The inspection took place on 27 June 2018. The inspection was unannounced.

Blackburn Lodge is a ‘care home’. People in care homes receive accommodation and nursing and personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Blackburn Lodge provides accommodation and support for up to 35 older people. The service provided respite care for people as well as permanent accommodation and care. Respite care is a short term solution for people whose main carers need a break to be able to take a holiday or attend to personal business. The service also provided a reablement service for people, with a three week stay. Reablement is a short and intensive service to help people regain their independence and confidence to continue living in their own homes. This service is offered to people who are frail and recovering from an illness or injury. There were 24 people living at the service at the time of our inspection. People had varying care needs. Some people had diabetes or had epilepsy or suffered a stroke, some people required support with their mobility around the home and others were able to walk independently.

At our last inspection on 21 May 2016, we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

A registered manager was employed at the service and had been in the position since the last inspection. 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.

Staff continued to be aware of their responsibilities in keeping people safe and reporting any suspicions of abuse. Staff knew what the reporting procedures were and were confident their concerns would be listened to.

Individual risks were identified and steps continued to be taken to reduce and control risk. Staff had the guidance they needed to support people to maintain and improve their independence while at the same time preventing harm. Accidents and incidents were appropriately recorded by staff; action was taken and followed up by the registered manager.

The procedures for the administration of people’s prescribed medicines was still managed and recorded appropriately so people received their medicines as intended. Regular audits of medicines were undertaken to ensure safe procedures continued to be followed and action was taken when errors were made.

The registered manager and senior team leader carried out a comprehensive initial assessment with people before they moved in to the service, either for long term care, short term respite or reablement. People were fully involved in the assessment, together with their relatives where appropriate. Care plans were developed and regularly updated and reviewed to take into account people’s changing needs. People’s specific needs were taken account of and addressed in care planning to ensure equality of access to services.

People had access to a range of activities to choose from. Some people preferred their own company and pursued their own interests such as reading or watching TV and this was respected by staff. People were asked their views of the service and action was taken to make improvements where necessary.

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.

We carried out this inspection on the 21 and 25 April 2016, it was unannounced.

Blackburn Lodge is a service provided by a local authority. The service provides accommodation and personal care for up to 35 older people and short term care supporting people to regain their independence with input from other health and social care professionals. They also provide care so that people’s main carers have ‘respite’ time. In addition to the short term care and support, the service provides care and support to nine people who live permanently at the service. There is a day care centre on the ground floor of the premises. People who live in the service are accommodated on the first floor of the building. At the time of the inspection, 34 people were living at the service.

The service had a registered manager. 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.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The registered manager understood when an application should be made. They were aware of the Supreme Court Judgement which widened and clarified the definition of a deprivation of liberty. The service was meeting the requirements of the Deprivation of Liberty Safeguards.

People were protected against the risk of abuse. People told us they felt safe. Staff had been trained and recognised the signs of abuse or neglect and what to look out for. Both the registered manager and staff understood their role and responsibilities to report any concerns and were confident in doing so.

Staff were recruited using procedures designed to protect people from unsuitable staff. There were sufficient numbers of staff to meet people’s needs. Staff were available throughout the day, and responded quickly to people’s requests for help. Staff had the knowledge and skills to meet people’s needs, and attended regular training courses. Staff were supported by the registered manager and felt able to raise any concerns they had or to make suggestions to improve the service for people.

Staff were trained to meet people’s needs. They met with management and discussed their work performance at one to one meetings and during annual appraisal, so they were supported to carry out their roles.

People demonstrated that they were happy at the service by smiling and chatting with staff who were supporting them and greeting the registered manager warmly. Staff interacted well with people, and supported them when they needed it.

There were risk assessments in place for the environment, and for each person who received care. Assessments identified people’s specific needs, and showed how risks could be minimised. There were systems in place to review accidents and incidents and make any relevant improvements as a result.

People and their relatives were involved in planning their own care, and staff supported them in making arrangements to meet their health needs. Staff contacted other health and social care professionals for support and advice.

Medicines were managed, stored, disposed of and administered safely. People received their medicines when they needed them and as prescribed.

People were provided with a diet that met their needs and wishes. Menus offered variety and choice. People said they liked the food. Staff respected people and we saw several instances of a kindly touch or a joke and conversation as drinks or the lunch was served.

Staff encouraged people to undertake activities and supported them to become more independent. Staff spent time engaging people in conversations, and spoke to them politely and respectfully.

The provider and the registered manager investigated and respon

During our inspection we sat with people that used the service, listened to their comments and observed interactions with staff. We spoke with staff as we observed the usual daily routines of the home. The inspection was assisted by the manager.

People said that they liked living at Blackburn Lodge. We observed people being involved in discussions about the help they needed and their preferred day to day routines. We saw that people had enough to do and could join in with activities if they wanted to. We observed that the staff were kind, caring and on hand to help when needed.

Comments from completed surveys undertaken by the service in 2013 included “They are wonderful I cannot say any more than that, I am very happy here”, “Provides good care and food”, “I have been so happy here, so much love and care” and “Blackburn Lodge has created a comfortable and caring respite which shows in the happy life led here by people who are well attended in all respects”.

People were asked for their consent before any care or treatment was given.

People received care and support that was well planned and sensitively delivered.

Medicines were handled appropriately and people who used the service had their medicines given to them in a safe way.

We found that there was a robust recruitment process in place that helped to make sure that only people who were deemed as suitable were employed to care for people that used the service.

Effective quality assurance procedures ensured that people were provided with a good service.

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 CQC inspector, who was joined by an “Expert by Experience” (people who have experience of using services and who can provide that perspective).

During the visit we carried out a “Short Observational Framework Inspection” (SOFI). SOFI is a specific way of observing people’s care to help us to understand the experience of people who are unable to talk with us (for example, due to dementia).

The registered manager was available during the afternoon of the inspection, and the inspector gave feedback to her at the end of the inspection.

We spoke with staff and relatives during the visit; and we talked with people living in the home, in communal areas, and in their own rooms. People who were able to express their feelings spoke positively about the home. We gathered evidence of people’s experiences of the service by reviewing questionnaire responses and comments in other documentation, as some people were unable to talk clearly with us.

Some of people’s comments included:

“I don’t really want to be in a Home but as I have to be in one, this is a good place to be.”

“I am only here for a week while my family are away and I am really enjoying my stay. If I needed to, I would happily live here permanently.”

“My son found this Home for me. I have never regretted coming here, everyone is so happy and I love the food.”

“I came here for a week to see if I would like it. I knew straightaway I would be happy here, so here I am.”

“Coming here has been the best thing I have ever known.”

“The staff here are a happy lot. We have a good laugh.”

“It is great here. I don’t regret coming in. I came in for respite at first and decided to stay.”

People said they liked living at Blackburn Lodge. They said they had been involved in discussions about the help they needed and their preferred day to day routines. People said they had enough to do and could join in with activities if they wanted to. They said they were happy with the support they received, that the staff were kind, caring and on hand to help when needed. People said they liked the food, there was a choice of menu and that they chose where to eat. They said they knew who to speak to should they have any concerns. They said they had no concerns.