The inspection took place on 31 August and 1 September 2017 and was unannounced. We carried out this inspection because we had a number of concerns shared with us. These concerns came from health and social care professionals who had visited the home. These concerns were about the care and support people were receiving in relation to the Mental Capacity Act and best interests decisions.

Avon Lodge Care Home is a care home with nursing care for up to 62 predominately older people. People have general nursing care needs and some are living with dementia. At the time of our visit there were 61 people living at the home.

There was a registered manager in post. 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 of the Health and Social Care Act 2008.

People told us they felt safe living at the home. Staff were aware of what constituted abuse and the actions they should take if they suspected abuse.

Risks associated with people's care, daily routines and activities were identified with action taken to minimise these. Care plans addressed the support people required with personal care, maintaining their health and their activities of daily living.

People were provided with safe care by adequate numbers of appropriately skilled staff being made available.

Staff recruitment procedures were safe and the employment files contained all the relevant information to help ensure only the appropriate staff were employed to work at the home.

People received their medicines when they required them and in a safe manner. Staff received training and guidance to make sure they remained competent to handle people's medicines.

The home was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS). Staff had received appropriate training, and had a good understanding of the Mental Capacity Act 2005 (MCA) and the DoLS. Staff had the right skills and training to support people appropriately.

People told us they felt there were enough staff available on each shift. Staff felt well supported by the manager and received regular supervision sessions and appraisals.

People told us the staff were friendly and caring and they felt safe in their presence. We observed staff caring for people in a way that promoted their dignity in a respectful manner.

People told us they enjoyed the food in the home. They were offered a choice of meals which were appropriate for a balanced diet.

People had access to a range of healthcare professionals when they required specialist help. Care records showed advice had been sought from a range of health and social care professionals

People were actively encouraged to provide feedback. Complaints were investigated and action taken to address concerns when needed. People and their relatives told us they had no complaints.

The registered manager assessed and monitored the quality of the service provided for people. Systems were in place to check on the standards within the home. These included regular audits of care records, medicine management and health and safety.

Avon Lodge Care Home is registered with the Care Quality Commission (CQC) to provide accommodation, nursing and personal care for up to 62 people including people living with dementia. The home was arranged as three separate units. These were called; Orchard, Treetops and Meadows. At the time of our inspection 59 people were using the service

This inspection was unannounced and took place on 23 and 24 November 2016.

There was a registered manager in post. 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.

People received a service that was safe. Staff understood their role and responsibilities in keeping people safe from harm and knew how to raise any concerns. Risks were assessed and plans put in place to keep people safe. There was enough staff to safely provide care and support to people. Medicines were well managed and people received their medicines as prescribed. Infection control measures were in place.

Staff received regular training and the support needed to meet people’s needs. People were supported to make choices and decisions. People had enough to eat and drink. Arrangements were made for people to see their GP and other healthcare professionals when required. People’s healthcare needs were met and staff worked with health and social care professionals to access relevant services

People received a service that was caring. They were cared for and supported by staff who knew them well. Staff treated people with dignity and respect. People were supported to maintain relationships with family and friends. The service people received was based around their individual needs and preferences. People were encouraged to make their views known, with staff listening and making changes where required.

The service was well-led. The registered manager and senior staff were respected and demonstrated good leadership and management. They had an open, honest and transparent management style. The provider had systems in place to check on the quality of service people received and any shortfalls identified were acted upon. The vision and values of the service were effectively communicated to people, relatives and staff. The provider and management team had a plan for further developing and improving the service people received.