The inspection took place on 4 December 2018 and it was unannounced. Hunters Lodge is a ‘care home’ for older people. 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. On the day of our inspection 30 people were using the service.

There was 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.

People felt safe living at the service. Staff knew how to recognise abuse and how to report it. Risks were assessed so that staff knew what action to take to keep people safe. They did this while also promoting people’s independence and autonomy.

There were sufficient numbers of staff, with the required knowledge, skills and experience to support people with their needs. Recruitment processes were safe and this meant that so far as possible only people of suitable character and experience were employed.

Medicines were managed in a safe way. Staff had received training about this and knew the level of support people required with their medicine.

Staff were knowledgeable about the needs of the people they supported. People were supported to make choices around their care and daily lives. Staff had attended training to ensure they were able to provide care based on current practice when assisting people.

Staff always gained consent before supporting people. There were policies and procedures in place in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards and staff followed these.

People were supported to eat and drink enough and had a balanced diet. Staff understood and met people’s nutritional needs. They supported people in a sensitive way. People had access to the healthcare professionals they required.

People were treated with kindness and compassion by the staff. Staff knew people well and often went that extra mile to make sure people were as comfortable as possible. People’s social needs as well as their physical and emotional needs were incorporated into the plan of care and used to promote and maintain people’s abilities and independence.

People and their relatives were involved in making decisions and planning their care, and their views were listened to and acted upon. Staff treated people with dignity and respect. People knew how to raise concerns and had confidence that they would be listened to and action would be taken. Feedback provided was used to make improvements to the service.

People were complimentary about the registered manager and staff. It was clear that relationships between people and staff were positive and people had confidence in the service. There were effective quality monitoring systems. A variety of audits were carried out and this meant that any shortfalls were quickly identified and used to drive improvements.

Hunter’s Lodge is a service that provides accommodation for up to 36 people. Care and support was provided to enable people to live as independently as possible and to continue to work towards any chosen goals.

There was a manager in place who was applying to be a registration 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 and associated Regulations about how the service is run.

People who used the service told us that they felt safe and staff knew them well, relatives we spoke with also confirmed this. Everyone we spoke with said that staff were always caring and treated people as individuals. People also told us that staff knew their individual needs and choices. People accessed the local community and activities were regularly available.

Staff were aware of how to protect people from abuse and avoidable harm and were aware of safeguarding procedures. Therefore any allegations or recognised incidents of concern were dealt with and reported in the required manner. Staff had been trained to enable them to have the skills and knowledge needed to provide appropriate support to people. We saw robust records that showed the extensive training that had been completed and staff confirmed they had on going updated training to refresh their knowledge.

Relatives said that they knew they could discuss any matters with staff and that issues would always be addressed immediately.

People had access to healthcare professionals should this be necessary. Care plans had details of any specific conditions and how to identify any health problems. The appropriate health services were contacted when necessary. Our discussions with people at the service and our review of records confirmed this.

The provider and staff were aware of requirements of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS) 2008. Our observations and review of records showed that people were encouraged to make independent decisions and choices. Our discussions with people living at the service also confirmed this.

There were systems in place to assess and monitor the quality of the service. This included regular discussions with people who used the service. The provider regularly issued questionnaires to gather the opinions and thoughts of individuals, the results were then collated and discussed with the staff team.

Summary of findings

During our inspection we spoke with three people using the service and observed other people throughout the day. We spoke with six relatives and four staff. We also reviewed the care records for four people.

People were treated with respect and involved in decisions made about the care and support they needed. One person told us they were asked about the help they needed and said, “I much prefer to stay in my room in the afternoon and will probably have a nap too.” Relatives were involved to support their family member to make decisions about the help they needed.

Lunch was a sociable event. People dined in company or alone depending on their preferences. People were satisfied with the meals provided. One person said, “The meals are exceptional.” A relative told us, “The food is very good here.” Catering staff were trained to provide nutritious meals that met people’s dietary needs and preferences.

Hunter’s Lodge was decorated and furnished to a good a standard. All areas inspected were clean, tidy and fresh. Bedrooms had an en-suite washroom facility. Regular checks on the premises ensured the environment was secure and well maintained.

Staff were screened to ensure they were suitable to work with vulnerable people. All new staff were trained for their job role.

People knew how to make a complaint and confident to do so. All records relating to people using the service, staff records and the management records were kept up to date and stored securely.

We saw some people living at Hunters Lodge had limited communication and were unable to answer direct questions about some of the essential standards we reviewed. We observed people and their interactions with each other and with staff. We saw people listening to music, folding paper napkins and reading newspapers. One person told us they were happy at the home and well cared for. We saw the activities co-ordinator encourage people to join in making Christmas tree decorations. Lists of daily activities were displayed in the lounge and circulated to people using services. Staff told us people went on local trips to the pub, the brewery, and the garden centre with the home's mini bus and a driver.

We saw some people laying the table for lunch in the dining room assisted by staff. We observed people were given information about meal choices and first course drinks at lunch time and were supported to make informed decisions. People choose from a range of drinks - sherry, fruit juice, fizzy drinks, water or beer. We saw staff were alert to people's health needs when people were unable to eat a meal they were offered a nourishing drink supplement. This would ensure people's dietary needs were met and there was no risk of deterioration in their health status

To help us to understand the experiences of people living at the home we used our SOFI (Short Observational Framework for Inspection) tool. This allowed us to spend time watching what was going on in a service and helped us to record how people spend their time, the type of support they get and whether they have positive experiences.

Some people living at Hunters Lodge had limited communication and were unable to answer direct questions about some of the essential standards we reviewed. We did speak with people in a general way and asked some questions. We spoke with two people and they told us that staff were caring and the food was good. We spoke with two visitors and they both confirmed the care was excellent and managers were helpful and supportive.