We inspected the service on 4 May 2017 and the inspection was unannounced. Lingdale Lodge is a care home without nursing and provides care and support for up to 48 older people including people living with dementia. At the time of the inspection there were 44 people using the service.

There was a registered manager in post. It is a requirement that the service has 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.

At our previous inspection on 1 & 2 February we found that improvements were required in all areas and the provider was not meeting three of our regulations. At this inspection we found that improvements had been made.

Staff understood their responsibilities about protecting people from abuse and avoidable harm. Risk was assessed and management plans were put in place. Staffing numbers and skill mix were sufficient to meet the needs of people who used the service. The provider followed recruitment procedures to minimise risks because they carried out checks before employment was offered

People received the right medicine at the right time because medicines were managed, stored and administered in line with current professional guidance.

Staff had received training and were supported to carry out their roles, and knew how to meet people's individual needs.

Consent was sought before the delivery of care and support. People had their capacity to make decisions assessed and staff were working within the principles of the Mental Capacity Act.

People were supported to eat and drink a varied and nutritious diet. They had access to the healthcare services they required.

Staff were caring and had developed positive relationships with people. People had their privacy and dignity respected and were involved in making decisions about their care and support.

Staff knew people well and understood their needs. Care and support was delivered in the ways that people preferred. People felt comfortable making a complaint and confident they would be listened to.

The culture of the service was open and inclusive. There was a clear organisational structure and staff understood their responsibilities. The quality of the service was monitored and changes were made to improve.

This inspection took place on 1 and 2 February 2016. The first day of the inspection was unannounced. We told the provider that we would be returning for a second day.

Lingdale Lodge provides accommodation, care and support for up to 48 people who require personal care. On the day of our inspection there were 47 people using the service.

There is a registered manager at the service. 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 at the service. Staff had a good understanding of the various types of abuse and knew how to report any concerns.

We found a number of areas around the premises that presented risks to people that used the service. Those risks had not been appropriately addressed.

People's risk assessments and care plans had not always been reviewed to ensure that they continue to meet people needs and protect them from harm.

There were enough staff on duty to meet people's needs. Staff commenced employment before pre-employment checks had been carried out. Staff had not always received sufficient training to enable them to carry out their roles.

People generally received their medicines as prescribed. People were supported to access healthcare professionals when they required them.

The information relating to the people's mental capacity was not decision specific and therefore did not fully meet the requirements of the Mental Capacity Act (MCA) 2005 legislation.

People were supported with drinks, snacks and meals throughout the day. There were limited opportunities relating to the dining experience for people to help themselves.

People and relatives told us that they felt involved in the decisions about their care and support.

People told us that staff showed concern for their well-being. However staff did not always respond appropriately to the needs of people with dementia. Staff had not identified that a person had sustained an injury.

People felt able to discuss any of their concerns. There was a complaints policy in place however it required updating.

People enjoyed the activities that were provided. Regular activity sessions took place.

Quality monitoring systems that were in place had failed to identify and address the concerns that we found. The provider had failed to act on feedback from the Fire Service. The provider had failed to ensure that people’s records were securely maintained.

We identified that the provider was in breach of three of the Regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 (Part 3). You can see what action we told the provider to take at the back of the full version of the report.

Two residents we spoke with told us that they felt well looked after and cared for at the home. One person told us, "I'm well looked after. The food is good." Relatives we spoke with spoke in complimentary terms about the home. Two relatives we spoke with told us that they had been involved in decisions about the care of their parents who lived at the home. Another relative told us that the home had asked them for their views and opinions about the care provided. All of the relatives we spoke with were satisfied about the quality of care provided. A relative told us, "I'm confident that my father's care needs are met. I'm happy that he is being well looked after." Another relative told us, "The care is brilliant. I can't thank the staff enough. The staff understand my mother's needs." Another relative told us, "I can't fault the home. My mother tells me she is happy here. She is always clean and tidy when I visit her."

Staff supported people in a dignified manner. One care worker in particular excelled at the way they supported people. Other care workers spoke politely to people and were attentive to their needs. We saw an example of poor practice by one care worker which we brought to the attention of the manager and which was quickly resolved.

We found that here were enough care workers on duty to attend to the needs of people. The home provided a safe and caring environment for people.

We spoke with two people who used the service and we observed people when they spent time in a communal lounge. One person we spoke with told us that, "The care could not be any better." They told us that they felt that their care needs had been met and that, "The carers are very good to me." That person liked that they could spend their relaxation time how they chose and that the home had organised many stimulating and meaningful activities. The second person we spoke with told us that their care "had been excellent." That person told us that the service had supported them to as independent as they wanted to be and had encouraged them to maintain an interest in their hobbies.

We saw care workers supporting people with activities and routines. People were engaged in meaningful activities. Those people who required support at meal times received support as did people who required support with their mobility. Care workers responded promptly to requests from people who used the service. Care workers we spoke with understood the care needs of the people they supported.

People felt satisfied with the service provided at Lingdale Lodge. They told us that staff responded promptly when they asked them for help and were helpful.

Some people chose to spend a lot of time in their own bedrooms. They were pleased that they had this option and appreciated having their own comfortable room to relax in. One person told us; “I have all my own things and lots to keep me busy.”

People felt safe and thought staff looked after them well.

People felt satisfied with the service provided at Lingdale Lodge. They told us that staff responded promptly when they asked them for help and were helpful.

Some people chose to spend a lot of time in their own bedrooms. They were pleased that they had this option and appreciated having their own comfortable room to relax in. One person told us; “I have all my own things and lots to keep me busy.”

People felt safe and thought staff looked after them well.