Rodlands Care Home is residential care home registered to provide care for up to 21 people in a residential area of Weymouth. At the time of our inspection there were 17 older people living in the home. Some of the people had a dementia or other life limiting conditions such as diabetes or Parkinson’s. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The home had 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. Although the registered manager was away during day one and day two of our inspection we spoke with them on day three.

At our last inspection we rated the service Good. At this inspection we found the evidence indicated the home remained Good although we have recommended it refers to current guidance on best practice for improving the home environment to make it more ‘dementia friendly.’

People felt safe. Staff had a good understanding of how to safeguard people from harm and abuse. They understood what signs to look for and how to raise a concern. The home had robust recruitment processes to ensure that people were supported by staff who were suitable to work with them. People had personalised risk assessments that staff understood and used to help reduce the risk of avoidable harm. Medicines were managed safely. Staff were confident with this task and had regular, formal observations to check their competency. The home conducted audits to ensure incidents or issues were resolved and chances of them reoccurring minimised.

People’s needs and choices were assessed with their involvement. This included listening to them and noting aspects of their lives that were important to them and made them individuals. This diversity was acknowledged, respected and supported. Reviews of the support people required were completed and included evidence that they were included in these discussions. People were supported by staff that had received training that gave them the skills and confidence to meet their specific needs. People were supported to have a balanced and varied diet. People were supported to maintain their health and wellbeing. This included support to attend routine appointments or with visits from health professionals.

Staff understood the principles of the Mental Capacity Act 2005 (MCA 2005) and how it applied to the people living there particularly when they lacked capacity to make certain decisions affecting their life. The MCA 2005 provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. 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 demonstrated a kind and caring approach towards people. People told us staff knew them well and treated them as individuals. People were consulted with about the care they received and were given opportunities to express their views. People were supported to make decisions about things such as what they wanted to eat or drink, what they wanted to wear, and who and how they wished to spend their day including participation in activities.

Given the increasing needs of people living there, we recomme

The inspection took place on 2, 8 and 13 June 2016.

Rodlands Care Home is registered to provide accommodation and personal care for up to 21 people in a residential area of Weymouth. At the time of our inspection there were 17 older people living in the home.

There was a registered manager in post at the time of our inspection. 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.

Staff understood how people consented to the care they provided and encouraged people to make decisions about their lives. Care plans did not reflect that care was being delivered within the framework of the Mental Capacity Act 2005 when people did not have clear capacity to make decisions for themselves. However, staff showed they understood the importance of enabling people to make their own decisions wherever possible and understood the need to provide care that is in a person’s best interests. Deprivation of Liberty Safeguards had been applied for where a person who needed to live in the home to be cared for safely did not have the mental capacity to consent to this.

People had support and care when they needed it from staff who had been safely recruited. These staff were consistent in their knowledge of people’s care needs and spoke confidently about the support people needed to meet those needs. They told us they felt supported in their roles and had undertaken training that provided them with the necessary knowledge and skills. There was a plan in place to ensure staff received the training they needed to stay up to date with the care needs of people living in the home.

People felt safe. They were protected from harm because staff understood the risks people faced and how to reduce these risks. They also knew how to identify and respond to abuse. Information about how to report abuse was available to staff. People also told us they saw health care professionals when necessary and were supported to maintain their health by staff. People’s needs related to ongoing healthcare and health emergencies were met and recorded. People received their medicines as they were prescribed.

Everyone described the food as good and there were systems in place to ensure people had enough to eat and drink.

Quality assurance had led to improvements being made and people, relatives and staff were invited to contribute their views to this process. Where improvements were identified as necessary following feedback action had been taken. For example there were plans to improve the range of activities available to people and decorating work had begun in the building after feedback from people and relatives. Staff, relatives and people spoke positively about the management and staff team as a whole.

Our inspection of 15 July 2013 found there were no effective systems in operation designed to prevent, detect and control the spread of health care associated infections. There was no guidance for visitors to reduce the risk of cross infection to protect people who used the service and staff. Staff did not demonstrate knowledge in wearing the correct personal protection equipment (PPE) such as gloves and aprons in accordance with the provider’s policy.

During this inspection, we saw that at the entrance to the home there was guidance for visitors on how to reduce the risk of cross infection. Additional guidance for staff in the correct use of aprons had been produced and staff were observed following this guidance. An effective system designed to prevent, detect and control the spread of health care associated infections had been implemented.

We spoke with four people and one person’s relative. All told us they were happy at the home and that the staff were approachable. They told us they could express their views. People spoke positively about the care they received and the staff and management within the home. One person told us, “The staff here are my friends, I have no complaints whatsoever. I’m very happy here.”

People were cared for in a clean, hygienic environment. However, there were no effective management auditing systems in operation designed to prevent, detect and control the spread of health care associated infections. There was no guidance for visitors to reduce the risk of cross infection to protect people who used the service and staff.

The provider had effective systems to monitor pre-employment checks and recruitment procedures for staff.

The home had suitable systems to monitor the quality of service provided.

We spoke with seven people who lived at the service and a visitor and looked at four care plans. One person told us “the girls are ever so nice. I can always talk to them”. Another said “the staff are excellent”. Another told us "I'm very happy here. The food is excellent". A visitor told us they were made very welcome at Rodlands and staff were very hospitable. We observed this to be the case.

People experienced care and support that met their needs and protected their rights. We observed people being supported by staff and saw that people's privacy, dignity and independence were respected. People's views and experiences were taken into account.

Through reviewing arrangements for staff training in safeguarding people, talking to staff and reviewing care plans we found that people were protected because the provider had taken reasonable steps to identify the possibility of abuse and prevent it from happening.

A review of staff records and talking with staff demonstrated that people were safe and their needs were met by competent staff who told us they felt well supported. One member of staff said “it’s a close team”.

The provider had in place systems that sought people's views and took account of complaints and comments. This meant the provider had an effective system to assess and monitor the quality of service.

The purpose of the review was to follow up specific concerns identified at our last review in May 2011. We were not able to get direct comments from most people living in the home as they were not able to reliably recount their experiences.

We saw that staff actively involved relatives in the assessment and review of the care needs of people. We observed that staff were respectful and considerate to people at the home.

We saw that some people went out on short outings to the shops and care workers sometimes organised activities such as bingo. There were no other organised activities at the time of our visit and the home was actively recruiting to fill the vacancy for an activities coordinator.

We found improvement in the assessment and documentation of each person’s social history, interests and preferences. This had improved staff understanding of people as individuals and helped them plan and provide person centred care.

There was an improvement in the prevention and control of infection at the home. Disposable paper towels were available in shared toilets and bathrooms. Plans for refurbishment of toilet facilities and the laundry room had been drawn up and these were being implemented.

A permanent chef had been recruited to work in the kitchen and people were very pleased with the quality of meals and food provided.

We were not always able to get direct comments from most people living in the home as they were not able to reliably recount their experiences. Staff actively involve relatives in the assessment and review of the care needs of people.

Some people were able to tell us they were happy with their room and the home environment. One person told us the food at the home was fine. Others said the food variable but they got more than enough and the choice was good. One person, although limited in their insight as to why they were at the home, told us that they didn’t like the activities and they were very bored. It wasn’t clear that staff were aware of their previous interests.

We were able to observe how people experienced care and saw that staff were respectful and considerate and tried to take account of individual preferences. We observed that there were enough staff to help with personal needs and ensure that people were safe.