Whitehall Lodge is a small residential care home for three people with a range of mental health conditions.

Rating at last inspection.

At our last inspection in December 2015, we rated the service good. At this inspection we found 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.

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Why the service is rated Good.

People told us they continued to receive care which protected them from avoidable harm and abuse. We found that incidents had been reported to the local authority safeguarding. Risks to people's safety were identified and measures were in place to help reduce these risks. When people required support to take their medicines this only happened when staff had received the training and were competent to do so. Regular checks on staff practices were undertaken to support people's safety. People thought there were enough staff to provide support and meet their needs.

People are 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 support this practice.

Staff had received training to provide them with the skills and knowledge they needed to provide the right care and support people as required. People were provided with care which continued to be effective in meeting their individual needs.

People enjoyed spending time with staff that cared for them and were treated with dignity and respect. People were encouraged to maintain their own personal interests and take part in activities within the home or out in the local community.

People's care was planned in ways which reflected their preferences and wishes. Health and social care professionals' views and suggestions were listened to and considered when people's care was planned.

People knew how to complain if they needed to.

People living at the home and their relatives were encouraged to give regular feedback on the service provided through meetings and questionnaires. The registered manager regularly checked the quality of the care people received. Where actions were identified these were undertaken to improve people's care further.

Our inspection was unannounced and took place on 22 December 2015. The inspection was carried out by one inspector.

The provider is registered to accommodate and deliver personal care to a maximum of three adults who lived with a mental health condition and/or an associated need. At the time of our inspection three people lived at the home.

At our last inspection of April 2014 the provider was meeting all of the regulations that we assessed.

The manager was registered with us as is required by law. 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. The registered manager was also a joint provider for the home.

People felt safe. Risks to people had been assessed appropriately and were monitored. Systems were in place to protect people from the risk of abuse.

There was sufficient staff on duty to meet the care and support needs of people. The provider ensured that staff were recruited safely.

Staff felt that they had received adequate training. They felt that they were equipped with the skills and knowledge they needed to provide safe and appropriate support to people.

Although people received their medicines as they had been prescribed there had been one isolated incident where medicine records had not been maintained adequately.

Staff understood the circumstances when the legal requirements of the Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards (DoLS) were to be followed to prevent any unlawful restrictions.

People felt it was a good place and they were happy there. People were encouraged and supported to be as independent as possible.

People felt that the staff were kind, helpful, respectful and polite.

Complaints systems were available so that people could state their concerns or dissatisfaction if there were any.

The management of the home was stable. Both providers [one of whom was also the registered manager] were involved in the running of the home on a daily basis. People felt that the quality of service was good. Systems were in place to monitor the service to ensure it met the needs of the people who lived ther

One the day of our inspection we talked with the manager and looked in detail at the records for three people. We observed how people were being cared for and talked with two people who lived there. We visited on a weekday and all three people were at home. We talked with one staff member and health professional. We also spoke with two relatives. One relative commented, “The care is quite good actually, there’s a lot of one to one time with the staff.”

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask;

• Is the service caring?

• Is the service responsive?

• Is the service safe?

• Is the service effective?

• Is the service well led?

This is a summary of what we found;

Is the service safe?

People had been cared for in an environment that was safe, clean and hygienic. There were enough staff on duty to meet the needs of the people living at the home and a member of the management team was available on call in case of emergencies. People told us they felt safe. Safeguarding procedures were robust and staff understood their role in safeguarding the people they supported.

The Care Quality Commission monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While no applications have been made in accordance with these safeguards, proper policies and procedures were in place, and the manager understood their responsibilities in relation to the law.

There were policies and procedures in place to make sure that unsafe practice is identified and people are protected. This included the correct administration of medication. The staff and manager had a good understanding of whistle blowing policy.

Is the service effective?

People told us that they were happy with the care that had been delivered and their needs had been met. It was clear from our observations and from speaking with staff that they had a good understanding of people’s care and support needs and that they knew them well. Some people had certain dietary needs that staff supported them with, enabling people to make informed choices. This included taking people to the shops and supporting them to buy food of their choice.

We found that the home was very person centred and all staff were aware of peoples choices, preferences and support needs. Care plans had been written to reflect this but needed to be updated. One professional told us “The people are provided with a very homely service there.”

