This comprehensive inspection took place on the 7 and 8 November 2018. We visited the service on the 7 November 2018 and carried out telephone calls to relatives and stakeholders on the 8 November 2018.

The Lodge 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.

Lodge Care Home is registered to provide accommodation with personal care for up to 36 older people, some of whom may have needs associated with dementia. Care is provided in one adapted building across two floors. At the time of our visit there were 28 people living at the service.

This was the first inspection of this service following a change of ownership.

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.

Feedback from people and relatives about the staff and management team was positive. People told us staff treated them with kindness and care provided with dignity and their rights to privacy protected. People were at ease in their surroundings and told us that they felt safe with all of the staff who supported them.

There were systems in place and training provided for staff to safeguarded people from the risk of abuse. Alleged safeguarding incidents were reported and investigated appropriately.

There were sufficient numbers of staff to meet people's needs and this was closely monitored and reviewed. Staff received training relevant to their roles. Opportunities were provided to support staff with regular supervision and annual appraisal. This enabled staff to discuss their work performance as well as their training and development needs. We recommended staff be provided with additional training to meet the needs of people they cared for such as, people diagnosed with Parkinson’s, those with in-dwelling catheters and support for people with sight and hearing impairment.

There were safe systems in place to safely store and ensure people received their medicines as prescribed. Staff were trained in medicines management and regularly had their competency to administer medicines assessed.

People’s care was planned and reviewed. However, further work was needed to ensure guidance was provided with regular review for staff where people needed support with their catheter care, support for people with a sight and hearing impairment and for those with a history and at risk of skin cancer. We recommended guidance be provided to staff on how the associated risks should be managed. This should include how staff should undertake regular monitoring of people’s skin and prompts as to when to consult with specialists for advice.

Work had been carried out to produce guidance for staff as to people’s life history and what was important to them. This was particularly important when caring for people living with dementia.

People's nutritional needs were assessed and met. Professional advice and support was obtained for people where risks such as choking, swallowing difficulties and inadequate food and fluid intake. People were provided with a choice of pleasantly presented food suitable for their individual dietary needs.

People were supported to access when needed, health and social care professionals to ensure they received appropriate care and treatment. However, people did not have access to dental and eye health care checks. The regional manager told us they would address this as a matter of urgency.

The management team and staff understood their roles and responsibilities in relation to the to the requirements of the Mental Capacity Act 2005 (MCA) and re