We completed an unannounced inspection of Rook Lodge on 6 and 7 June 2018. We last inspected this service on 9 June 2016 and rated the service Good. However, the service did not ensure people were always safe. This was due to a lack of window restrictors on the first floor and resulted in a breach of legal regulations. At this inspection we found that the provider had taken action to fit window restrictors on all floors and was now meeting legal requirements. The rating of the service remains Good.

Rook Lodge is a care home. 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. Rook Lodge can accommodate up to ten people in one adapted building. It provides care and support for people with long-term mental health illnesses. At the time of the inspection, there were six people using the service.

The service 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.

People told us they felt safe living at the service and that staff treated them with respect and dignity. Staff understood the risks from abuse people faced and safeguarded against them. The service had completed personalised risk assessments for people, with informed risk management plans on how best to work with any risks identified. Accidents and incidents were recorded and responded to. We saw evidence of recruitment processes that met required Health and Social care standards. We saw that medicines were stored correctly and administered safely. There were adequate number of staff working at the service.

People received person-centred care from the service. Their care plans were detailed and personalised ensuring that each person had an appropriate care package to support them. Independence was promoted as people were encouraged to live socially enriched lives. Staff had received training in a variety of appropriate topics, including the Mental Capacity Act and how to administer medicines safely, and we noted the service had planned specialised and specific training in the future. Staff receive regular supervision and appraisals.

Staff treated people with kindness and compassion. We asked people and staff about the management of the service and all provided positive feedback, highlighting a ‘homely’ atmosphere to the service.

People could make choices about how they wanted to live their lives, deciding what food and drink they wanted, how to spend their time and what activities they wanted to pursue. We noted people could raise concerns or complaints about their care to the service and that the service welcomed this feedback. People were supported to access health care when they needed it.

There was a positive ethos at the service. Staff enjoyed their roles and were well supported by the registered manager and provider. There were quality assurance processes in place to monitor the standards of care being provided and the service worked closely with external stakeholders to ensure people’s needs were being met.

This unannounced inspection took place on 9 June 2016. Rook Lodge provides accommodation and support with personal care, for up to ten people who need support to maintain their mental health. At the time of the inspection, there were seven people using the service.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

People told us staff treated them with respect and dignity. They told us they were happy living at the service. Relatives said staff were kind and friendly. We noted people had risk assessments, which identified possible risks and guidance for staff on how to manage them. Records showed and the registered manager confirmed that new staff underwent recruitment processes which involved them completing an application form and providing satisfactory evidence to show they were fit for their roles. Staff had received training in Mental Capacity Act 2005 (MCA), medicine administration and mental health awareness.

People’s care plans were personalised which meant that each person had a care package unique to them. The service promoted independence by encouraging and supporting people to travel using public transport, to self-administer their medicines and to do shopping and cooking. Staff received training relevant to their roles and were knowledgeable about promoting independence. People used community facilities and were happy the support staff provided. They told us they had social and leisure activities and attended colleges. We noted people were free to invite friends or families to visit them at the service.

People, relatives and staff were positive about the management of the service. They told us the registered manager listened to them. They confirmed that they were asked to make suggestions regarding the quality of the service. We recommended that the quality assurance process including action plans resulting from feedback from stakeholders should be carried out by the registered manager.

The service had a complaints procedure. People and relatives told us they knew how to make a complaint if they were unhappy about the service.

We found that the provider did not have effective systems in place to ensure that the premises were safe. This was a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have told the provider to take at the back of the full version of this report.

At the last inspection in July 2013 we found that people were at risk of unsafe or ineffective care because accurate and appropriate records were not being kept. On this follow-up visit we found that personal records had been reviewed and updated. They contained accurate and up to date information about people's needs. This meant that people were protected from the risks of unsafe or inappropriate care.

People’s care, health and welfare needs were being met. They told us they were happy with the quality of care that they received. One person who used the service said “its nice living here, I like it.” Another told us “I am happy with the amount of support. There is a fine balance between independence and support but I think they have got it right.” A healthcare professional told us “they provide a very good service. My client has improved a lot since being here. They keep him stable and know when he is not well.”

We found that there were sufficient staff on duty to meet people’s needs. People told us that staff were always available to provide support when needed. A member of staff said “there are always enough staff and any gaps are covered by regular staff to maintain continuity.”

People were given meals that they liked and that met their nutritional needs. Three people had their meals together and the remainder cooked for themselves with varying levels of assistance from the staff. One person who used the service said “I do my own cooking in my flat but there is always someone on hand when needed.” Another told us “we fill out the menu and everyone is asked what they want.”

People were not always protected from the risks of unsafe or inappropriate care because accurate and appropriate records were not maintained.

During the course of the inspection we met and spent time with eight of the nine people who used the service. Five people talked to us in more detail about what they did, what they liked and about Rook Lodge. All of those we spoke with were happy with the care and support provided by the service. People told us that they were treated with respect by staff and that staff were approachable and supportive. One person said, “Staff are very supportive and there is an open door policy. It's easy to talk to someone. There is no them and us. I am treated with respect and have control of what happens.”

People also confirmed that they received the support that they needed with regard to their health issues. One person said, “They have given me good support with my health issues.” People told us that they were supported to develop and maintain their independence skills. For example, cooking and household chores.

People who used the service said that they had opportunities to discuss the quality of the service provided and that they knew how to complain or who to talk to if they were not happy about something. They told us that they discussed things individually with their key worker or at the ‘residents’ meetings.