Pulsford Lodge is a residential care home for up to 49 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.

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Pulsford Lodge specialises in the care of older people. It is a purpose built home with accommodation for people arranged over two floors. At the time of the inspection there were 39 people living at the home

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and on-going 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.

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Why the service is rated Good

There was a registered manager in post. 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 registered manager and provider monitored the quality and safety of the service. They were committed to seeking people’s views and making on-going improvements.

People felt safe at the home and with the staff who supported them. There was an open and transparent culture which encouraged people and staff to raise concerns. People and staff felt listened to, and were confident that any complaint or concern would be taken seriously.

People received effective care which met their needs because staff had the skills and knowledge required. One person said, “They [staff] know exactly what they are doing. You can just relax.” People were consulted about their care and the running of the home.

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 supported this practice.

Staff knew people well which enabled them to provide care that was personalised to the individual. People were able to follow their own routines and staff respected people’s choices. Staff encouraged people to continue to take part in activities and hobbies which interested them.

Staff were well motivated and felt supported by the registered manager and the provider. This helped to create a happy relaxed atmosphere for people to live in. One person told us, “The staff are all excellent and always cheerful.”

This inspection was unannounced and took place on 4 February 2016.

Pulsford Lodge provides care and accommodation to up to 50 people. The home specialises in the care of older people. At the time of this inspection there were 37 people living at the home.

The last inspection of Pulsford Lodge was carried out in January 2014. No concerns were identified with the care being provided to people at that inspection.

There is a registered manager in post. 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 home was well led because there were effective systems in place and a strong management team. People knew who the registered manager was and said there were lots of opportunities to discuss their care or make suggestions about the running of the home.

Pulsford Lodge was situated in a small rural town and was very much part of the local community. They home had links with various local groups which made sure people continued to feel part of the community. There were opportunities for people to take part in a wide range of group and one to one activities according to their interests and hobbies.

People felt safe at the home and praised the staff who supported them. One person said “I think we all feel safe because the staff are so kind.” There were sufficient numbers of staff available at all times to keep people safe and to meet their needs. People we asked said there was always staff available to assist them when they needed help. One person said “They respond quickly to you, day and night.”

Risks of abuse to people were minimised because there was a good recruitment procedure and staff received training to enable them to recognise and report any suspicions of abuse. Staff felt confident that any concerns reported would be dealt with to make sure people were protected.

People told us they felt well cared for. One person said “If you have to be in a care home you couldn’t do better.” Another person said “I had no idea what to expect but it wasn’t this. The care, the facilities and staff are excellent. The carers genuinely care. The quality is unbeatable I couldn’t be better looked after.”

People received care and support that met their needs and took account of their preferences. People were involved in decisions about their care and treatment and were able to make choices about their day to day routines. Care plans contained risks assessments which outlined measures in place to enable people to take part in activities with minimum risk to themselves and others. Risk assessments were updated when people’s needs or abilities changed.

There was good access to healthcare professionals and staff were proactive in seeking advice from appropriate professionals if they had concerns about a person’s health. People received a diet in line with their assessed needs and dietary preferences. People were complimentary about the food served at the home. One person said “Food here is very good. Always a choice.” Another person said “Food is pretty good. Excellent roast dinners.”

People knew how to make a complaint if they were unhappy with any aspect of their care. People were confident that any complaints made would be taken seriously and action would be taken to rectify any shortcomings.

Pulsford Lodge is part of a larger care organisation. On our arrival we were informed that the registered manager was away managing a situation in one of the other homes. We were told that she had been doing this since October 2013. However she was maintaining contact with Pulsford Lodge one or two days a week. The deputy manager told us that the Care Quality Commission was aware of the other situation, but had not been formally informed of the management arrangements for Pulsford Lodge.

We did not consider that the care or standards at Pulsford Lodge had been in any way adversely affected by the manager's absence.

We found Pulsford Lodge to be well managed in each of the five care standards that we inspected.

People living at the home, and their families, expressed a high degree of satisfaction with the care and support that they received. One person told us "I would be foolish to say anything other than I am happy here. It's very nice here, very friendly." A relative said "It could not be any better, it would be impossible!" Staff also explained how much they enjoyed working at Pulsford Lodge.

People told us that they were happy living at the home and were able to choose what they wanted to do when they wanted to do it. Comments included "Staff treat me as a friend which pleases me very much" and "Staff are very friendly and kind".

People's care plans reflected people's individual needs and preferences. Staff demonstrated that they understood people's care needs and we observed throughout the visit that people were cared for in a calm and timely way. We observed that there were up to date risk assessments that were linked to people's care plans and evidence of multi professional team working in the case notes.

We observed that there was a system was in place to identify people's concerns and the actions that were taken by the registered manager to address them. We noted that a person who woke early in the morning had been provided with heavier blinds by the registered manager. The person was 'delighted' that their concern had been addressed.

People told us that there always seemed to be enough staff on duty to meet people's care needs and call bells were answered promptly. We observed that people had chosen to spend the rest of their lives in the home and their choices at the end of life were managed with respect and kindness.

Themed conversations enabled people to participate in sharing their views and influence changes in the home.

Everyone we spoke with was very happy with the care that they received and the fact that they were able to carry on with their chosen lifestyles. Comments included “It lovely here, I just ring the bell if I need anything,” “We are all very well looked after” and “I’m very well looked after and there is lots of entertainment to keep me occupied.”

People said that they were able to make decisions about all aspects of their day to day lives. Everyone asked said that they were able to choose what time they got up, when they went to bed and how they spent their day. One person said “We are well looked after but also very free to do as we please.” Another person said “They help me when I need help but I decide how and when I want help.”

Many of the people spoken with commented positively on the range of activities available at the home. People told us that they were informed in advance of what activities were occurring each week so they could plan their time. People said that they were able to choose the activities that interested them and were not pressured to join in with other activities. Along with the usual range of activities, such as bingo, quizzes and arts and crafts there were various groups that were run by people living at the home. These included a gardening group, a choir and a music appreciation group.

Throughout our visit we observed that staff interacted with people in a respectful and kind manner. People living at the home appeared comfortable and relaxed with all staff. Everyone said that staff were always kind and approachable. One person told us “I have nothing to worry about and feel very safe here.”

Everyone asked said that they would be comfortable to speak with the manager or a senior member of staff if they had any concerns or complaints. People felt sure that any complaints would be dealt with.

During the inspection there were numerous positive comments about the staff. These comments included; “They are all lovely without exception,” “All the staff are very, very approachable” and “Staff are all very nice and extremely helpful.”

People who lived at the home felt that there was always enough staff on duty to provide the care that they needed. People said that staff responded very quickly if they rang their bell or asked for assistance. Throughout our visit we noted that call bells were answered promptly. Everyone said that staff were patient and kind when supporting them and that they never felt rushed.

People said that they were asked their opinions about the care that they received and were able to make suggestions about the running of the home. People said that they were able to give suggestions at formal meetings or informally on a day to day basis.