This service was inspected on 07 December 2018 and the inspection was unannounced. At our last inspection in January 2018, the service was rated as ‘Good’ in all questions asked.

We undertook an unannounced focused inspection of The Lodge on 07 December 2018. We inspected the service against two of the five questions we ask about services: is the service safe? and is the service well led? This was because information of concern had been bought to our attention regarding the service.

The Lodge is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided and both were looked at during this inspection.

The Lodge accommodates eight people with a learning disability in one adapted building. At the time of the inspection there were eight people living at the service. The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

There was a registered manager, but they were not present during the inspection and had recently submitted their application to de-register as the registered manager of 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 appeared comfortable in the company of the staff who supported them and regularly approached them for reassurance and support. Staff now felt confident that they would be listened to if they raised concerns and that management would act on those concerns appropriately.

People were supported by sufficient numbers of safely recruited staff. Staff were aware of the risks to people and how to support them safely but audits in place had failed to identify where information had not been updated in some care records.

People received their medicines as prescribed but ‘as required’ protocols in place for some people were incorrect and did not provide staff with the information they required in order to administer the medication safely and effectively.

Concerns regarding the reporting and recording of accidents and incidents were being looked into and analysis was taking place to ensure lessons were learnt when things went wrong.

Management acknowledged they had failed to respond appropriately and provide the relevant support to staff when six staff had been dismissed.

A number of whistle-blowing concerns had prompted management to act swiftly and meet with all staff. Plans were in place to address the concerns raised by whistle-blowers and additional support was being provided to all staff.

Staff felt supported and listened to and were confident that management would act on issues raised.

This inspection took place on 29 and 31 January 2018 and was unannounced. The service was last inspected in November 2015 and was rated as ‘Good’ in all questions asked.

The 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.

The Lodge accommodates eight people in one adapted building. At the time of the inspection there were eight people living at the service. The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

There was 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.’

Systems were in place to ensure people were supported by staff who had received training in how to recognise signs of abuse. Staff were aware of what actions they should take if they suspected a person was at risk of harm. Where safeguarding concerns arose, they were responded to appropriately.

Staff were aware of the risks to people and how best to support them. Behaviour management plans in place provided staff with information on how to support people safely and in line with their specific needs.

Safe systems of recruitment were in place. The skill mix of staff on each shift ensured the appropriate support was available to people on a daily basis. Systems were in place to ensure people received their medicines as prescribed by their GP and staff competencies in this area were checked.

Systems were in place to protect people from the spread of infection. Accidents and incidents were reported, recorded and investigated and where appropriate lessons were learnt.

Care records provided staff with the information required to effectively support people’s care, health and social well-being. Staff were supported by the management team through regular supervisions, training and team meetings. Systems were in place to monitor staff learning and ensure that staff put into practice the training that was provided.

People were supported to visit their GP and other healthcare professionals, in order to maintain good health. People were involved in planning their weekly menus and where possible, encouraged to be involved in the preparation of their food and drinks.

Staff obtained people’s consent prior to offering support. 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.

People receive support from caring staff who treated them with dignity and respect. People were comfortable in the presence of staff, who provided them with comfort and reassurance. People were provided with information in a format they understood.

People were supported to contribute to the planning of their care. Staff supported people in a way that took account of their individual needs and preferences.

Where complaints were raised, they were investigated and responded to accordingly and where appropriate, lessons were learned. People were confident that if they did raise concerns they would be listened to and action would be taken.

The service was considered to be well led. People, relatives and staff spoke positively of the changes in management and practice. Staff were motivated and felt supported by in their role and were on board with the registered manage

This inspection took place on 2 November 2015 and was unannounced. The Lodge provides accommodation for eight people with learning disabilities and additional complex needs who require personal care. On the day of the inspection, there were seven people living at the home.

The home was last inspected in November 2013 and at that time was found to be meeting all of the regulations that we assessed.

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.

People felt safe in the home and were supported by staff who knew how to recognise abuse and how to report it. Risks to people were identified, managed and reviewed. Where accidents and incidents had taken place, lessons were learnt and acted upon. There were sufficient staff available to meet the needs of the people living in the home.

People were supported to make decisions about their daily living and were encouraged to maintain their independence.

People received their medicines when they needed them and staff were trained to do this safely.

People had their health care needs reviewed on a regular basis by their GP and other health care professionals. Staff were aware of people’s individual healthcare needs and referrals were made to health care professionals where necessary.

Staff felt supported and well trained to do their job and were knowledgeable about the needs of the people they cared for.

People were treated with dignity and respect and had good relationships with staff who treated them with kindness.

People and their families were involved in the planning of their care and reviews took place on a regular basis.

People’s views on the care provided to them were actively sought. People were confident that if they had to raise a complaint, then it would be dealt with to their satisfaction.

People spoke highly of the registered manager and staff group and staff were highly motivated.

The registered manager conducted regular audits to check the quality of the care provided in order to improve the service offered to people.

On the day of our inspection there were six people living at the home. We spoke with two people, three staff members and the registered manager.

Records showed that people were involved in their care planning and they consented to the care and support they received. We observed that staff asked people for their opinion, and this was respected.

We saw that staff delivered appropriate care and support for people throughout the day. People we spoke with told us that staff looked after them.

We found robust systems in place for the management of medicines. Arrangements were in place to ensure that people received their medicines as prescribed.

Selection and recruitment processes were robust to ensure that appropriate staff were employed to look after people at the home. We asked one person whether the staff were nice. They said, “Yes.”

People were aware of how to complain if they were unhappy with the service. We saw the complaints process displayed in a communal area which people could access.

There were eight people living at the home when we carried out our visit and each person had a care worker to support them. We spoke with four people, three care staff, the deputy manager and the manager of the home.

We saw that people were involved in making choices about what they wanted to do and what they ate and drank. One person told us they went out for a walk and nice drink.

We found that people's needs were appropriately assessed and planned to ensure that the care people received was safe and appropriate. All of the people we spoke with told us they were happy with the care they received. One person told us, "It’s lovely here at the Lodge, everyone is friendly and positive”.

We found that people's care records provided an overview of people's needs and preferences. We found that people were involved in their care planning and a range of different activities. So that they were supported to do the things that were important to them. One person told us, "I do my care plan”.

Staff knew how to safeguard people from harm and felt confident that if they had to report any abuse, action would be taken to protect people.

We saw that people’s health and welfare needs were met by competent staff that had appropriate checks, supervision, training and appraisal.

There was a system to monitor the quality of service people received through regular reviews and audits.