Manor Lodge provides accommodation, personal care and nursing for up to 120 people some of whom may be living with dementia. At the time of our inspection, 117 people were living at the service. The service was delivered in a purpose built building set over two floors divided into seven units. The service was set in a residential area with easy access to the local community and had a large garden. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission regulates both the premises and the care provided, and both were looked at during this inspection.

At the last inspection, the service was rated Good. At this inspection we found the evidence supported a rating of outstanding in caring and well led, there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Staff were well trained and attentive to people's needs. Staff were very compassionate and able to demonstrate that they knew people well. Staff created a homely environment and treated people like family with dignity and respect. Staff were passionate about providing individual care to people that added value to their lives. Staff were inclusive of people’s choices and beliefs and treated people with dignity and respect.

Staff shared the registered manager’s vision to provide outstanding care. There was an inclusive culture at the service and people’s, relatives and staff’s views and opinions were listened to. There was a strong governance framework and the service worked towards making continuous improvements, by following research and using innovative ideas.

Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. There were systems in place to minimise the risk of infection and to learn lessons from accidents and incidents. People were cared for safely by staff who had been recruited and employed after appropriate checks had been completed. People’s needs were met by sufficient numbers of staff. Medication was dispensed by staff who had received training to do so.

People were safeguarded from the potential of harm and their freedoms protected. Staff were provided with training in safeguarding adults from abuse, Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice.

People had sufficient amounts to eat and drink to ensure their dietary and nutritional needs were met. The service worked well with other professionals to ensure people’s health needs were met. People's care records showed that, where appropriate, support and guidance was sought from health care professionals, including a doctor, district nurse, tissue viability nurse, palliative care nurse and dementia specialist. The environment was appropriately designed and adapted to meet people’s needs.

People were provided with the opportunity to participate in activities which interested them at the service. These activities were diverse to meet people’s social needs. People knew how to make a complaint should they need to. People were provided with the appropriate care and support at the end of their life.

The inspection took place on 25 November 2015 and was unannounced.

Manor Lodge provides accommodation and personal care including nursing care for up to 120 older people some of whom may be living with dementia. The service has four units offering residential, residential dementia, nursing and nursing dementia care.

On the day of our inspection, 115 people were using the service. There were a mix of men and women and people from different cultural backgrounds. A number of different faiths were practiced.

There was a registered manager in place. 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.

The service had appropriate systems in place to keep people safe and staff followed these guidelines when they supported people. There were sufficient numbers of care staff available to meet people’s care needs and people received their medicine as prescribed and on time.

The provider had a robust recruitment process in place to protect people and staff had been recruited safely. Staff had the right skills and knowledge to provide care and support to people.

People were treated with kindness, compassion and warmth by staff who knew them well and who listened to their views and preferences. Their dignity and well-being was respected and their individuality maintained. Staff were committed and highly motivated in their work.

People’s health and emotional needs were assessed, monitored and met in order for them to live well. The service was individualised and person centred. The service worked closely with relevant health care professionals. People received the support they needed to have a healthy diet that met their individual needs. The food and drink available was to a high standard.

People were able to raise concerns and give their views and opinions and these were listened to and acted upon. Staff received guidance about people’s care from up to date information about their changing needs.

There was a strong registered manager who was visible in the service and worked well together with the team. People were well cared for by staff who were supported and valued.

Management systems were in place to check and audit the quality of the service. The views of people were taken into account to make improvements and develop the service.

During our inspection we used a number of different methods to help us understand the experiences of people using the service, because some people had complex needs which meant they were not always able to talk to us about their experiences. We spoke with or observed the care provided to seven people using the service. We also spoke with one person’s relative and six members of staff, including the registered manager.

People told us they were happy living in Manor Lodge. We observed staff offering people choices and treating them with respect and dignity. We saw that staff understood how to meet people’s needs, including those with dementia.

The relative we spoke with told us they thought their relative was well cared for and spoke positively about the manager and staff team. They said they had no concerns about the care being provided by the home.

We found that systems were in place to ensure people had their medicines at the times they needed them and in a safe way.

We saw that people were safe because their health and welfare needs were being met by staff who were properly trained and supported to provide care and treatment.

Arrangements were also in place to ensure people had their comments and complaints listened to and acted on effectively.

We spoke with eight people who used the service. All were complimentary about the quality of services provided. They commented that staff were always "approachable", "kind" "helpful" and "professional" and seemed knowledgeable about their needs. The majority of people told us the food was "tasty and well-cooked" and they were provided with a choice of meals. However, one person commented "there is too much mince on the menu" and another said "the menu is rather repetitive but they are improving by introducing a 'chef's special' on Saturday."

People who lived at the home told us they had spacious comfortable rooms that were always kept clean, tidy and well maintained. People told us the home was always "well-kept and homely".

We spoke with three relatives who told us they were always kept informed of their family member's progress and welfare. They told us they were always welcomed and offered appropriate hospitality including refreshments. They said they felt they could visit whenever they wanted.

People with whom we spoke confirmed that they felt respected and involved by staff. They confirmed that they were happy in the home and if they required any assistance staff would respond promptly. They were generally satisfied with the level of care and attention provided by staff and were able to approach staff if they had any concerns and felt confident that these would be addressed appropriately.

Visitors with whom we spoke confirmed that they were consulted about and involved with the care that their relative were receiving and felt able to talk to senior staff if they had any concerns.