Stewart Lodge Care Home is a small care home that provides accommodation and personal care for up to three people. The home specialises in looking after adults with mental health needs. There were three people using the service at the time of our inspection.

This inspection took place on 21 November 2016 and was unannounced. At our previous inspection in November 2013, we found the provider needed to make improvements with regard to ensuring that there was sufficient evidence of staff training and supervision. The provider was also asked to make improvements with regard to ensuring records were always available and up to date. During our inspection of 21 November 2017 we found that the provider has made the necessary improvements in these areas and that they now met the regulations we inspected.

The service had a registered manager who was also the sole director of the company which owns the service. 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 were supported by adequate numbers of staff who had been safely recruited. The staff were supported by the registered manager who provided supervision and leadership as well as opportunities for training to help staff meet people's needs and carry out their role.

Records required to be kept by the registered provider relating to staff and the management of the service were readily available and consistently maintained.

People using this service experienced responsive care and support that was person centred and appropriate to their needs. People expressed their views and were involved in making decisions about their care and treatment. Individuals had personalised care plans that were regularly reviewed to make sure they got the right care and support. Risk assessments aimed to keep people safe whilst supporting them to maintain and develop their independence as far as possible.

Staff made sure people’s dignity was upheld and their rights protected. Staff understood their responsibilities where people lacked capacity to consent or make decisions. This was because they had received training in safeguarding people and on the principles of the Mental Capacity Act (MCA) 2005 and the Deprivation of Liberty Safeguards (DoLS). Appropriate DoLS applications had been made where required.

People took part in activities that interested them and were supported to maintain relationships with family and friends who were important to them. Individuals were encouraged to build and develop their independent living skills both in and outside the service.

People told us they received ongoing advice and treatment from health and social care professionals to ensure that they stayed as well as possible. They had access to other services when they needed them. Any advice from external professionals was included in their care and acted on accordingly. People were supported to keep healthy and their nutritional needs and preferences were met. The provider had appropriate arrangements in place to manage medicines.

Auditing systems were used effectively to keep checks on standards, develop the service and make improvements. People and others involved with the service had opportunities to share their views and the provider listened to their feedback.

We spoke with all of the people using the service during our inspection. People were positive about the care and support they received. One person said, “The staff are lovely.” And “I would definitely say something if I wasn’t happy.” Another told us, “It’s nice here. They take me out and I go to college. I’m happy here.”

We saw from people’s individual records, people had been involved in planning and developing their care plans. People had been able to sign their agreement to the care and support planned for them. Each person had a current care plan which set out their care and support needs. Detailed instructions were documented for staff about how these needs should be met. Staff were also given guidance about how to encourage and support people to be independent, participate in activities and maintain regular contact with friends and family. We saw known risks to people’s health, safety and welfare had been identified and plans were in place to manage these.

From the records we looked at these had been reviewed and updated so that staff had up to date information about people’s current care and support needs. There were enough staff to meet these needs. Medical records we looked at showed medicines were administered appropriately and stored safely in the home.

We spoke with one of the people using the service during our visit. They told us ‘It’s alright here. I’m as well as can be expected’. They told us about the things staff did to support and encourage them to be independent. They also said staff cooked them their favourite meal almost every day. They said about staff ‘they look after me and are very respectful’.

We looked at the records of people using the service and saw people had up to date care plans which identified their specific care and support needs. There was detailed information for staff about how these needs were to be met.

Staff received training to keep their skills and knowledge up to date. They told us they worked in a supportive environment.

The provider carried out checks within the home to make sure that risks to people’s health, safety and welfare were identified, managed and mitigated.

Stewart Lodge Care Home is a small care home that provides accommodation and personal care for up to three people. The home specialises in looking after adults with mental health needs. There were three people using the service at the time of our inspection.

This inspection took place on 12 and 17 November 2015 and was unannounced. At our previous inspection in October 2013, we found the provider was meeting the regulations we inspected.

The service had a manager who was in the process of applying to register. They told us that the previous registered manager had left over six months ago although we had not been notified of this in a timely manner. 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 were supported by adequate numbers of staff who had been safely recruited. However, they were not supported by a suitably trained or supervised staff team which could lead to people's needs being unmet. There were insufficient arrangements to ensure that staff were appropriately trained and supervised to meet people's needs and carry out their role.

Records required to be kept by the registered provider relating to staff and the management of the service were not readily available or consistently maintained.

People using this service experienced responsive care and support that was person centred and appropriate to their needs. People expressed their views and were involved in making decisions about their care and treatment. Individuals had personalised care plans that were regularly reviewed to make sure they got the right care and support. Risk assessments aimed to keep people safe whilst supporting them to maintain and develop their independence as far as possible.

Staff made sure people’s dignity was upheld and their rights protected. Staff understood their responsibilities where people lacked capacity to consent or make decisions. This was because they had received training on the principles of the Mental Capacity Act (MCA) 2005 and the Deprivation of Liberty Safeguards (DoLS). Appropriate DoLS applications had been made where required.

People took part in activities that interested them and were supported to maintain relationships with family and friends who were important to them. Individuals were encouraged to build and develop their independent living skills both in and outside the service.

People told us they received ongoing advice and treatment from health and social care professionals to ensure that they stayed as well as possible. They had access to other services when they needed them. Any advice from external professionals was included in their care and acted on accordingly. People were supported to keep healthy and their nutritional needs and preferences were met. The provider had appropriate arrangements in place to manage medicines.

Auditing systems were used effectively to keep checks on standards, develop the service and make improvements. People and others involved with the service had opportunities to share their views and the provider listened to their feedback.

We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to staff training and supervision and the availability of records. You can see what action we told the provider to take at the back of the full version of this report.