About the service: Lodge Lane Nursing Home provides nursing care and accommodation for up to twenty people with enduring mental health needs. On the day of the inspection 16 people were living at the service. Accommodation is provided on two floors, with lounges available on both floors. A passenger lift and stairs provide access to the first floor. The dining area is on the ground floor. There is also a conservatory and a garden and a small car park at the front of the building. Assisted bathing facilities are provided. Staff are on duty twenty-four hours a day to provide care and support for the people who use the service. 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.

People’s experience of using this service:

This comprehensive inspection took place on the 29 and 30 November 2018 and 19 December 2018 and was unannounced.

People who used the service were happy about the service being delivered to them. People told us they enjoyed the food but they had mixed comments depending on which chef was on duty.

We recommend the service review the dining experience and look at trialling various initiatives to help improve this aspect of support for people.

We identified a breach of regulation relating to good governance as we did not see sufficiently established and effective quality assurance systems in place. The provider’s quality assurance processes had not initially identified the issues highlighted during this inspection.

We identified a breach of regulation relating to staff training and support. Staff noted improvements to the service since the registered manager commenced in post. They felt supported and listened to. The registered manager had actions in place to update staff with training and to provide all staff with regular supervision and appraisals.

Staff supported people to take their medicines safely and as prescribed. The registered manager took appropriate on-going actions to offer more person-centred support. This ensured people living at the service could choose when they wanted their medication and where they wanted their medications stored.

Health and safety needed regular oversight and support to consistently manage safe systems at the service. We noted some areas of repair. The quality and safeguarding manager arranged for the repairs during the inspection to help improve the standard of maintenance within the service.

We recommended the service review the environment to access published guidance in developments to meet the needs of people who were living with cognitive impairments and dementia.

People were protected from potential harm and abuse. Staff were knowledgeable of local safeguarding procedures. The provider and staff have recently taken appropriate safeguarding actions following reports of alleged poor practice.

Recruitment procedures were safely managed to minimise the risk of unsuitable people being employed to work with vulnerable people. Agency staff were used for some vacancies and to help provide one to one support for some people at the service. People at the services were unsure how many staff they could expect to see on each shift.

We recommend the registered provider includes staff, people receiving support and relatives in their assessments of staffing levels so they are fully informed and consulted about the staffing levels provided.

Detailed care plans described the support people needed. They included information from external healthcare professionals. People’s health was well managed and the positive links with professionals promoted their wellbeing. People were referred to appropriate health and social care professionals when necessary to ensure they received treatment and support for their specific needs. Staff had followed the Code of Practice in relation to the Mental Capacity Act 2005 (MCA).

Information and arrangements were in pla

The inspection took place on the 18 February 2016 and was unannounced. We arrived at the home at 10am and left at 6.30pm.

Lodge Lane Nursing Home provides nursing care and accommodation for up to twenty people with enduring mental health needs. On the day of the inspection 19 people were living at the service.

Accommodation is provided on two floors, with lounges available on both floors. A passenger lift and stairs provide access to the first floor. The dining areas are on the ground floor. There is also a conservatory and a garden at the back and a small car park at the front. Assisted bathing facilities are provided.

The service had a registered manager in post who had worked at the home for 23 years. 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.

Prior to this inspection we received feedback from the local authority contract monitoring, three social workers and a visiting GP. They were very complimentary about the care at Lodge Lane.

The service provided good care and support to people enabling them to live fulfilled and meaningful lives. People told us they liked living there and the staff were kind and supportive.

The interactions we observed between people and staff were positive. We heard and saw people laughing and smiling. People looked comfortable, relaxed and happy in their home and with the people they lived with.

People’s health and well-being needs were well monitored. The registered manager and staff responded promptly to any concerns in relation to people’s health and also encouraged people to attend health checks recommended for their age group and gender. People were provided with information about diet and healthy eating and were fully involved in all aspects of menu planning and meal preparation.

People had their medicines managed safely, and received their medicines in a way they chose and preferred.

People who lived at Lodge Lane were supported to lead a full and active lifestyle. Throughout the inspection we saw people coming and going from the home either independently or supported by staff. Some people went out for short trips to the shops or to visit friends and others were partaking in other planned activities. Activities and people’s daily routines were personalised and dependent on people’s particular choices and interests. People were supported to develop their skills and pursue employment and educational opportunities.

People were able to express their opinions and were encouraged and supported to have their voice heard. People were fully involved in planning and reviewing their care and support needs. All of the files we looked at evidenced that people were involved in decisions about their care.

Some people who used the service did not have the ability to make decisions about some parts of their care and support. Staff had an understanding of the systems in place to protect people who could not make decisions and followed the legal requirements outlined in the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS).

There was an extremely positive culture within the service, the management team provided strong leadership and led by example. The chief executive and registered manager had clear visions, values and enthusiasm about how they wished the service to be provided and these values were shared with the whole staff team.

Individualised care was central to the home’s philosophy and staff demonstrated they understood and practiced this by talking to us about how they met people’s care and support needs. Staff spoke in a compassionate and caring way about the people they supported.

There were sufficient numbers of staff to meet people’s needs and keep them safe. The provi