The Lodge is registered to provide care for up to 15 people with mental health support needs and physical disabilities.

At the last inspection, the service was rated Good. At this inspection, we found the service remained Good.

People who used the service, and their relatives felt the service was good and they were happy the way staff provided care and support to them. Relevant checks had been undertaken before staff started working at the service.

People told us staff treated them with dignity and respect and felt there were enough staff around to meet their needs. Staff encouraged people to be as independent as possible. We saw the interactions between people and staff were positive.

People were able to access appropriate healthcare when needed. They were given a choice of healthy food and drink, to ensure their nutritional needs were met. Their medicines were stored and managed safely.

Staff respected the views of people on how they wanted their care delivered. People were involved in the planning of their care and support and were supported to take part in activities of their choice.

Staff received training and support to ensure people’s needs were met. They felt the service was managed well and could discuss their concerns with the registered manager.

Staff supported people to have in the least restrictive way possible. They were aware of the requirements of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS).

The provider had systems in place to monitor and sought the views of relatives, staff and people on how to improve the quality of the services. They also ensured concerns or complaints were investigated and resolved in a timely manner.

There were systems in place to protect people from the risk of harm. Staff were knowledgeable on how to keep people safe. Risks to people were identified and there was guidance in place to ensure people's safety.

People's needs had been assessed before they started using the service. Their care plans provided information to staff on how to support them.

The provider had an effective system in place to monitor the quality of the service and to deliver improvements to the care and support people received.

This inspection took place on 9 September 2015 and was unannounced. At the last inspection on 04 June 2015 we found the service to be breaching regulations as people were not wholly protected from the risks of unsafe or inappropriate care and support as we saw care records were not always up to date. After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breach.

We undertook this focused inspection to check that they had followed their plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for The Lodge on our website at www.cqc.org.uk.

The Lodge is registered to provide care for up to 15 people with mental health support needs and physical disabilities.

There is a registered manager in place. 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.

At this inspection we found the registered manager had taken sufficient action to ensure people were protected from the risks of unsafe care and support as we found care records had been updated to reflect people’s needs.

This inspection took place on 04 June 2015 and was unannounced. At our last inspection in August 2014 we found the provider was meeting the regulations we inspected.

The Lodge is registered to provide care for up to 15 people with mental health and physical disabilities.

There was a registered manager in place. 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 not wholly protected from the risks of unsafe or inappropriate care and support as we saw care records were not always up to date.

Staffs demonstrated a good understanding of the requirements of the Mental Capacity Act 2005, and were aware of the steps to take should someone who used the service need to be deprived of their liberty for their own safety. The service had policies and procedures in place for staff to follow to report any abuse they may witness or become aware of. Staff also received training on how to keep people safe.

There was appropriate arrangements were in place in relation to the obtaining, recording and administration of medicines.

People received individualised care that met their needs. People were supported to attend health and medical appointments, and the staff sought medical assistance when people were unwell.

People and relatives told us they were satisfied with the care and support provided at the service.

Staff received appropriate training, professional development, supervision and appraisal to support them in delivering care and other services.

The registered manager had regular contact with people using the service and their representatives. They welcomed suggestions on how they could develop the services and make improvements.

There were processes to ensure people were able to contribute to discussions about how they preferred to be cared for and supported. People were supported by attentive and patient staff who understood the need to respect people's privacy and dignity. We saw staff interactions with people using the service were sensitive and respectful.

People who used the service appeared at ease in their surroundings and spoke freely about their experiences.

We found one 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 this report.

A single inspector carried out this inspection. The focus of the inspection was to check if the service had made improvement with regards to record keeping and administration of medicines.

During an inspection on 12/06/14 we sampled the Medicine Administration Records (MAR) sheets and noted staff were not always giving medicines as prescribed. They were also making changes to the MAR sheets without the consent of the prescriber/doctor. For example, a number of medicines were prescribed to be given four times a day; the staff had changed the MAR sheet for the medicines to be given only when required without contacting the prescriber/doctor.

We noted people’s personal records including medical records were not always accurate and fit for purpose. We reviewed four files and found that some information were not up to date. For example, the property list for one person was not filled in; some of the paperwork on one person’s files were not dated and signed.

During this visit we found the provider had taken appropriate action to protect people against the risks associated with the unsafe management of medicines, which included the obtaining, recording, administering, safe keeping and disposal of medication. We also found that people’s personal records including medical records were accurate and fit for purpose.

A single inspector carried out this inspection. The focus of the inspection was to answer five key questions; is the service safe, is the service effective, is the service caring, is the service responsive, is the service well led?

Below is a summary of what we found. The summary describes what people using the service and the staff told us, what we observed and the records we looked at.

If you want to see evidence that supports our summary please read the full report.

This is a summary of what we found:

Is the service safe?

We observed the way staff interacted with the people using the service and saw they treated people with respect and dignity. Safeguarding procedures were in place and staff had been provided with safeguarding training. Staff demonstrated a good understanding of what kinds of things might constitute abuse, and knew where they should go to report any suspicions they may have.

Is the service effective?

People we spoke with told us they were satisfied with the care and support provided by staff. It was clear from speaking with staff that they understood people’s care and support needs, and were familiar with their likes and dislikes. We saw people using the service and their relatives were involved in helping staff plan people’s care plans. Their views and experiences were used to develop their care plan.

Is the service caring?

We observed care being provided in a respectful, supportive manner. Support that was offered to people was individualised and geared to their agreed needs. People looked relaxed and comfortable throughout our inspection. People also had an allocated member of staff known as a key-worker who coordinated their care.

Is the service responsive?

Staff had a good understanding of the needs of people. People’s needs were assessed before they moved into the home and were reviewed on a regular basis. Where necessary, the provider had sought the assistance of other health and social care professionals in the assessment of people’s needs and formulation of care plans.

Is the service well-led?

The home had a registered manager who was experienced and knew the service well. The views of people using the service and the staff that cared for them were taken on board by the provider. They also visited and carried out monthly audits of the service. However, we noted that improvement was needed with regards to record keeping and administration of medication.

People we spoke with told us that The Lodge provided good care and that the staff were helpful and friendly. One person told us “When it comes to kindness and looking after they are good”. Another person told us “I have a buzzer. They are very good at coming when I buzz”.

We found that care was provided in accordance with people’s wishes and with their consent. Care was delivered according to individual assessed need and appropriate health and social care professionals were involved in people’s care. Staff received professional development and there was an effective process in place for dealing and acting on comments about the service.

People we spoke with were happy with the service they received. People told us that they enjoyed the privacy offered by the environment and its proximity to the local park. One person told us “I like it here. I’ve been here about a year and it is much better than where I was before.” Another person told us, "I've got friends who come to see me here, it's not bad at all".

People were included in decision making about their care and treatment which was delivered in line with assessed need. There were checks on staff taking place prior to employment commencing. People were cared for in a well maintained environment and we found records kept by the service were accurate and stored securely.

People told us that they felt that staff were friendly and helped them with their daily activities. People told us they enjoyed the food and that they were able to help decide what was on the menu.