This inspection took place on 30 September 2016 and was unannounced.

Bradstowe Lodge is owned and run by a charitable organisation. It provides accommodation and personal care support for up to 27 older people. It is situated on the seafront of Broadstairs and has coastal views. At the time of the inspection there were 26 people living at the service.

A registered manager was in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 day to day running of the service was managed and overseen by the registered manager with the support of a deputy manager and a head of care. They were all present during the inspection.

People said they felt safe living at the service. Risks to people were identified and assessed and guidance was provided for staff to follow to reduce risks to people. People received their medicines safely and on time.

Staff knew about abuse and knew what to do if they suspected any incidents of abuse. Staff were aware of the whistle blowing policy and the ability to take concerns to agencies outside of the service. Staff were confident that any concerns they raised with the management team would be investigated to ensure people were kept safe.

The registered manager followed the provider’s recruitment policy to make sure that staff were of good character. Staff completed regular training, had one to one meetings and annual appraisals to discuss their personal development. There were consistent numbers of staff deployed, day and night, to meet people’s needs. Contingency plans were in place to cover a shortage of staff in an emergency.

The registered manager and staff understood how the Mental Capacity Act (MCA) 2005 was applied to ensure decisions made for people without capacity were only made in their best interests. Staff knew the importance of giving people choices and gaining their consent.

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. These safeguards protect the rights of people using services by ensuring that if there are any restrictions to their freedom and liberty, these have been agreed by the local authority as being required to protect the person from harm. There was no-one living at Bradstowe Lodge with an authorised DoLS.

People enjoyed a choice of healthy, home-cooked, food and told us they had enough to eat and drink. People’s health was assessed and monitored and staff took prompt action when they noticed any changes or a decline in health. Staff worked closely with health professionals, such as community nurses and GPs, and followed any guidance given to them to ensure people received safe and effective care.

People told us they were happy living at the service and that their privacy and dignity were respected. Staff spoke with people in a patient, kind, caring and compassionate way. People were involved in the planning of their care and support and told us care was provided in the way they chose. Each person had a descriptive care plan which had been written with them and their relatives. People’s religious and cultural needs were recorded and respected.

People knew how to complain and told us they had no complaints about the quality of service or the support they received from the staff team. The provider had a complaints policy and procedure, a copy was given to each person at the service.

People’s friends and family could visit when they wanted and there were no restrictions on the time of day. Staff spent time with people on a one to one basis. There was a range of activities which people told us they enjoyed. People were encouraged and supported to maintain as much independence as

We were able to speak with nine people about life in the home. We observed a meal time and the support people received. We spoke with one relative, a district nurse, several staff members and the manager.

People told us that they ‘felt listened to, respected and well cared for’. One person said that they were ‘…always asked’ before any support was provided. People had few if any grumbles, and a person explained that ‘…the manager is often around, always available to speak with; they do not just sit in the office you know’. We observed that staff spent time listening and speaking with people too. We asked several people if life was like this all the time. All people and the relative said what we saw was no different on any other day of the week. One person said ‘…staff have a great sense of humour’. Another person said the quality of the activities and events was ‘always top notch’.

We found that people had thorough assessments before moving to the home, and that their care was well planned. Staff were delivering care in a kind and thoughtful way based on individual preferences.

The environment was purpose built to meet the people’s needs. It was extremely clean and well maintained. All steps to reduce the chance of infection spreading had been considered and put into action.

Medicines were managed safely and the district nursing team were consulted for additional support for care, welfare and palliative care medicine matters.

We followed up the actions we asked the service to take at the last inspection. We found that the service had taken action to improve so the compliance actions were met.

People said that they were satisfied with the service and that they were happy living at Bradstowe Lodge. People said “The food is quite good. They (staff) come round and ask what you would like. They offer different things,”

“The food is good and yes we do get a choice. I like most things but I could have something else if I asked,”

“We get spoiled, the food is very good” and “I am having scampi today as I am not too keen on fish.”

People said that the staff were kind and caring. People told us “I like the staff, they are all pleasant” and “I am very well looked after.”

People who use the service told us what it was like to live at this service and described how they were treated by staff and their involvement in making choices about their care. They also told us about the quality 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 joined by an Expert by Experience (people who have experience of using services and who can provide that perspective).

We 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.

All of the 10 people with whom we spoke gave us generally positive feedback about the service. One of them said, “The staff are all tip top here and very attentive and polite. They make the place really and so I’ve no concerns about being here." Another person said, "The meals are okay but I think we should have a definite choice at each time. Sometimes I’m not that keen on the set meal but I don’t want to make extra work for staff by asking them to do me something else."

A carer (relative) said, “I’ve been very impressed with the staff because they are genuinely caring and always look very professional and neat."

Everyone we spoke to said that they were happy or very happy at Bradstowe Lodge.

Everyone said that the food was good or very good and that there were always alternative choices of meals on offer.

People said that the home was kept clean and that the their bedrooms were clean. They said that the laundry service was good.

People told us that they felt safe and had the care and support they needed.One person told us “I cannot praise them enough. The girls (staff) are lovely. They are very kind and they help me. We have a singer who comes in and all sorts of things going on. There is enough to do for me, I like peace and quiet. I am happy here”.

Another person said “I am very well looked after here. It is very good. My room is very nice, I have a lovely outlook. I have no complaints”.

People were very complimentary about the staff and managers. People told us that they thought the home was well managed and that staff were kind.