Arun Lodge Residential Care Home is a service that provides care and support for a maximum of 19 older people, some of whom were living with dementia. Nursing Care is not provided. On the day of our inspection there were 16 people living at the home.

At the last inspection carried out on the 14 August 2014 the service was rated Good. At this inspection we found the service remained Good.

We carried out this inspection as part of our routine schedule of inspections and to check that people were still receiving a good standard of care and support.

People told us they felt safe with staff. Relatives had no concerns about the safety of people. There were policies and procedures regarding the safeguarding of adults and staff knew what action to take if they thought anyone was at risk of potential harm.

Potential risks to people had been identified and assessed appropriately. There were sufficient numbers of staff to support people and safe recruitment practices were followed. Medicines were managed safely.

Staff had received all essential training and there were opportunities for them to study for additional qualifications. All staff training was up-to-date. Team meetings were held and staff had regular communication with each other at handover meetings which took place between each shift.

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 were supported to have sufficient to eat and drink and to maintain a healthy diet. They had access to healthcare professionals. People’s rooms were decorated in line with their personal preferences.

Staff knew people well and positive, caring relationships had been developed. People were encouraged to express their views and these were respected by the staff who supported them. People were involved in decisions about their care as much as they were able. Their privacy and dignity were respected and promoted. Staff understood how to care for people in a sensitive way.

Care plans provided personalised information.. People’s personal preferences and their likes and dislikes were documented so that staff knew how people wished to be supported. There was a variety of activities on offer which people could choose to do. Complaints were dealt with in line with the provider’s complaints procedure.

Weekly and monthly checks were carried out to monitor the quality of the service provided. There were regular staff meetings and feedback was sought on the quality of the service provided. People and staff were able to influence the running of the service and make comments and suggestions about any changes. Regular one to one meetings with staff and people took place. These meetings enabled the registered manager and provider to monitor if people’s needs were being met.

Further information is in the detailed findings below.

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service.

This was an unannounced inspection.

Arun Lodge is a care home service that provides care without nursing for up to 21 older people. There were 16 people living at the home at the time of our inspection. People who lived at the home required different levels of support. Some people were independent and others required low level support from staff with personal care; for example washing, dressing, eating and mobility or to maintain good health. The home was not a specialist dementia service but did support people living with dementia to continue to live there and to be cared for within a familiar environment and by staff who knew them well.

The home was managed by the provider who is in day to day charge and worked alongside staff in order to provide care to people. The provider is the person who has the legal responsibility for meeting the requirements of the law.

Staff followed the requirements of the Mental Capacity Act 2005 (MCA). Staff observed the key principles of the MCA in their day to day work checking with people that they were happy for them to undertake care tasks before they proceeded. The service had good systems in place to keep people safe. Assessments of risk had been developed and reviewed.

People told us they were happy with the service they received. People were supported by kind and caring staff and positive relationships existed between them. One person told us they liked living at the home because, “I wake every morning to the laughter of the staff”. Another person told us, “It is important to laugh, I like it here”.

There were pictures of the provider’s family on the walls and people told us the providers sometimes brought their dogs to the home. People told us they missed the dogs when they weren’t there and sometimes secretly fed them treats. Special occasions such as birthdays were celebrated and people’s friends and relatives were welcomed. This contributed to the homely atmosphere of the service.

The service employed enough, qualified and well trained staff, and ensured safety through appropriate recruitment practices. The home was clean and measures were in place for the prevention and control of infection. Equipment was regularly serviced and replaced when necessary. The provider had appropriate arrangements for the safe ordering, administration, storage and disposal of medicines. People were supported to get the medicine they needed when they needed it.

Staff received induction training to meet people’s need and keep them safe.. Staff completed an induction which involved observing other staff to learn about their role. Staff practice was overseen to ensure that staff were competent to be able to deliver the care people required. Staff felt supported by the provider and were positive and enthusiastic about their roles.

Meal times were a focal point for people to get together within the home. Meal times were a lively and inclusive affair although people could eat in their rooms if they chose. Food was home cooked and in line with people’s preferences. One person told us, “The food is good, homemade, cooked on the spot, There is time to eat no pressure put upon us. The atmosphere in the dining room is relaxed”. People were supported to have sufficient to eat and maintain a balanced diet.

