This unannounced inspection took place on the 23, 24 and 25 October 2017. The service had previously been inspected in October 2014 and was found to be compliant with the Health and Social Care Act 2008.

Windsor Lodge Care Home is a family run care home registered to provide care and accommodation for up to 9 older people. At the time of our inspection eight older people were living there.

The home had previously been the proprietor’s family home which had been converted into a care home. The home has an extremely attractive and well maintained garden with fountains and ponds. Visitors had to pass through an electronic security gate before they are able to access the property. This added to people’s sense of security.

The home has a registered manager in place. 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.

We found the service was safe because systems were in place and staff had received training in how to identify and report concerns of abuse. Employment practices meant the risk of employing inappropriate staff had been reduced. Records demonstrated medicines were administered by trained staff, and in line with the prescribed dosage and time. The medicines were stored securely and stocks tallied with recorded amounts. Risks related to the care being provided in the home, the environment and equipment had been assessed. Risks were minimised where possible to ensure people, staff and visitors were kept safe.

Sufficient numbers of trained and experienced staff were available at all times. This offered a consistency in the care provided. Staff had received additional training and were able to lead on specific areas of care such as diabetes, infection control and end of life care. This meant all staff were kept up to date on best practice in these areas.

Staff were supported through regular contact with the registered manager, induction, training, supervision and appraisals. Training was completed in the areas deemed as mandatory by the registered manager, these included moving and handling, nutrition and health and safety amongst others.

People’s mental capacity had been taken into consideration. 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’s nutritional and hydration needs were being met. Staff were aware of people’s preferences and individual needs. This information was shared with the cooks who prepared meals people enjoyed. Variations were made to the menu to ensure everyone’s preference was met.

From our observations and feedback from people living in the home we could see staff were extremely caring, considerate and gentle in their approach to people. Interactions between staff and people were very positive and reassuring. Communication flowed easily and familiarity was evident. People’s privacy and dignity was maintained and staff went the extra mile to support people in areas of people’s lives that were important to them. The quality of care we observed in the home was outstanding, this was because everyone was treated equally, their care was focussed on them as individuals and staff provided care in a meaningful way.

People’s dignity and privacy were protected and their independence was promoted. Staff knew people well and knew about their life histories. People were encouraged to maintain hobbies and interests as well as develop new skills. Initiatives had been introduced to empower people to be able to share their views, participate in learning in how to self-care, and improve their communication with the provider. Community participation was actively pr

People told us they and/or their family had been given the opportunity to visit the home before they moved in. This ensured it met their needs and expectations. They said the staff treated them as individuals and respected their views and choices. They told us they were consulted about any changes to their care and could choose how they spent their day.

People’s care and support needs were assessed and delivered in line with their individual care plans. These were detailed, regularly reviewed and updated. Risk assessments were in place to identify and reduce the likelihood of injury or harm with guidelines in place for staff to follow.

People had access to healthcare professionals and specialist support to ensure their health and wellbeing.

Daily activities were provided to those who wished to take part. They were provided in groups and as a one to one session for those who preferred a one to one setting. The activities included trips out into the community as well as in house activities.

People said they felt safe and staff looked after them well. One person said ''It's very secure here, which I like, even the gates are electronic which makes us safe.'' People we spoke with knew who to speak to if they had concerns and one person added ''I have no reason to grumble at all, they look after me very well.''

People we spoke with told us the staff were kind and helped them in their day to day lives. One person told us ‘’the care that they give us is really good, it’s obvious I get good care, you only have to look at me to tell.’’ Another person told us ‘’the staff will do anything you ask them.’’

People’s needs had been assessed before a placement at the home had begun. This ensured their needs could be met appropriately. A comprehensive pre admission assessment was undertaken and included risk and needs assessments. Care plans addressed people's individual needs, were detailed, reviewed and updated regularly.

Daily activities were provided to those who wished to take part. These included one to one activities and group activities.

The home was clean and tidy and people's bedrooms had been personalised.

Relatives told us they were kept informed about their loved one's health care needs and were involved in their reviews of care. They had no concerns about the care and support their relative received. They found the staff to be caring and polite ‘’they have been fantastic…the home is not institutionalised but homely and welcoming.’’ They told us they were kept informed of events in the home through newsletters and were involved in the care planning and review process. One relative stated they were happy with the choice of home they had made ‘’God must have sent us there… it is more like a family ….I am going there myself when my time comes.’’

This inspection was undertaken over two days. Windsor Lodge Care Home provides accommodation and support for older people. The service can accommodate up to nine older people. At the time of our inspection eight people were using the service.

The service had a registered manager who had been in post since the service registered with the Care Quality Commission in January 2011. 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.

We found the service was providing care that was personalised to meet their needs within a warm homely atmosphere. Staff understood the needs of the people living in the home and were committed to improving people’s quality of life. They provided care and support with kindness, empathy and compassion. People were cared for and supported by a dedicated caring team led by a manager who was proactive in continually looking at ways of improving people’s experience of care and further developing the service in their best interests.

Staff were appropriately trained and skilled. They received a thorough induction when they began working at the home and regular training thereafter. They were committed to make sure the care provided was safe and effective to meet people’s needs based on local and national best practice. Staff told us they felt well supported and received regular one to one supervisions and an appraisal of their work. The manager monitored their work and discussed with them any further developmental needs to enable them to further develop their skills to enhance the lives of people using the service.

People and relatives we spoke with told us they felt safe and knew who to speak to if they had any concerns. Staff understood their duty of care and responsibilities regarding safeguarding people from harm and knew what to do if there were any instances or allegations of abuse including making any referrals in the absence of the manager. Independent advocacy services were available for people to access if they wanted the assistance of an advocate; one person had been supported to access such a service and this had been successful.

Staff were knowledgeable about the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) and how it related to people living in the home. Staff we spoke with demonstrated an understanding of capacity and consent, and acting in people’s best interests.

People were involved with meal choices and menu planning so they met their individual needs and at times suitable to them. Any specialist diets were catered for. For example one person was a vegetarian and their needs were met well.

The registered manager assessed people’s dependency levels regularly to ensure there were enough staff on duty to meet people’s needs appropriately. People we spoke with told us there was always enough staff and one added “You always have the feeling that there is someone around when you need them. I only have to ring the bell and staff come quickly.”

We found the service to be well-led by a registered manager who was committed to provide a high quality of care in which people’s needs and preferences remain the focus on care delivery. They continually strived to look for new ways to improve the service and involved both the people who used the service, visitors and relatives in the process. They had an open door policy and were available to meet with people and/or relatives when they required.

People living in the home and their relatives were very happy with the services received and felt they had made the right choice when deciding on a home to meet their needs. They found it to be a well-managed home, which put people at the centre of everything that was done in the home which centred around the people who lived there. People were treated like family including visitors and relatives to the home.