Herald Lodge care home provides support to older people and to older people living with dementia. The home comprises of two floors, with people with more advanced dementia mostly living on the first floor (although they had access to the ground floor facilities). The service accommodates a maximum of 42 people. The home was full at the time of our visit.

At the last inspection, the service was rated ‘Good’. At this inspection, whilst the home continues to be rated good overall, we saw a lot of improvements which showed the home was working towards a possible ‘outstanding’ rating in the future.

The home continued to provide safe care for people who lived at Herald Lodge. There were enough skilled and knowledgeable staff on duty to meet people’s needs and staff were deployed effectively to support safe care. The provider undertook comprehensive checks on the suitability of prospective staff to work at the home.

Staff had a detailed knowledge and understanding of people’s needs. They provided excellent care for people and were responsive to people’s thoughts and feelings. Staff had received training which gave them the knowledge and skills they needed to provide effective care.

The majority of people who lived at the home lived with dementia. Staff knew how to support people with dementia well. They understood the importance of accepting the person’s reality and working alongside it, providing re-assurance and support. Staff also understood the importance of gaining people’s consent before undertaking any task on their behalf, or before supporting a person with that task.

People were happy, settled and demonstrated extremely positive relationships with staff. The manager and staff saw the home as an extended family, and relatives and visitors told us they felt a family atmosphere when they visited.

People enjoyed the meals provided and had a range of choices throughout the day. The meal time experience was a pleasant occasion. People were offered a range of drinks throughout the day so they were not thirsty.

People had a very good range of activities to engage them during the day. This included planned weekly activities, as well as impromptu activities, reminiscence, and chats with staff.

Staff were alert to risks associated with people’s care. When people required the support of healthcare professionals, the home ensured they were referred in a timely way. Staff acted on the advice of the healthcare professionals involved in people’s care. Medicines were managed safely.

Staff felt well supported by the registered manager and their senior team. They received individual support, good induction and training to provide them with skills and knowledge. They felt able to speak with the management team if they had any concerns. The registered manager felt well supported by the provider. Staff and the management of the home worked well as a team.

The registered manager listened and acted on any areas of concern raised by people or their families. They asked people and their relatives to complete questionnaires about the quality of care, and responded to any areas people were not as satisfied with. The registered manager demonstrated a real passion for ensuring people who lived at Herald Lodge received high quality care.

This inspection took place on 14 October 2015 and was unannounced.

Herald Lodge care home provides support to older people and to older people living with dementia. The home comprises of two floors, with people whose dementia has advanced, primarily living on the first floor. The service accommodates a maximum of 42 people. Forty one people were living at the home at the time of our visit.

The home has 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 2014 about how the service is run.

The home had sufficient staffing levels. Staff had the skills, knowledge and experience to work well with people who lived at the home. This was due to an effective induction and ongoing staff training.

Staff understood safeguarding policies and procedures, and followed people’s individual risk assessments to ensure they minimised any identified risks to people’s health and social care. Checks were carried out prior to staff starting work at Herald Lodge to ensure their suitability to work with people in the home.

Medicines were managed well to ensure people received their prescribed medicines at the right time. Systems were in place to ensure medicines were ordered on time and stored safely in the home.

Staff respected and acted upon people’s decisions. Where people did not have capacity to make informed decisions, ‘best interest’ decisions were taken on the person’s behalf. This meant the service was adhering to the Mental Capacity Act 2005.

The provider was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS) and had followed the advice of the local authority DoLS team. The provider had referred some people to the local authority for an assessment when they thought the person’s freedom was restricted.

People were provided with sufficient to eat and drink and people’s individual nutrition needs were well supported. People enjoyed the food provided. Where changes in people’s health were identified, they were referred promptly to other healthcare professionals.

People and visitors to the home were positive about the care provided by staff. During our visit we observed staff being caring to people, and supported people’s privacy and dignity.

Not all care plans were centred on the person. Activities were provided, however they were not always sufficiently linked to people’s individual needs or wants, or supported people whose dementia was more advanced.

People who lived at Herald Lodge, their relatives, and staff, felt able to speak with management and share their views about the service. Complaints were responded to appropriately.

The new manager had worked hard to improve the culture of the home. They and their leadership team had the confidence and support of staff to drive improvements in the home.