About the service: The Lodge was a residential care home that was providing personal and nursing care for 39 people at the time of the inspection, some of whom were living with dementia. Accommodation was provided in a purpose built home across two floors, with communal areas on each floor.

People’s experience of using this service:

People and their relatives were very positive about the service and the care provided. A relative said, “I think the care is excellent. I can’t think of anything they could do better.” A person using the service summed it up in one phrase, “I am happy here.” Another person said, “The staff are marvellous; nothing is too much trouble.”

People were cared for by staff who knew how to keep them safe and protect them from avoidable harm. Sufficient staff were available to meet people’s needs and people told us when they needed assistance, staff responded promptly. People received their medicines regularly and systems were in place for the safe management and supply of medicines. Incidents and accidents were investigated and actions were taken to prevent recurrence. The premises were clean and staff followed infection control and prevention procedures.

The service continued to be effective. People’s needs were assessed and care was planned and delivered to meet legislation and good practice guidance. Care was delivered by staff who were well trained and knowledgeable about people’s care and support needs. People were provided with a nutritious and varied diet and they were complimentary about the quality and choice of food offered. 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. When people were unable to make decisions about their care and support, the principles of the Mental Capacity Act (2005) were followed.

People were cared for by staff who were kind and compassionate. The atmosphere within the home was friendly and welcoming and staff were warm and considerate towards the people they cared for. People and their relatives felt involved and supported in decision making. People’s privacy was respected and their dignity maintained.

Staff were responsive to people’s individual needs and wishes and had an in-depth knowledge about each person. A person said, “Nothing is too much trouble for them.” Staff engaged with people very well and offered them choices on an ongoing basis. People had access to a range of activities and entertainment that they enjoyed. People’s views and concerns were listened to and action was taken to improve the service as a result.

The service continued to be well led and benefitted from clear and consistent leadership. The registered manager was praised by people, their relatives and staff, for their positive and supportive approach and their prompt resolution of issues. Systems were in place to monitor the quality of care provided and continuously improve the service. The management team and staff engaged well with other services and had developed positive relationships.

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

Rating at last inspection: Good (report published in July 2016)

Why we inspected: This was a scheduled inspection based on the previous rating.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

This inspection was unannounced and took place on 5 May 2016. At our last inspection in January 2014 the essential standards of quality and safety under the HSCA 2008 were found to be met.

The Lodge Care Home provides accommodation, nursing and personal care for up to 40 older adults, including some people who may be living with dementia. At the time of our visit, there were 39 people living at the service, including 22 people receiving nursing care. There was a registered manager at this 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 and their relatives were confident that people received safe care and to speak out if they had any concerns about this. People’s care, medicines and environment were safely managed. Risks to people’s safety associated with this and their health conditions were assessed before they received care and regularly reviewed to ensure that people received safe care and treatment.

Staff knew how to keep people safe and the arrangements for their recruitment and deployment helped to make sure that people were protected from harm or abuse.

Staff were trained and supported to perform their role and responsibilities. The provider's arrangements for this helped to ensure a valid and consistent approach to people’s care.

Staff obtained people’s consent or appropriate authorisation for their care, to ensure that people’s rights were upheld and their care was lawful.

Staff understood people’s health and nutritional needs and supported people to maintain and improve their health and nutrition. This was done in consultation with relevant external health professionals and staff followed their instructions for people’s care when required.

People received care from staff who were kind and caring. Staff treated people with respect and promoted their rights, comfort and choice in care.

People and relatives were appropriately involved in agreeing care provision. Staff understood and supported people to maintain their ongoing contact with family and friends who were important to them.

People received care that was personalised and responsive to their needs and wishes from staff who knew how to communicate with them.

People were supported them to engage in home life in a way that was meaningful to them. A range of environmental adaptations and equipment helped to promote people’s independence.

People and relatives were asked for their views about the care provided and informed how to make a complaint or raise any concerns. These were acted on and used to make improvements for people’s care when required.

The service was well managed and people, relatives and staff were confident of this. Staff were motivated, supported and informed to perform their role and responsibilities for people’s care.

The provider’s governance and management arrangements, helped to ensure appropriate direction and accountability for people’s care and to inform any improvements needed.

We spoke with seven people who used the service, three relatives, seven members of staff, the manager and the regional manager from the provider's office. People made very positive comments. These included, " I have settled very well here and everyone is so kind." Another person told us, "I have no complaints, the food is excellent and so are the staff." A recent survey of people who used the service and their relatives recorded that 99% of people said communication with staff was very good.

We found that people received their planned care in a professional and safe way from staff who were well trained and knowledgeable about their needs. Care records were detailed and contained all required information about people's choices and preferences.

We saw that people had a positive dining experience. There had been many choices of suitably nutritious food and drinks available throughout the 24 hour period.

We saw high standards of cleanliness throughout the home and checks to ensure the control of infection.

There was a system in place to ensure that people were protected against risks associated with medicines. People had received their medicines safely and as prescribed. There had been regular reviews of medication by the GP.

People's nutritional status had been monitored closely and action taken where there had been any concerns about weight loss.

There had been sufficient numbers of suitably qualified and experienced staff on duty at all times.

On the day of our inspection visit to the Lodge there were 40 people living there.

The Lodge offered both residential and nursing care, and we noted that during our visit, there were 18 people receiving nursing care and 22 receiving residential care.

We spoke with two people who live at the Lodge to gain their views of living at the, care home. We also observed the staff at various times throughout the day, to see how they interacted with people. We asked if people were happy living at the care home and we were told: “I’m very happy here, the staff are very nice.” A second person said: “It’s lovely, they really know how to look after us and the staff are lovely too, really lovely.”

Our observations of the staff as they were working at The Lodge showed that there was a level of both respect and understanding for the people living at the care home. We saw that the staff took the time to reassure people while talking to them in a friendly manner, and we also noted staff offering choices.