Green Lodge Respite Care Unit is a care home. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The home is registered to provide accommodation and support with personal care on a respite basis for up to nine people with a learning disability. At the time of the inspection, there were seven people using the service.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

At the last inspection in May 2016 the service was rated Good. At this inspection, we found the service remained Good.

The service had a registered manager in post. A registered manager is a person who has registered with the 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.

Pre-assessments were completed for people, care plans developed and reviewed for each person before they started using the service. The registered manager was communicating with relevant authorities to address this.

People were protected from harm. Each person had a risk assessment and staff knew how to ensure risks to people were managed. Staff were aware the actions they needed to take if they became aware of an incident of abuse.

The premises were clean and tidy. Staff had attended training on basic food hygiene and infection control, and knew how to reduce the risk of spread of infections.

The management and administration of medicines were thorough and accurate. People were confident that staff administered their medicines as prescribed by their doctors.

There were enough trained and experienced staff at the service. The recruitment of staff was robust and new staff were appropriately checked and inducted before they started work.

Staff had training and supervision opportunities to upgrade their knowledge and skills to meet people's needs. They told us they felt supported by the registered manager.

Staff had a good understanding of the Mental Capacity Act 2005 (MCA) and people's care plans showed mental capacity assessments had been completed and applications for Deprivation of Liberty Safeguards (DoLS) were made to local authorities.

Staff promoted people’s independence and treated them with respect and dignity. People were confident staff respected their privacy.

Various activities were available for people to enjoy both within and outside the service.

There were systems in place to ensure that various health and safety aspects of the service were regularly checked to make sure the facilities and equipment were safe.

People told us the food was good. People's nutritional and hydration needs were assessed and met. People could choose their meals.

Staff worked with healthcare professionals to ensure people had access to healthcare.

Complaints were recorded and investigated. people and relatives knew how to make a complaint.

The registered manager sought feedback to ensure people and relatives' views were considered in the improvement of the quality of the service.

This unannounced inspection took place on 11 May 2016. At our last inspection on 12 December 2013, we found that the provider breached regulations relating to ensuring people’s personal care and support records were up-to-date. Following this inspection, the provider sent us an action plan to tell us the improvements they were going to make. Green Lodge provides accommodation and support with personal care on a respite basis for up to nine people with a learning disability. Respite care is when a person uses the service for a short period to provide breaks for their families or unpaid carers. At the time of our visit four people were staying at Green Lodge

The service had a registered manager. 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.

Relatives told us people were safe. Each person had a risk assessment and staff knew how to manage identified risks to people. Health and safety checks had been carried out to ensure the facilities and equipment were safe. People’s medicine was stored safely and administered by staff who received appropriate training.

Relatives told us that staff were kind and knew how to support people. Staff received supervision and had training opportunities in areas such as Mental Capacity Act 2005 (MCA), medicine administration and moving and handling. New staff underwent recruitment processes, which involved completing an application form and providing satisfactory evidence, such as a police check, two reference letters and evidence to confirm they had the right to work in the UK.

Staff had the knowledge and ability to report safeguarding issues and the service had appropriate policies in place for staff to read and use. There were enough staff at the service. However, some of the staff were at the service temporarily and the registered manager did not always have sufficient information about them. We have made a recommendation about this.

People were supported to access activities of their choice. People were asked to make their choices of services and staff ensured they were supported with respect and dignity. We noted staff supported people to attend a place of worship. We noted that people enjoyed the food provided at the home. We recommended that the registered manager should consult people and their representatives regarding providing fresh and home prepared meals. We saw the service was spacious and relatives told us the premises were clean and tidy.

People were treated with respect and their care, health and welfare needs were met. They and their relatives were happy with the care they received. One person told us “it’s okay there. I like the staff and I liked the Christmas Party.” A relative said “I have no worries about her when she is there. I feel she is safe.”

There were systems in place to ensure people received their prescribed medication appropriately. A relative told us “they are very hot on medication.”

Staff received the training and support they needed to carry out their duties and to enable them to effectively support people who used the service. A member of staff told us “training is up to date and we have the training we need to do things properly. I get good support from the manager.”

People were not always protected from the risks of unsafe or inappropriate care because accurate and appropriate records were not always maintained.

People using services were happy with the care that they received. One person viewing the service said that they would like to stay at Green Lodge and that they were looking forward to it. People were able to express their views about the service and there were regular meetings with them and relatives to assess the quality of the service.

People received care according to their support plans which were monitored using a key worker system. People experienced care, treatment and support that met their needs and protected their rights.

People who use 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. The service had a recruitment process in place and people were supported by staff who had the necessary skills and knowledge to meet their needs. The provider had put in place an effective system to monitor the service.

On the day of the visit we met eight people who use this service regularly. Due to the degree of their learning disability and communication problems most people were unable to give us direct feedback about Green Lodge. However two people told us that they liked being at Green Lodge. One person said, “I like coming here because it is fun. Everything is fine.” Another said, “Green Lodge is the best.” We saw that people seemed relaxed in the company of staff and that staff treated people with respect.

We spoke to the relatives of six people who use the service. They were all positive about the quality of care provided and felt that people were safe and happy when they went to Green Lodge.

Relatives said:

“Staff have worked really hard to keep the service going in the absence of the manager. People go out a lot and they do a lot for people. The building is much more homely than it used to be and my daughter likes it there.”

“The staff are good. They look after my son well. They keep us informed of anything that happens. They take him out. It’s great. The clients seem happy. The staff are good. We are happy for him to go there. He is safe there. When we go away we can relax. Wonderful.”

“I feel that my daughter is safe at Green Lodge and there are no problems. They keep me informed and there is a communication book which they always fill in.”

“The quality assurance committee keep an eye on things. RCHL, the provider, have made a lot of improvements. The activities are good and there is a minibus to take people out. There is good contact. Staff know what help the clients’ need. They want to keep on improving and are keen listeners.”

“The service has definitely improved since my son first went there. Its better decorated and more homely now. It’s nice that there is a minibus and they get out. I find them easy to approach. They give me feedback about his visits. He is safe there and I am happy and satisfied.”

“I am really pleased with the place and my son loves going there and likes the staff. Staff have always been good but it is getting better. You can rely on them. He could not say if he didn’t like it but he would refuse to go if he did not. When we take him there after a little while settles and we know that he’s okay.”