This inspection took place on 28 June, 3 July and 20 July 2018 and was unannounced.

Strathmore Lodge is a ‘care home’. 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.

At our last inspection in June 2018 we rated the service as requires improvement. This was because people did not always receive their medicines in a timely way and staff were over stretched which meant people sometimes had to wait to be supported. Records were not kept up to date and information was not always current. There was a lack of management oversight and these issues had not been identified as areas that needed to be improved.

Since the previous inspection the Clinical Commissioning Group (CCG) have been supporting the registered manager to make the required improvements in relation to the safe management of medicines. There were effective systems in place for the safe storage and management of medicine and regular audits were being completed. This was a work in progress at the time of our inspection.

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 were safeguarded from the risk of harm. There were effective safeguarding procedures in place and staff had received safeguarding training.

There were sufficient numbers of staff deployed to meet people's needs. Safe recruitment practices were followed.

People were asked to consent to their care and support. The service operated within the principles of the Mental Capacity Act 2005 (MCA). Staff felt well supported and received training relevant to their roles.

People were supported to eat a healthy and balanced diet to help maintain their wellbeing. People were assisted to access a range of healthcare professionals.

People appeared comfortable and relaxed when engaging with staff and managers. Staff were positive about their work and the support provided. People were treated with dignity and respect.

People received care that was responsive to their changing needs and the service operated flexibly. People were supported to raise any concerns and these were investigated and resolved effectively.

The service had an open and inclusive culture and staff were positive about the support they received from staff and the registered manager.

Quality monitoring systems and processes were in place to help drive continual improvements. An action plan had been developed which recorded where action needed to be taken. Feedback was being sought to capture people views on the overall quality of the service.

The inspection took place on 8 June 2017 and was unannounced.

Strathmore Lodge provides accommodation for up to 19 people with residential and dementia needs. It does not provide nursing care. At the time of this inspection there were 18 people living at Strathmore Lodge.

There was a manager in post who had registered with CQC. 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.

When we last inspected the service on 19 August 2015 we found the provider was meeting the regulations. At this inspection although we found that the provider meeting the regulations, improvements were required to ensure continued compliance.

People told us they felt safe living at Strathmore Lodge. Staff understood how to keep people safe and risks to people's safety and well-being were assessed and kept under review to help to keep them safe. People's medicines were managed safely, by staff who had received training.

People had their needs met, however on occasions they had to wait a short time to be assisted. We observed there were adequate numbers of staff to support people but at times the staff were stretched and this meant that delays in assisting people or completing tasks in a timely way were noted.

Staff had received training and had the right skills and experience to support people safely. There was a recruitment process in place. However we found some recruitment records were inconsistent with regard to what information was obtained and recorded.

Staff received regular support from their line managers and attended regular team meetings. However staff had not received individual supervision and this was an area that required development. Staff told us they felt well supported and that they were valued and listened to.

People received the assistance they needed to eat and drink sufficient amounts to help keep them healthy. People were supported to maintain their health and staff worked closely with other professionals and made referrals to healthcare professionals when required.

People and their relatives were positive about the staff and management at the service. There was a cheerful ambience around the home. We observed staff to be kind and caring. Staff were knowledgeable about people’s individual requirements in relation to their care and support needs and preferences. People and or their relatives had been involved in the planning of their care where they were able to and where this was appropriate. Visitors were welcomed to the home at all times, and we observed a regular stream of visitors throughout the day.

People were supported to participate in some activities that were provided. However this was an area that required improvements as activities were not always available and were sometimes cancelled due to staff shortages.

There were arrangements in place to receive feedback from people who used the service and their relatives. People were able to raise any concerns they had and told us that they were confident they would be listened to and any concerns raised would be addressed.

There were some systems and processes in place to monitor the quality of the care and support provided for people who used the service. However this was an area that required improvements in particular in respect of the maintenance of record keeping.

This inspection was carried out on 19 August and was unannounced. Strathmore Lodge provides care for up to 19 elderly people of varying abilities, although the home is not a specialist dementia home it does have some long term residents who have now developed dementia and they have chosen to stay at the home.

There was a manager in post. A 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 and associated Regulations about how the service is run. The manager was also the nominated individual and the owner of the home.

On the day of our inspection, there were 18 people living at the home.

The Care Quality Commission (CQC) is required to monitor the operation of the Mental Capacity Act (2005) (MCA) and Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are put in place to protect people where they do not have capacity to make decisions and where it is considered necessary to restrict their freedom in some way, usually to protect themselves or others. At the time of the inspection applications had been made to the local authority in relation to three people who lived at the service and were pending an outcome. Staff were fully aware of their role in relation to MCA and DoLS and how to support people at risk of being deprived of their liberty.

People living at Strathmore Lodge received care that was personalised and staff knew them well. Relationships between people, the manager, care and support staff were positive. We found that staff were caring and responsive to people`s needs. People and their relatives told us they were very happy living at Strathmore Lodge and that the manager and staff were very supportive. Care plans were detailed and personalised and were reviewed regularly.

The provider had an effective recruitment process in place that protected the people who used the service. Many of the staff had worked at Strathmore Lodge for many years and people developed meaningful relationships with them.

People were supported to maintain a good health. GP visited the home when required or if people preferred they visited their GP at the surgery. The district nurse also visited people at the home when it was necessary.

We inspected Strathmore Lodge on 04 June 2013 and found that the provider was not meeting the required standards for the care and welfare of people who used the service.

During this inspection on 15 October 2013, we found that people’s personal care needs had been met. We observed people were well groomed and were laughing and joking together and with the staff. People we spoke with told us that the staff were 'smashing, very good and pleasant'. There was 'always something to do'. One person told us that living at the service was 'like being at home'.

We found that the provider had taken the steps required to meet the standards required for the care and welfare of people who used the service.

We visited Strathmore Lodge on 4 June 2013. We saw that there was a full refurbishment underway in the home. We were told by the manager that all the rooms in the home were being redecorated and that all people using the service would be supplied with new electronic beds and mattresses for their rooms. People we spoke to told us that they were happy with the changes that were being made to the home. We were told that the staff 'look after people and treat them well'. People who used the service told us that the staff did 'their best' and they had 'no complaints'. Whilst at the service we observed staff talking with people and people using the service seemed happy and comfortable in their surroundings.