We carried out an unannounced inspection at Bowmans Lodge Residential Care Home on 22 March 2017. The home provides accommodation and personal care for up to three people with mental health needs. At the time of our inspection there were two people living in the home.

At the last inspection on 02 June 2015 we rated the service Good. At this inspection we found the service remained Good.

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. The registered manager was also the provider.

People told us they were safe and they liked living in Bowmans Lodge. They told us their needs were met by staff employed at the service. People and staff were aware of safeguarding processes and how to report any concerns to the registered manager or local safeguarding authorities.

Staff and the registered manager were aware of people’s choices and provided people with support in a person centred way. Staff were knowledgeable of people`s needs and ensured they provided care and support based on people`s preferences, likes and dislikes.

The provider had a robust recruitment process in place which ensured that qualified and experience staff were employed at the home. Staff received training and support and were aware of their responsibilities when providing care and support to people at the service.

People were involved in the development and the review of their care and support plans. Support plans were detailed and descriptive of how people wished to be supported. People were supported to take decisions about their care and be independent.

People were supported to understand what healthy lifestyle meant and how to make the right food choices. People told us they were supported, to access healthcare professionals such as their GP as and when required. Staff responded appropriately to people`s changing needs by accessing support as required.

People received appropriate support from staff who was trained and competent to take their medicines safely.

The registered manager carried out regular audits and surveys to ensure they kept a close monitoring on the quality of the services they provided.

We undertook an unannounced inspection of Bowmans Lodge Residential Care Home on 2 June 2015. The home provides accommodation and personal care for up to three people who have mental health needs. At the time of our inspection there were two people living in 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 in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

CQC is required to monitor the operation of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are in place to protect people where they do not have capacity to make decisions and where it is considered necessary to restrict their freedom in some way, usually to protect themselves or others. The manager reported that no one living at the service was restricted in anyway under this act.

People were kept safe and free from harm. There were appropriate numbers of staff employed to meet people’s needs and provide a flexible service. Staff were aware of people’s choices and provided people with support in a person centred way.

The provider had an appropriate recruitment process which ensured that qualified and experience staff were employed at the home. The provider was in the process of reviewing the process around the validation and verification of references to ensure the procedure was as robust as possible. Staff received training and support and were aware of their responsibilities when providing care and support to people at the service.

Detailed support plans were in place detailing how people wished to be supported. People were involved in making decisions about their care where possible. Care and support was reviewed regularly with the person, or whenever there was a change of need.

People were supported to eat and drink well and were supported to access healthcare professionals such as the GP as they were required. Staff responded appropriately to people’s changing needs and accessing support as required.

Medication was administered by staff who had received training on the safe administration of medication.

We used the information we had gathered to answer the five questions we always ask:

Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well-led?

This is a summary of what we found:

Is the service safe?

We found that people's needs had been assessed and that their care and treatment was planned and delivered in a way as to ensure people’s safety and welfare. One person said “I feel safe here. I am well looked after.” Another person said “The staff are caring and helpful. It is a nice and comfortable here.”

Risk assessments had been carried out and regularly reviewed to reflect the changes in people’s needs. Health and safety audits were carried out so that people lived in a safe and comfortable environment.

There was a robust recruitment procedure in place to ensure that only people who were suited to working with vulnerable people had been employed. Relevant checks had been carried out. The staff members were trained and had worked at the care home for a number of years. This meant that the staff had the qualifications, skills and experience to care for people and meeting their needs.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. No applications had been submitted under this system. We saw evidence that staff had received training in Mental Capacity Act and DoLS and there were appropriate policies in place. The manager stated that they were aware of the process for making a DoLS application if required.

Is the service effective?

People had agreed and signed their care plans to indicate that they had been consulted about their care. We spoke with two people who lived at the home. They both said that that they were happy with the care and support they received. One person said "The staff are very caring and supportive. We go out on our own to the shops and visit friends and families. Another person said “We receive a marvellous service. The food is good and I have no concerns." Each person had a daily activity plan which they were aware of and participated in. People had their own keys to the home and their own bedrooms. Staff had received relevant training so that they were competent in their roles.

Is the service caring?

People told us that their needs had been met and that the staff were caring and helpful. We observed that there was a good interaction between staff members and people. One person said "I am involved in my care plans and I make the decisions about my care and support." The staff members had received relevant training and were experienced and skilled in meeting the needs of people.

Is the service responsive?

The care plans we reviewed demonstrated that people's needs had been assessed and met appropriately. People had been involved in the decisions about their care and any changes in their care needs had been discussed with them and their relatives. People accessed amenities and facilities in the local community. One person said “We all have our own keys and we go out and come back anytime we want. It’s like our own home.”

Is the service well-led?

People’s care and support had been planned and delivered in accordance with their identified needs. The home carried out an annual questionnaire survey of people who used the service, their relatives and the staff. The feedback from the surveys had been positive. People said that they had regular ‘residents’ meetings and discussed issues relating to the day to day running of the home. They said they felt that their views were listened to and acted on. Regular audits had been carried out to ensure that people’s needs were met and that they lived in a safe and comfortable environment.

At the time of our previous inspection, in April 2013, we had found that the provider was not meeting two of the four standards we inspected. At the time, we found that the premises had not been cleaned appropriately and people had been exposed to the risk of infection. We also found that people had been left unsupervised and there were an insufficient number of staff on duty.

During the present inspection, on 28 June 2013, we found that the provider had developed an action plan and had made changes and was now compliant. The people we spoke with said that staff ensured that the bedrooms and the communal areas were kept clean. They also said that staff were on duty daily to support them in developing their independent living skills.

During our inspection, we spoke with two people who use the service. One person said, "I like living here. The staff are good, and we do activities in the other home. We go out regularly, and see friends when we can. The food is all right." Another person said, "I have no concerns. I see my doctor and take my medicines regularly. Everything is all right."

We noted that people's needs had been assessed before they moved in. People's care plans had been reviewed and updated so that staff had current information to hand when supporting people. The management and administration of medicines was kept in good order.

However, we observed that people's bedrooms had not been kept clean and some bedrooms needed redecoration. We noted that two people had been left on their own in the home without supervision and the staff on call could not be contacted.

We carried out an unannounced inspection on 18 October 2012. We spoke to the three people who lived at the care home. We also spoke with the staff and reviewed care plans and records. We found that the provider was meeting all the standards we had reviewed.

The people we spoke with confirmed that their privacy and dignity was respected and that they had been involved in decisions about their care and support. They also said that they were happy with the support they received. One person said, “I came here with some hesitation but it turned out to be the best thing for me”. Another person said, “I am well looked after and the general atmosphere is good and pleasant."