Autumn Lodge is a large residential home which provides accommodation and support without nursing care for up to 34 older people. All accommodation is located over three floors; all bedrooms are single rooms, many of which have en-suite facilities. There is a large TV room complete with a pool table for residents to enjoy as well as a large day room, large dining room and smaller lounge areas. There is a medium sized garden to the rear of the building and a small car park at the front. The service is based in a residential area of Liverpool and close to local amenities.

At the last inspection, 31 July 2014 the service was rated Good.

At this inspection we found the service remained Good and continued to meet all of the essential standards that we assessed.

There was a registered manager for the service at the time of the inspection. A registered manager is 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 home operated within the principles of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). We were provided with information in relation to capacity assessments and processes which needed to be in place to make decisions in a person’s best interest. 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.

Medication was administered safely by staff who had received the appropriate training. Medication records were accurate, medication audits and competency assessments were conducted on a monthly basis and annual medication reviews were conducted for all people who lived at the home.

All care files contained individual care plans and risk assessments. Care plans were person centred and contained relevant information in relation to a person’s wishes, choices and preferences.

Staff were supported in their roles and completed the necessary training as well as specialist training to effectively support the people in their care.

People were protected from abuse. Safeguarding procedures were in place and staff were aware of how to report any concerns. All staff were able to explain their understanding of what ‘safeguarding’ meant and the actions they would take to safeguard people in their care.

Recruitment was safely and effectively managed. Suitable and sufficient references and disclosure and barring system checks (DBS) were in place for all staff. DBS checks ensure that staff who are employed to care and support people are suitable to work within a health and social care setting.

Staff supported people to make their own decisions with the food and drink during. People enjoyed the food provided and were encouraged to make choices about the different types of food and drink they wished to be purchased. Staff and kitchen staff were also familiar with specialist needs which needed to be supported.

A formal complaints process was in place at the home and people informed us that they knew how to make complaints if they ever needed to. At the time of the inspection there were no on-going complaints being investigated.

The home regularly held ‘resident’ meetings with the people living at the home at which they had the opportunity to discuss different aspects of their care, support and service delivery.

There was a variety of different audit tools and methods used to monitor and assess the quality of the home. These included internal and external audits as well as staff meetings, staff, resident and relative satisfaction surveys and compliance checks.

Autumn Lodge is a large residential home which provides accommodation and support without nursing care for up to 34 older people. All accommodation is located over three floors; all bedrooms are single rooms, many of which have en-suite facilities. There is a large TV room complete with a pool table for residents to enjoy as well as a large day room, large dining room and smaller lounge areas. There is a medium sized garden to the rear of the building and a small car park at the front. The service is based in a residential area of Liverpool and close to local amenities.

At the last inspection, 31 July 2014 the service was rated Good.

At this inspection we found the service remained Good and continued to meet all of the essential standards that we assessed.

There was a registered manager for the service at the time of the inspection. A registered manager is 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 home operated within the principles of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). We were provided with information in relation to capacity assessments and processes which needed to be in place to make decisions in a person’s best interest. 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.

Medication was administered safely by staff who had received the appropriate training. Medication records were accurate, medication audits and competency assessments were conducted on a monthly basis and annual medication reviews were conducted for all people who lived at the home.

All care files contained individual care plans and risk assessments. Care plans were person centred and contained relevant information in relation to a person’s wishes, choices and preferences.

Staff were supported in their roles and completed the necessary training as well as specialist training to effectively support the people in their care.

People were protected from abuse. Safeguarding procedures were in place and staff were aware of how to report any concerns. All staff were able to explain their understanding of what ‘safeguarding’ meant and the actions they would take to safeguard people in their care.

Recruitment was safely and effectively managed. Suitable and sufficient references and disclosure and barring system checks (DBS) were in place for all staff. DBS checks ensure that staff who are employed to care and support people are suitable to work within a health and social care setting.

Staff supported people to make their own decisions with the food and drink during. People enjoyed the food provided and were encouraged to make choices about the different types of food and drink they wished to be purchased. Staff and kitchen staff were also familiar with specialist needs which needed to be supported.

A formal complaints process was in place at the home and people informed us that they knew how to make complaints if they ever needed to. At the time of the inspection there were no on-going complaints being investigated.

The home regularly held ‘resident’ meetings with the people living at the home at which they had the opportunity to discuss different aspects of their care, support and service delivery.

There was a variety of different audit tools and methods used to monitor and assess the quality of the home. These included internal and external audits as well as staff meetings, staff, resident and relative satisfaction surveys and compliance checks.

During this inspection we spoke with eight people living at the home. They told us they felt supported to make decisions about their care and treatment and they felt staff treated them with respect and dignity. One person said "The staff are very friendly, always helpful….they help me when I need them and leave me alone when I don’t." Relatives we spoke with also were very complimentary about how their relatives were treated with respect and dignity.

We found that peoples need were assessed and care and treatment was planned and delivered in line with their individual care plan. One person said, "The staff are lovely, everyone including the owners make this a lovely home."

People living at the home were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. All of the people we spoke with that lived at the home were aware how to raise concerns of abuse.

We looked at the systems in place to see how the quality of service was monitored. We found that good processes were in place, people and their relatives were asked for their views about their care and treatment and they were acted on. There was evidence that learning from incidents had taken place and appropriate actions had been taken.

We found that personal and staff records were accurate, fit for purpose, held securely and remained confidential.

We carried out an early morning visit in response to information we had received about the service. Upon arrival we found that eight people who used the service were up, washed and dressed. We observed that over half the people using the service were awake and in the process of carrying out their morning routine. We spoke with five people who lived at Autumn Lodge, and people told us that the staff were very friendly and helpful. However a number of people told us they wanted more choice in terms of their daily routine.

Comments from people who used the service included:

"I would rather be in bed".

"It is a very long day".

"I would rather have an extra hour in bed than go to bed early".

Each of the people using the service had a care plan. The care plans we looked at were up to date and contained relevant information about the needs of the person. We saw limited evidence that people had been consulted with about their care plan or that they were in agreement with it.

We found that staff were knowledgeable about the people they provided care and support to. However, at the time of our visit we found that appropriate care had not been provided to each of the people using the service and measures in place to minimise risks to people had not been followed.

People told us what it was like to live at this home and described how they were treated by staff and their involvement in making choices about their care. They also told us about the quality and choice of food and drink available. This was because this inspection was part of a themed inspection programme to assess whether older people living in care homes are treated with dignity and respect and whether their nutritional needs are met.

The inspection team was led by a Care Quality Commission (CQC) inspector joined by an Expert by Experience who has personal experience of using or caring for someone who uses this type of service.

We also 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.

During our visit we spoke with seven members of staff who held different roles within the home and with many of the people who lived there. We also spoke with five relatives.

Everyone we spoke with was complimentary about the home and the support they or their relative had received. People told us that they had always been treated with respect and dignity and that they had always received the support they had needed.