We inspected this service on 2 March 2016. The inspection was unannounced. Our last inspection took place on 9 September 2013 when we found the provider was meeting all the standards we inspected.

The Lodge Nursing Home is registered to provide accommodation and nursing care for up to 10 people.

There was 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.

Some improvements were required to ensure the quality of the service was monitored to drive change. There was insufficient information provided to explain when people might need ‘as required’ medicines. People were protected from avoidable harm and abuse because staff understood their responsibilities and the actions they needed to take to protect people. People’s risks were assessed and there were management plans in place to ensure people were supported appropriately. Medicines were stored, recorded and administered correctly which ensured people received the treatments prescribed for them.

There were suitable recruitment checks in place to ensure staff were suitable to work within a caring environment. Staff received training and support to enable them to care for people effectively. People were able to choose nutritious meals and were offered frequent drinks to maintain their health and wellbeing. The advice of healthcare professionals was sought and implemented for people whenever specialist advice was required.

The provider recognised the importance of gaining consent from people and the requirements of the Mental Capacity Act 2005. There were arrangements in place to support people when they needed help with decision making.

Staff were kind, attentive, caring and showed an interest in people and their families. Staff understood people’s right to privacy and promoted their dignity by offering support and delivering personal care in a discreet way. Relatives were welcomed and supported by staff.

Staff knew people well and offered a personalised approach to care. People were encouraged to participate in hobbies and activities which interested them. Staff spent time socialising with people on a one to one basis.

People, relatives and staff felt supported by the registered manager and the acting manager. There were opportunities to share views on the service as there was an open and transparent ethos in the home.

We carried out this inspection to check on the care and welfare of people who used this service, and to ensure that compliance actions we made in December 2012 had been addressed. The visit was unannounced, meaning the service did not know we were going. We spoke with three people who used the service, three relatives and three staff about how the service was delivered.

During our inspection in December 2012, we made compliance actions in two areas. We said that people’s care plans did not record information on capacity and consent. We found that not all incidents that had affected the health, safety and welfare of people who used the service had been reported to the Care Quality Commission (CQC). Our visit was to establish these improvements had been made and to check that the needs of people who used the service were met.

We found that all necessary actions required had been taken. We saw that people were treated with respect and dignity. Relatives told us that they were involved in decisions regarding the care provided to their family member. One person told us: “They (the staff) always keep me informed and ask me about my relative's care. I’m asked to sign consent forms too if I agree”.

We found that staff were trained and supported to meet the needs of the people who used the service.

People using the service and relatives told us that they were happy with the care and support offered in the home. They said that staff were respectful and kind. One relative said, "They are genuine staff - I can't praise them enough".

We saw staff talking in a respectful way and had a kindly approach, understanding the needs of the individuals and being very aware about any triggers which may cause the person using the service to feel anxious or upset. One relative said, "I had concerns about my mum's weight but they discussed this with me and she was referred to a dietician. She also gets weighed weekly and has supplements to her diet". Another said, "They always treat me and my relative with respect".

Staff ensured that people went out into the community and a range of activities were offered. Photographs of celebrations which had taken place for the benefit of the people who use the service were seen. One to one activities were also provided for people who were unable or did not wish to participate in the group activities. During the inspection people using the service were invited by staff to make Christmas decorations which they seemed to be enjoying very much. One person who used the service was seen to be helped by staff to unravel her yarn as she was knitting.

Other professionals who attend the home commented that they found the staff there very welcoming and open to suggestions for improvement or change to an individual's care plan.

Feedback comments received from other professionals about the service were generally very positive.

The previous key inspection report told us that relatives and people using the service had been satisfied with the care they received.

During our visit we spoke with people using the service, their relatives and staff members. Feedback comments about the service included, “I feel very able to ask staff if I’m not sure of anything”, “staff here, are only too pleased to ensure my relative is as comfortable as possible.”