The inspection took place on 25 and 29 January 2018 and was unannounced.

Chippendayle Lodge Residential Care Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Chippendayle Lodge Residential Care Home provides care and accommodation to a maximum of 52 people. There were 35 people living at the service at the time of our inspection, some of which were living with dementia.

At the last inspection, the service was rated Good. At this inspection we found the service remained Good.

A registered manager was employed at the service and had been in the position since July 2016. 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 supported by a deputy manager and a number of senior care assistants.

People continued to be protected from the potential risk of abuse. Individual risks were identified and steps continued to be taken to reduce and control risk, making sure people and staff had the guidance they needed to prevent harm while at the same time supporting independence. The environment and equipment continued to be serviced and checked to ensure the safety of people. There continued to be enough staff to meet people’s needs, however the registered manager had identified an additional member of staff was required at mealtimes. Recruitment practices were safe to ensure people were protected from the risk of unsuitable staff.

People continued to receive their medicines safely as prescribed by their GP. There were systems in place to ensure that medicines had been stored, administered, audited and reviewed regularly. People were protected by the prevention and control of infection where possible, with systems in place to ensure the risk of contamination were minimised. Accidents and incidents continued to be managed effectively.

People’s needs and choices continued to be assessed when they started using the service, either as respite or on a permanent basis. People received care that was personalised to their needs. People were offered the opportunity to take part activities which they enjoyed. People were encouraged to raise concerns or complaints and were asked for feedback about the service they received. People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

People continued to be given choice at mealtimes and were able to access drinks and snacks throughout the day. People’s nutrition and hydration needs had been assessed and recorded. Staff and the kitchen team met people’s specific dietary needs and support. Staff ensured people remained as healthy as possible with support from health care professionals, if required.

People continued to be treated with dignity and respect. Staff were kind and caring and knew people’s needs and preferences. Staff were responsive to people’s emotional needs, proving reassurance in a calm manner.

Staff continued to receive training to meet people’s assessed needs. Staff received support and supervision with their line manager. Staff continued to be given the opportunity to discuss any concerns or improvements about the service at team meetings.

People and others were encouraged to express their views and had completed surveys. Systems were in place to monitor the quality of the service being provided to people. They were a range of checks and audits carried out to ensure the safety and quality of the service that was provided to people.

Furthe

The inspection was carried out on 16 October 2015 and was unannounced.

The home provided residential accommodation and personal care for older people, some of whom were living with mild dementia. The accommodation was provided over two floors. A lift was provided for people to move between floors. There were 25 people living in the home when we inspected.

There was a registered manager employed at the home. 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 home is run.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. Restrictions imposed on people were only considered after their ability to make individual decisions had been assessed as required under the Mental Capacity Act (2005) Code of Practice. The registered manager understood when an application should be made. Decisions people made about their care or medical treatment were dealt with lawfully and fully recorded.

People felt safe and staff understood their responsibilities to protect people from harm. Staff had received training about protecting people from abuse. The management team had access to and understood the safeguarding policies of the local authority and followed the safeguarding processes.

The registered manager and care staff used their experience and knowledge of people’s needs to assess how they planned people’s care to maintain their safety, health and wellbeing. Risks were assessed and management plans implemented by staff to protect people from harm.

There were policies and a procedure in place for the safe administration of medicines. Staff followed these policies and had been trained to administer medicines safely.

People had access to GPs and their health and wellbeing was supported by prompt referrals and access to medical care if they became unwell.

People and their relatives described a home that was welcoming and friendly. Staff provided friendly compassionate care and support. People were encouraged to get involved in how their care was planned and delivered. Staff upheld people’s right to choose who was involved in their care and people’s right to do things for themselves was respected.

The registered manager involved people in planning their care by assessing their needs when they first moved in and then by asking people if they were happy with the care they received. Staff knew people well and people had been asked about who they were and about their life experiences. This helped staff deliver care to people as individuals.

Incidents and accidents were recorded and checked by the registered manager to see what steps could be taken to prevent these happening again. The risk in the home was assessed and the steps to be taken to minimise them were understood by staff.

Managers ensured that they had planned for foreseeable emergencies, so that should they happen people’s care needs would continue to be met. The premises and equipment were maintained to keep people safe.

Recruitment policies were in place. Safe recruitment practices had been followed before staff started working in the home. The registered manager ensured that they employed enough staff to meet people’s assessed needs. Staffing levels were kept under constant review as people’s needs changed.

Staff understood the challenges people faced and supported people to maintain their health by ensuring people had enough to eat and drink.

If people complained they were listened to and the registered manager made changes or suggested solutions that people were happy with. The actions taken were fed back to people.

People felt that the home was well led. They told us that managers were approachable and listened to their views. The registered manager and other senior managers provided good leadership.

The inspection visit was conducted by two inspectors over a period of two hours. We spoke with the director of operations and care, the deputy manager, one carer and one kitchen assistant.

We viewed five staff files, the training matrix for the service, the appraisals schedule and the supervision meeting schedule.

We found that staff had been receiving training relevant to their roles.

We saw records to show that staff had been meeting with their manager formally for supervision.

We saw that the provider had updated the supervision and appraisal policy to show the frequency of supervisions and appraisals that staff could expect.

Staff told us that they felt well supported by their manager and that the deputy manager's "door was always open".

Staff also told us that they were well supported in indentifying training and development which would enable them to further their careers.

We spoke with 17 people who used the service and four visitors. We also spoke with staff, the deputy manager and the director of care.

People told us that they were happy at the home. One person said “The staff are very kind and caring”. A relative of a person who used the service told us “I am glad I found this Home for my Mother”. We looked at four people’s care records and found that their care was delivered in line with their needs.

We observed people being supported to eat and drink and spoke with kitchen staff about the menus. People were supported appropriately and were able to make choices about what they ate and drank.

We looked at five sets of staff files, training records and supervision records. We found that although most staff had received training there were still some areas that staff needed to obtain refresher training. We also found that staff had not received regular appraisals.

We looked at the complaints policy which was followed by the service. We saw that it was available in a communal area where it could be accessed by people who used the service and their visitors.

We looked at care records and staff records held by the service. We found that they were kept securely and were accurate and up to date.

During our inspection we spoke to people who used the service and their relatives. We also used observation tools to observe interactions between people and staff. We made observations over the lunchtime period and although we saw some positive interactions, we found that people were not always supported appropriately to eat their lunch.

On the day of our inspection, the Head of Care was on cooking duty as the permanent cook had left the service a couple of weeks before and the current kitchen assistant had called in sick on that morning. There was one senior care worker on duty and three care workers on the morning of our inspection. The deputy manager was not feeling well, however she told us that she could not go home as there was no one to cover as the manager was on leave. A member of staff told us that they were one member of staff short that day.

Relatives of people we spoke with told us that they were happy with the care that their relative received. One relative said “The staff are lovely and look after my mum well”.

We looked at how medications were stored, dispensed and recorded. We saw that there were appropriate processes in place for ensuring that medication was administered safely.

We looked at care records for five people who used the service. We saw that some care records were not accurate and did not reflect all of people’s current needs.