Is the service caring?

People were supported by kind and attentive staff. We saw that the staff and manager showed patience and gave encouragement when supporting people. One relative told us “I think the home is fine, my (relative) likes it there". A professional told us "The manager is very happy to advocate on behalf of people when they are in hospital, they are very caring. They make sure we have all the up to date information about the persons health needs on the ward.”

Is the service responsive?

People’s needs had been assessed before they moved into the home. People told us they had a lot of one to one time with the staff. People had access to activities that were important to them, and staff were aware that people’s wishes and choices changed regularly. We observed staff supporting these changes. People had been supported to maintain relationships with their friends and relatives. One relative told us “If there’s a problem, they phone me straight away.”

Is the service well-led?

Staff told us they were clear about their roles and responsibilities. The service worked well with other agencies and services to make sure people received their care safely and effectively.

A professional told us “It’s a very positive working relationship.” The service has a basic quality assurance system and they use their community meetings and handover meetings to assure the quality of service delivery to people.

Our inspection was unannounced so no one knew we would be going there.

Three people lived at Whitehall Lodge on the day of our inspection. We spoke with all three of the people who lived there, the manager and two members of staff to find out their views about the service provided. One person who lived there said, "I like it here it is very good. I can go out when I want to”. Another person said, “I like it here. They are very good and look after me”. A staff member said, “I think we look after the people here well. They tell us that we look after them well”.

We saw that people were encouraged to do things for themselves which promoted their independence skills and self- esteem. One person said, “I can go out when I want to. I use the bus or book a taxi to go to the shops or visit my family.” We saw that people were supported to have regular health checks of their physical and mental health to promote their good health and ensure their wellbeing. One person who lived there told us, “I go to see my consultant regularly.”

People had been provided with varied food and drink options to prevent malnutrition and dehydration. One person who lived there said, “I like the food. We decide what we want on the menu every weekend for the following week”.

We saw that the premises were adequately maintained and were safe.

Due to the size of the care home only three permanent staff were employed there. We determined that staff received regular training. We saw and the staff member on duty told us that although staff supervision processes were informal staff were adequately supported by the manager.

We saw that a complaints procedure was available for people who lived there or their relatives to access if they were unhappy or dissatisfied with the service provided.

There were three people living at the home on the day of our visit, no one knew we would be visiting. We spoke to the three people who lived at the home, two relatives, two staff and the manager.

We looked at records relating to people’s care and observed staff caring for them. People told us and we saw that choices were offered and that people's views were sought and acted upon. One person said, ‘’They are always asking me if I am happy with my care.’’

Staff spoken to was able to tell us about people's needs so that they received care in a way that they preferred. One staff told us, ‘’People always choose and we help them.’’ Both relatives told us they were consulted about their relative's care and kept informed about their relative's health so they felt involved in their care.

We saw that people were relaxed in their environment and that systems were in place to keep people safe from harm.

Staff received a range of training so that they had up to date knowledge and skills in order to support the people who lived in the home.

There were systems in place to monitor how the home was run, to ensure people received a quality service.

We carried out this review to check on the care and welfare of people using this service.

We spoke with two people who resided at Whitehall Lodge Care Home and we looked at their care plans. We also spoke with a member of staff and asked what people’s care needs were.

People told us that they were involved in their care. People told us that staff went through their care plan every month to discuss their needs.

People also told us they “Have input with care” and “feel involved”. People told us that they “agree with care” being provided and “if I don’t agree they amend the care plan”.

People told us that the staff treated them politely and with respect. People also told us that “Staff are ever so good, give right care” and that staff were “on hand to help”.

One person told us they “like the staff, they promote independence”. Another person told us that “staff are nice, overall happy here”.

We saw that people were well presented, clean and looked content at the time of our visit.

People told us that there were residents’ meetings held every Saturday and that any actions were recorded in a book. We were told that the book was reviewed the following to week to make sure any actions were completed.

People told us that the “Manager listens to ideas” and that they “help with the food shopping”. People also told us that they “have a choice of food” and “make the menu on Saturday”.

We saw that people helped prepare their food for lunch at the time of our visit and were happy doing this.

People told us that they completed questionnaires on the quality of the service on a yearly basis. People also told us that staff chatted with them on a regular basis and asked how good the service was.