White Rose Lodge is care home which provides a service for older people and people with dementia. People in care homes receive accommodation and personal care as a package of care under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided and both were looked at during this inspection. The service is registered to accommodate a maximum of 38 people. There were 27 people using the service at the time of inspection.

At our last inspection, we rated the service good. At this inspection the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format, because our overall rating of the service has not changed since our last inspection.

The service did not have a registered manager in post at the time of inspection. The registered manager had deregistered with CQC on 6 December 2018. Steps had been taken by the provider to recruit a new registered manager. A registered manager is a person who has registered with the CQC 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 told us they felt safe. Staff continued to be recruited safely and there was adequate staff to meet people’s needs. Medicines were administered safely. Systems were in place to reduce the risk of cross infection.

Staff had appropriate induction, training and supervision to support them in their roles. People were supported to access healthcare services. People’s nutrition and hydration needs were met. The environment was suitable for people’s needs.

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 told us staff were kind and caring. We observed positive interactions during the inspection. Staff respected people’s privacy and dignity.

People’s care plans were written in a person-centred way. Staff delivered responsive care to meet people's needs. The provider used technology to monitor the service and to support people to maintain relationships. There was provision for people to take part in activities.

People told us they were well supported by the deputy manager. The management team held family meetings and relative meetings. The service worked in partnership with health professionals and the local community.

Further information is in the detailed findings below.

This inspection took place on 28 June 2016 and was unannounced. We previously visited the service on 6 February 2015 and we found the registered provider had met the regulations we assessed during that inspection.

White Rose Lodge is registered to provide accommodation and personal care for up to 38 older people, some of whom may be living with dementia. On the day of this inspection there were 30 people using the service. The service has various seating areas and people can choose to spend the day in one of the communal areas or in their own room. The service is located on the sea front in the seaside town of Bridlington in East Yorkshire and is close to town centre facilities. The service has its own grounds and parking area.

The registered provider is required to have a registered manager in post and on the day of the inspection there was a manager registered with the Care Quality Commission (CQC). ‘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.’

Overall we found the premises were safely maintained and there was evidence in the form of maintenance certificates, contracts and records to show this. However, we found that some of the portable appliances at the service had not been tested in line with the registered provider’s policy and the annual gas safety check for the kitchen was last completed on 24 June 2015 which meant it was overdue by four days at the time of this inspection. We have made a recommendation about the timely servicing of appliances and systems in the report.

People told us they felt safe living at the service. People were protected from the risks of harm or abuse because there were effective systems in place to manage any safeguarding concerns. The registered manager and care staff understood their responsibilities in respect of protecting people from the risk of harm.

Staffing numbers were sufficient to meet people’s need and we saw that duty rotas accurately reflected this. Recruitment policies, procedures and practices were followed to ensure staff were suitable to care for and support vulnerable people. The management of medication was safely carried out.

People were cared for and supported by qualified and competent staff that were regularly supervised. Communication was effective, people’s mental capacity was appropriately assessed and their rights were protected. People's nutritional needs had been assessed and people told us they were very happy with the food provided. We observed people’s individual food and drink requirements were met.

We observed assessed people received compassionate care from kind and considerate staff and that staff knew about people’s needs and preferences. People were supplied with the information they needed at the right time, were involved in all aspects of their care and were asked for their consent before staff undertook care and support tasks. People told us that staff listened to them, respected their decisions and treated them with dignity and respect.

Care plans were person centred, reviewed and updated regularly and information was effectively communicated to enable staff to provide person centred care responsive to people’s needs. People had the opportunity to engage in a variety of pastimes and activities if they wished to do so.

Overall, care staff and people who lived at the service told us the service was well managed. People told us they would not hesitate to express concerns or make a complaint, and they were confident their concerns would be listened to and acted on. There was a process in place to manage complaints that were received by the service. In addition to this, there were systems in place to seek feedback from people who lived at the service, relatives

This inspection was carried out to check that the registered person had taken appropriate action to make improvements to the service that had been identified at our inspection on 28 August 2014.

Our inspector visited the service and the information they collected helped answer one of our five 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 is based on our observations during the inspection, speaking with staff who support people who use the service and from looking at records. If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

Medication was being stored safely and at the correct temperature. Staff were completing medication records correctly although one record was only signed by one person instead of two. Staff had received appropriate training to give them the knowledge and skills to administer medicines safely.

There were sufficient numbers of staff on duty to ensure that people's needs were met. Ancillary staff were employed to undertake catering and domestic tasks and this enabled care staff to spend their time supporting the people who lived at the home.

Is the service effective?

Not applicable.

Is the service caring?

Not applicable

Is the service responsive?

Not applicable.

Is the service well-led?

Not applicable

This inspection was carried out as part of our programme of scheduled inspections. The local authority had identified some concerns during safeguarding investigations and quality monitoring visits, and we had received information of concern prior to the inspection; this included concerns about low staffing levels and medication errors. We looked at these areas of concern during this scheduled inspection.