The needs and choices of people had been clearly documented in their care records. Where people’s needs changed the provider acted quickly to ensure the person received the care and treatment they required. People had access to healthcare services when required.

Leisure and social activities were available in accordance with people’s individual needs. Some people used community facilities such as the local pub or tea shops. Activities took place within the home and a Priest visited to give Holy Communion to those who wished to take part.

The provider sought feedback through questionnaires from people and their relatives. The provider took steps to ensure that care and treatment was provided in an appropriate and safe way and, where necessary, improvements were made. People told us they knew how to complain and any concerns were acted upon. The provider, along with senior staff, provided good leadership and support to the staff. The provider was involved in the day to day monitoring of the standards of care and support that were provided.

During our visit we met and spoke with three people living at the home. We also spoke with three members of staff.

We gathered evidence by spending time watching how people spent their time, the support they got from staff and whether or not they had positive experiences.

We saw that staff addressed people by their preferred names. Personal care was carried out in private and staff were discreet when asking about care needs. We saw that people felt comfortable in approaching staff and asking for assistance.

All of the people that we spoke with told us that they were happy living at the home and that they felt that their care needs were being met. One person said, “They are my family, I really am happy living here”. Another person said, “I just couldn’t look after myself anymore. I came here to keep my family happy really as they were worried about me. But it was the best decision I have ever made. I am happy here and safe which is a big weight off of everyone’s minds”.

We found that people had planned care that met with their needs. We also found that people’s consent had been obtained prior to treatment where appropriate.

We saw that people were cared for in a clean environment.

People we spoke with told us that they were happy living in the home; they said that they were well cared for by staff that were friendly and helpful.

One person said, “I can go out whenever I want to, staff take me shopping”.

Another person said, “The food here is lovely, we have something different every day and it is always nice and fresh”.

We spoke to three people during the visit. Each of the three people we spoke to said they like living at the home.

People said they were treated with respect and dignity. The following comment was made: “I cannot fault them. No one has been rude to me. If it was my choice I would be at home, otherwise I am very happy.”

Choice was said to be available in the food and activities available as well as in how people spent their time.

People said their care and support needs were met and that they had seen a copy of their care plan. Activities were said to be provided and included exercise sessions and musical entertainment. During the visit we observed people taking part in an exercise session.

Staff were said to be helpful and respectful. One person said: “The staff treat me with great respect and efficiency.”

Sufficient numbers of staff were said to be on duty.

People said they felt safe living at the home.

People commented that the home’s management were approachable and that any suggestions or requests can be made. One person said: “We are asked for our views. Mrs Rawlins is open to suggestions. She often asks us if we have any suggestions.” Another person referred to survey questionnaires being supplied so that people can give their views on the service provided.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.

We spent 40 minutes observing people and staff in one of the home’s lounges. People had generally positive experiences. Staff were observed to support people in a calm and respectful manner explaining to people what they were doing. Clear information was given to people by staff. People were appropriately assisted with mobility needs.

We also observed that the lunch time meal included staff and people eating together in the dining room. This appeared to be a positive experience for both the staff and people by creating a convivial atmosphere.

We spoke to five people during the visit. People said they were satisfied with the service they received.

People said they were treated with respect and that their dignity was promoted. Reference was made by two people to the homely atmosphere with comments such as, “It’s my home now,” and, “The staff are like my friends.”

Choice was said to be available in how people spent their time. People confirmed they have been able to get up and go to bed when they wish and can choose how they send their day.

People said they received the care and support they need. One person told us he/she was aware he/she had a care plan but had not seen it and another person did not know if he/she had a care plan or not. People also said they were able to maintain their independence.

A range of activities were said to be provided including theatre performances at the home, discussions, cooking sessions and trips out. One person described how he/she has been able to continue with religious services in the home by a visiting priest.

People said they felt safe at the home.

The food was said to be good and the following comments were made: “It’s out of this world,” and, “Excellent.”

People said there were enough staff on duty and that staff responded promptly when they asked for help when using the call points in their rooms.

People told us the home is kept clean.

Two of the five people we spoke to said they had completed a satisfaction survey on their views of the home.