About the service: South Lodge Care Home is a care home that provides nursing, personal care and accommodation for up to 106 older people. Accommodation is arranged over four floors, in four distinct units. People had individual apartments with wet rooms and, in some cases, kitchenettes. At the time of our inspection, there were 93 people using the service.

What life is like for people using this service:

•Staff were not always effectively deployed in the service to ensure people received support and assistance in a timely manner. The manager was in the process of taking action to mitigate risks for people and ensure sufficient numbers of staff were always deployed to meet people’s needs.

•Staff were not always clear in their day to day roles and responsibilities. People, relatives and staff felt able to share their views about the service but were not always confident action would be taken to make required improvements.

•The provider undertook a range of quality audits and checks which helped to monitor the quality of the service provided and identify where improvements were required. Records did not always clearly demonstrate timescales for improvements or if improvements had been actioned.

•Staff understood their role to safeguard people from the risk of abuse and manage risks associated with people’s care and support.

•People received their medicines safely; lessons had been learnt from recent medicine errors. Staff followed procedures and guidance to prevent and/or reduce the risk of infections and cross infection for people.

•Staff were safely recruited and had completed relevant training to give them the skills and knowledge they needed to meet people’s needs.

•People’s needs were assessed before using the service and this information was used to develop care plans.

•People were supported to eat and drink healthily and reduce the risk of poor nutrition. Staff supported people to access the healthcare they needed to maintain their well-being.

•People were supported to have choice in their daily lives and staff supported them in the least restrictive way possible.

•People were treated with kindness and respect. People and their relatives were supported to express their views and make decisions about the care they received. Staff promoted people’s independence and respected people’s right to privacy and dignity.

•People received personalised care from staff who followed detailed guidance in people’s care plans. People were able to participate in a range of meaningful activities.

•People and relatives knew how to raise concerns and complaints about their care.

•People were supported to receive end of life care in line with their wishes and preferences.

•The manager was clear on their responsibilities and demonstrated a commitment to ensuring people receiving quality, good care.

Ratings at last inspection: This was the first inspection under the new provider; the service had previously been rated as Good.

Why we inspected: This was a scheduled inspection.

Follow up: We will continue to monitor the quality of the service through the information we receive until we return to visit as per our re-inspection programme. If any information of concern is received, we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk.

This inspection took place on 7 June 2016 and was unannounced.

South Lodge is registered to provide nursing and residential care and support for 106 older people with dementia and mental health needs. At the time of our inspection there were 97 people using the service.

The home has four floors. The Langton unit is situated on the ground floor and Charnwood and Foxton units on the first and second floors. Beacon Knowle unit is situated on the top floor and specialises for people living with dementia. It has restricted access for the safety of the people living there.

South Lodge had 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.

People felt staff were kind and caring, and their privacy and dignity was respected in the delivery of care and their choice of lifestyle. Most of the relatives we spoke with were also complimentary about the staff and the care offered to their relatives. People were involved in the review of their care plan, and when appropriate were happy for their relatives to be involved. We observed staff offered people everyday choices and respected their decisions. People’s care and support needs had been assessed and people were involved in the development of their plan of care. Staff had access to people’s care plans and received regular updates about people’s care needs.

People were provided with a choice of meals that met their dietary needs. The catering staff were provided with up to date information about people’s dietary needs, and constantly sought the opinions of people to tailor their individual meal choices. Medicines were ordered, stored and administered safely and staff were trained to provide the medicines people required. Care plans included the changes to peoples care and treatment, and people attended routine health checks.

There were sufficient activities staff to provide a good level of planned and meaningful person centred activities for people over all seven days of the week. The provider had engaged with national activity providers association (NAPA) to identify appropriate activities and pastimes, and train staff accordingly. Staff had a good understanding of people’s care needs. People were able to maintain contact with family and friends as visitors were welcome without undue restrictions. Staff sought medical advice and support from health care professionals.

Staff were subject to a thorough recruitment procedure that ensured staff were qualified and suitable to work at the home. They received induction and on-going training for their specific job role, and were able to explain how they kept people safe from abuse. Staff were aware of whistleblowing and what external assistance there was to follow up and report suspected abuse.

There were sufficient staff available to meet people’s personal care needs and we saw staff worked in a co-ordinated manner.

Staff told us they had access to information about people’s care and support needs and what was important to people. Staff knew they could make comments or raise concerns with the management team about the way the service was run and knew these would be acted on.

The provider had a clear management structure within the home, which meant that the staff were aware who to contact out of hours. The registered manager undertook quality monitoring in the home, which fed into the checks the area manager carried out to keep the board of directors informed on the progress of the home. The provider had developed opportunities for people to express their views about the service. These included the views and suggestions from people using the service, their relatives and health and social care professionals. We received pos

People using the service and their relatives told us they felt safe and well cared for. We found the environment to be welcoming and friendly and the facilties available to people using the service to be very good.

We observed staff delivering care and support in a patient and efficient manner. People we spoke with told us they trusted the care staff and believed them to be well trained and capable of delivering the care they needed. The provider also took steps to ensure staff maintained their professional skills and displayed a professional approach to their duties.

The provider takes approriate steps to ensure people's care needs are accurately indentified and fully met whilst they use the service. Members of staff and people using the service told us that they felt supported by the management and were confident any concerns they had would be addressed quickly and satisfactorily.

People told us that the care workers were very good and they felt well cared for. Relatives also commented positively about the care that people received. A relative commented, “The permanent staff are fantastic and I’d rate them highly.” Another relative commented that they were happy with the attitude and approach of staff saying it was excellent.

People told us they knew about their care files and the planned care had been discussed with them. Relatives spoken with also felt the care workers knew about people’s individual needs and were able to meet this.

People told us they felt safe and well looked after by care workers. We saw people using the staff call system. Relatives also told us they thought people were safe, and they had not seen care practices gave them cause for concern.

People told us the routine was relaxed and flexible. People were able to stay in their rooms or use communal areas as they wished. People told us residents meetings were held on a regular basis. People told us they were able to raise issues at these meetings, and they felt listened to.

During this inspection we spoke with sixteen of the people who used the service at South Lodge and with five visitors. We also spoke with the managers of the service, the cook, activities organisers and five of the care staff employed there.

Overall, the people we spoke with confirmed that they were satisfied with the care and support they received. One told us, “I am very pleased. They look after me very well here. I recommend this place to others.” Another said, “It is all very satisfactory. I am well looked after.” They also told us that they were pleased with the meals provided. One told us, “The meals here are absolutely fine. There is a wide variety.” Another person added, “The quality of the food is very good – you get variety and choices.”

The building was decorated and furnished to a good standard throughout. People’s apartments were furnished with their personal belongings and reflected their individual tastes and interests. One told us, “My room is very homely, I have my own things around me.” Equipment was available to help people’s needs to be met in a safe and timely way.

There were arrangements in place to help capture the views and comments of people who used the service. Regular audits were carried out to check that the service was operating reliably.