The Lombrand is a care home that is registered to provide accommodation and personal care to a maximum of 21 people who have mental health needs. The property is a large house which is situated close to transport links and other local amenities in Bridlington, in the East Riding of Yorkshire. At the time of this inspection there were 15 people using the service.

At the last inspection in March 2015 the service was rated Good. At this inspection we found the service remained Good.

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.

Risks to people and the environment were assessed and plans put in place to mitigate any identified risks. Policies and procedures were in place to manage medicines. The provider had safe recruitment procedures in place and ensured there were sufficient numbers of staff on duty to support people’s needs. Staff were trained in safeguarding and had a good understanding of how to respond to safeguarding concerns.

People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

The provider had a plan of training in place to ensure staff had the correct skills to meet the needs of the people using the service. Staff were supported through supervision and received an annual appraisal. People were provided with a balanced and varied menu to meet their nutritional needs.

Staff provided care and support in a meaningful and caring way. They knew the people who used the service well. People were involved in the planning of their care and support.

People's care and support needs were detailed, reviewed and met by staff who had a good understanding of how and when to provide people's care. Staff respected people's choices and independence.

There was a complaints procedure in place and people told us they knew how to complain.

Further information is in the detailed findings below.

The inspection of The Lombrand took place on 12 March 2015 and was unannounced. At the previous inspection on 15 October 2013 the regulations we assessed were all being complied with.

The Lombrand provides a service to a maximum of 21 people who have mental health needs. People are accommodated and provided with care and support to enable them to lead fulfilling lives in the community. At the time of our inspection there were 20 people using the service.

The service has 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.

When we spoke with people about living at The Lombrand they told us they were quite satisfied with the support they received and the relationships they had with the staff. They said the liked living at The Lombrand as some of them had lived there many years. They said, “It’s all right here. I’ve been here some years and I don’t have to worry about anything”, “The staff do most of the work here and know what their responsibilities are” and “The staff are all right. We get good food and the staff look after us well.”

We found that people were protected from the risks of abuse and harm by the systems in place to monitor and report the care they received and by the level of training that staff undertook to carry out their responsibilities in this area.

Systems in place adequately evidenced that the service ensured people’s safety regarding fire risk and heating and electricity provision. We found that all equipment in relation to these was appropriately serviced and maintained. There were no specialist features to the premises and no specialist equipment required by people that used the service, which meant that the service predominantly provided homely, domestic accommodation. There was one exception where safety could have been an issue and that was the height of the banisters on stairs and landings. We referred these to the local authority Health and Safety Department and asked the provider to take action in respect of any recommendations they made.  These recommendations were met immediately after the visit from the Health and Safety Officer.

We saw that there were sufficient staff on duty to provide the levels of support that people needed. People mainly required guidance and encouragement and for those experiencing illness or who were more dependent due to increasing age, a little help with personal care. Staff expressed the view that they had sufficient numbers on duty to attend to people’s needs. Rosters corresponded with those staff actually on duty and were an accurate reflection of the staffing levels.

We saw that staff were safely recruited to care for vulnerable people, as they had been part of a recruitment process that required them to be security checked through the Disclosure and Barring Service and the provision of employment references.

Medication was appropriately handled and administered and records we saw were accurate and up-to-date. People were satisfied with the way in which their medication was managed.

Information held on staff training, qualifications and supervision showed the service followed a yearly plan for updating staff skills and knowledge and regular discussions about performance and development.

The Care Quality Commission monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. DoLS are part of the Mental Capacity Act 2005 (MCA) legislation which is designed to ensure that the human rights of people who may lack capacity to make decisions are protected.

We found that staff had completed MCA and DoLS training and knew about their responsibilities. The registered manager told us there had been several ‘best interest’ meetings held for people as required and we saw that these had been appropriately recorded and reviewed. Best interest meetings involve healthcare professionals and family members coming together to assist a person who may not have capacity to make a decision about a specific issue that affects their lives.

We found that the service provided a choice of adequate food and drink to people to ensure they lived a healthy lifestyle. We found that people all ate together to encourage socialisation and for staff to monitor people for loss of appetite and possible signs of illness.

People told us that they were happy at The Lombrand and that they felt ‘cared for’. We saw that the staff were polite, helpful and thoughtful towards people that used the service. Staff showed caring and understanding qualities. People told us they felt involved in the day-to-day aspects of their care and therefore they engaged in the process of receiving the support they needed to live a meaningful life. People had plenty to think about and do if they wanted to and we saw that they chatted with each other, laughed about some situations and also deliberated over others.

People had up-to-date care plans in place to aid them and the staff to provide the support they needed. These were regularly reviewed with the aid of appropriate healthcare professionals and social service professionals.

Complaints and concerns were appropriately addressed using the service’s procedures and people we spoke with were familiar with them. People said they felt comfortable about speaking up as necessary and so issues rarely became complaints.

We found that the service was run by a conscientious registered manager who had respect and backing from the staff team. The culture of the service was one of a family approach to communal living where respect for each other was vital. Most people interacted well with each other but where this was not the case people had agreed to ‘live and let live’. People and staff were polite and civil towards each other and generally got on well because of this.

There was a system in place to assess and monitor the quality of the service, which included seeking people’s views on a regular basis and used auditing of different areas of the support and care provided.

When we visited The Lombrand we found that people were happy living there. One person told us “I like living here and it’s better than living elsewhere”. Another person told us “It is the best home I have ever lived in”. We observed that people seemed relaxed and contented. Care plans were detailed and personalised.

We saw that the system for administering medication was robust although some improvements in managing and recording boxed medication were needed. The environment was well maintained and suited to the needs of the people who used the service.

There was a comprehensive system in place for the supervision and training of staff. Staff reported that they felt supported by management. The service had an audit system in place that was used effectively by staff and management and action planning was monitored and carried out well. People who used the service and staff were given various opportunities to feed back and be involved in the development of the service.

People said that they were happy with the care they received. They told us that the staff were nice and treated them well. One person said, ‘I am very happy here. The staff are nice’.

However we found improvements were needed to make sure people who use the service were safeguarded and their wellbeing was promoted.

This inspection was carried out to check whether shortfalls identified at our last inspection in May 2012 had been addressed and to ensure that people who used the service were now safe and fully cared for.

We found the atmosphere in the home was relaxed and friendly and people who lived there were interacting positively with each other and with the members of staff supporting them.

However, when we visited on 23 August 2012 we found that robust recruitment procedures and record keeping were not in place. People were not protected from the risk of unsafe or inappropriate care. The provider had taken action to remedy this and we found improvements in staff recruitment and record keeping when we visited the service again on 31 August 2012.