaction.

Most people we consulted with told us that they liked living at Furze Hill lodge. This was because it had a relaxed, friendly atmosphere and it was a comfortable place to live with a person telling us “I am well looked after”. Carers spoke positively about the care their relative receives, commenting: “the care is very good” and “it’s very reassuring to know that my mum is so well looked after”. A carer told us how impressed they have been when their relative has needed medical intervention and how quickly the doctor has been called.

People who live at the service described the food as: “good” “excellent” and that they enjoyed the meals provided. One person told us “The food is very good the only thing that could improve is better suppers sometimes”. People told us that there was a choice of two main dishes meal time.

People told us that they felt they were living in a safe and secure environment and felt confident to raise any concerns they had with management and felt that this would be dealt with promptly.

We observed that the interactions between staff and people they were supporting were relaxed and sensitive with people clearly at ease in the company of staff. People described staff as “good” “caring” “very kind” and “work very hard”. A person told us “I can ring the call bell anytime and they always arrive quickly, they don’t keep you waiting day or night”. Carers spoke consistently of the kindness of staff with their comments including “The staff are all lovely they really do seem to care about mum”. People and carers told us that there is usually sufficient staff on duty to get the help or support needed and when they wanted it.

People told us they were happy with their bedrooms and the communal areas of the home. A person said “its like living a hotel as it is so nicely decorated”. A person told us about being able to furnish their bedroom with their own small items of furniture.

Carers and people living at the service told us that they are regularly asked for their views about the service and if there was anything that could be improved upon. They said that in response their views had been listened to and they felt that they had some influence over what happened at the service. A person told us “They encourage us to tell them if anything is wrong”.