Our inspector visited the service and the information they collected helped answer our five 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 is based on our observations during the inspection, speaking with people using the service and the staff supporting them and from looking at records. If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

Staff demonstrated an understanding of the different types of abuse and the action they needed to take if they became aware of an incident or allegation of abuse. They said that they would not hesitate to take action if they observed poor practice. On the day of our visit there were insufficient numbers of staff on duty to meet people’s needs. Medicines were not stored safely and there were errors in recording.

Is the service effective?

People were supported to consult with health care professionals about their health care needs and any concerns about their general well-being. Any contact with health care professionals had been recorded and care plans had been updated to reflect advice given.

Is the service caring?

We saw that staff were caring and compassionate, and that there was good interaction between people who lived at the home and staff. One person told us, “I have no complaints about staff at all. We are very lucky to have them.” However, some issues were raised about privacy and dignity.

Is the service responsive?

There was a complaints procedure in place and people who lived at the home told us that they would not hesitate to use it. Appropriate records were kept of any complaints that the home had received.

Is the service well-led?

There was a registered manager in post. They had produced an action plan recording the improvements they planned to make to the service following the outcome of recent safeguarding investigations. Some progress had been made towards meeting the requirements of the action plan. People who lived at the home were consulted about their care although there was a lack of opportunity for relatives and friends to express their views. The premises were safe and well maintained.

We have asked the provider to tell us what they are going to do to meet the requirements of the law in relation to the unsafe management of medicines and maintenance of safe staffing levels.

We did not speak to people who lived at the home during this inspection. We spoke to people when we visited the home in May 2013 but this inspection focussed on improvements to the quality monitoring system.

At the last inspection we were concerned that no analysis of accidents and incidents was taking place, that there had been no recent staff meeting and that audits had not taken place to monitor the quality of the service provided.

At this inspection we found that a number of improvements had been made. Staff meetings were now being held as well as residents meetings. Quality surveys had been distributed and the responses had been analysed. The minutes of residents meetings recorded that people were invited to make comments and complaints.

Audits were being undertaken to monitor that systems in place at the home were being followed. These included audits of the medication system, care plans, dining arrangements, health and safety, accidents and incidents and safeguarding. Competency checks had been undertaken with staff to ensure that they had the skills to administer medication safely to people who lived at the home.

The area manager had visited the home each month to check that the quality audits were being carried out and that any action points had been completed. In addition to this, they carried out their own quality checks.

Improvements had been made to the way training was provided for staff.

We decided to visit the home on a bank holiday to gain a wider view of the service provided. This was part of an out of normal hours pilot project being undertaken in the North East region.

During this inspection we spoke with three people who lived at the home, a relative and four members of staff. We spent time in one of the lounges observing the interaction between people who lived at the home and staff and saw that this was positive.

There were activities for people to take part in and people were offered choices, including where to spend the day and what to have to eat and drink. We observed that personal care was carried out sensitively by staff.

Staff were able to explain the different types of abuse and what action they would take if they observed poor practice. Staffing levels were sufficient to meet the needs of the people who lived at the home although we saw that staff struggled on occasions to meet everyone's needs at the same time. Staff had received appropriate training.

The premises were well maintained; we observed that regular safety checks were carried out by the handyman.

We looked at quality monitoring systems and found regular audits were not taking place to ensure that staff were following the policies and practices that were designed to ensure the safety of people who lived at the home. Regular residents meetings had been held so people who lived at the home had the opportunity to express their views about the care they received.

People who used the service were very satisfied with the service and staff. They told us staff promoted privacy, dignity and respect throughout their care giving and that communication between staff and themselves was "Very good".

People told us staff discussed their care and treatment with them. They were able to make choices and decisions about their daily lives, and the staff respected their wishes and supported their independence.

People told us the meals provided at the service offered them lots of choice and variety. People said they enjoyed living in the home and the staff were friendly and supportive.

People said that they had good access to outside healthcare professionals and they were satisfied with the level of medical support given to them. They said staff were good at giving them their medication on time and when they needed it.

People understood about safeguarding of adults and told us that they felt safe within the service. They told us there was an open door policy within the service which worked well and they were confident of using the complaints system if they needed to.

People told us they enjoyed living at White Rose Lodge and the staff were kind and helpful. People commented, ”I love it, it’s my home”, “I have all of my possessions and I like it very much”, “I like to get up about 6.30 am and the staff know this” and “The staff are lovely.”

People told us they were well cared for and saw a range of health care professionals as required. One person said, “I see the doctor when I need to”.

People told us the food was varied and choice was offered. People commented, “We always get enough and usually it’s home cooked” and “The food is lovely.”

People told us they felt ‘safe’ in the home and any problems were dealt with.

People told us that they were happy with the environment, “Everywhere is clean and tidy” and “It was one of the reasons we chose here, the home is lovely and clean.”

People told us that their views and concerns were listened to, “Yes any problems are sorted out” and “I have no complaints.”