Bell Lodge is registered to provide accommodation and personal care for up to 15 people. There were 12 people living at the home at the time of this inspection. At the last inspection, in November 2014, the service was rated Good. At this inspection we found that the service remained Good.

People continued to receive safe care. Staff were appropriately recruited and there were enough staff to provide care and support to meet people’s needs. People were consistently protected from the risk of harm and received their prescribed medicines safely.

The care that people received continued to be effective. Staff had access to the support, supervision, training and on going professional development that they required to carry out their roles. People were supported to maintain good health and nutrition.

People developed positive relationships with the staff who were caring and treated people with respect, kindness and courtesy. People had detailed personalised plans of care in place to enable staff to provide consistent care and support in line with people’s personal preferences. People knew how to raise a concern or make a complaint and the provider had implemented effective systems to manage any complaints that they may receive.

The service had a positive ethos and an open culture. The registered manager was a positive role model in the home. People and relatives told us that they had confidence in the manager’s ability to provide consistently high quality managerial oversight and leadership to the home.

This unannounced inspection took place on 5 November 2014. Bell Lodge is a care home providing accommodation and personal care for up to 15 people some of whom are living with dementia. There were 11 people living at the home at the time of this inspection.

At the last inspection on 15 May 2013 we asked the provider to take action to make improvements to staff training and this action has now been completed.

There were two registered managers 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 who used the service were well looked after by a staff team that had an in depth understanding of how people wanted to be supported. Staff encouraged people to be independent and treated them with dignity, respect and compassion.

There was sufficient staff on duty to keep people safe. The managers were also available to cover at short notice if required.

Equipment used to assist people’s mobility and safety requirements was regularly serviced and maintained in good working order.

The procedures to manage risks associated with the administration of medicines were followed by staff working at the service.

People were supported to have sufficient to eat and drink to maintain a balanced diet.

CQC monitors the operation of the Mental Capacity Act (MCA) 2005 Deprivation of Liberty Safeguards (DoLS) and reports on what we find. DoLS are a code of practice to supplement the main Mental Capacity Act 2005. These safeguards protect the rights of adults by ensuring that if there are restrictions on their freedom and liberty these are assessed by appropriately trained professionals. The manager had knowledge of the MCA 2005 and DoLS legislation and knew how to make a referral for a DoLS authorisation so that people’s rights would be protected.

Staff received Induction, training and regular supervision and appraisal.

Management audits were in place to monitor the quality of the service, and improvements had been made to the environment following feedback from relatives.

We spoke with one person that used the service who when asked about the service told us “They’re all very pleasant”.

We spoke with two relatives of people that used the service. One relative told us “It’s a great service. We wouldn’t want mum to be anywhere else”. Another relative told us “It’s just brilliant”.

We spoke with a staff member who told us that they felt well supported and that they received regular supervision.

We found that people's preferences were recorded in their care plans and that care plans and risk assessments were regularly reviewed. We found that there were appropriate arrangements in place to manage medication.

We had concerns about how frequently staff were receiving training.

We spoke to people who used the service, they told us: - " They look after me, I get plenty to eat and it's quite good." Another person told us:- "The staff look after me and it's very homely."

Staff members told us that they enjoyed their work and because it was a small home they got to know the people who live there well.

We found that care plans and risk assessments were in place and being regularly reviewed. We found that staff had received appropriate pre-employments checks. However, we found concerns about medication and records.

We spoke with three residents. All spoke highly of the staff and the care they received. We spoke with one relative. She told us the care was “brilliant”. We looked at the comments made by residents and relatives in satisfaction surveys completed in 2011. One relative commented, “staff are anxious that all residents have their specific needs met.” Another relative described the staff as “very caring.”