This was an unannounced inspection which took place on 19 June 2017.

Claremont Lodge Care Home is registered to provide nursing and residential care for up to 35 older people. The home is purpose built, with all rooms having ensuite facilities. There are extensive landscaped gardens surrounding the home and ground floor rooms have patio doors that open on to garden area. At the time of our inspection 27 people were living at the home. People’s needs varied. Some people were quite independent and only needed minimal assistance whilst others required assistance with all aspects of their care.

During our inspection the registered manager was present. 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.

At our previous inspection in May 2015 we found that as and when required (PRN) medicines were not always managed safely and this resulted in a breach of regulation. In response, the registered manager sent us an action plan that detailed the steps that would be taken to address this. At this inspection we found that medicines were managed safely and the previous breach of regulation was met. Staff followed safe medicine administration procedures and people said they were happy with the support they received to manage their medicines.

People told us that staff were kind, caring and respectful and we observed this to be the case during our inspection. People said that they were treated with respect and dignity and that their rights were promoted. We observed interactions by staff that were genuine and warm however, some people and staff commented about staffing levels. People said that this did not affect their safety but that they affected the quality of care provided. This is an area for development that the provider has started to act upon.

Staff were suitably trained and skilled and received training relevant to the needs of people who lived at the home. Staff were supported and received group and one to one supervision. Staff had received safeguarding training and reporting procedures were in place if abuse was suspected.

People said that they were happy with the medical care and attention they received. People’s health needs were managed effectively. Potential risks to people were assessed and information was available for staff which helped keep people safe. Equipment was available in sufficient quantities and used where needed to ensure that people were moved safely and staff practiced safe moving and handling techniques.

Quality monitoring systems were in place to ensure action was taken when areas for improvement were identified. Robust recruitment checks were completed to ensure staff were safe to support people. Everyone that we spoke with said that the registered manager was a good role model. Staff, people who lived at the home and their relatives said that the registered manager actively sought their views, listened and acted upon them. Views were sought via questionnaires and during group meetings.

People received responsive care based on their individual needs. A new care planning system was being introduced at the home that would provide more detailed care plans for staff to refer to. It would also give people greater opportunities to be involved in any reviews of their care.

People said that they consented to the care they received and that their freedom of movement was not restricted. Mental capacity assessments were completed for people and their capacity to make decisions had been assumed by staff unless there was a professional assessment to show otherwise.

People said that the food at the home was good and that their dietary needs were met. There were a variety of choices available to people at all mealtimes.

We spoke with three people who lived at the home. They were satisfied with the care and support they received and were happy living at Claremont Lodge Care Home. One person told us, "I have lived in a couple of other care homes before and this is the best by far". Another said, "It's a very friendly place and there's always something to do". A visitor said, "I have been coming here a number of years and it's always been a good home as far as I'm concerned". We noted that the home employed a full-time activities co-ordinator who organised a wide range of social events and activities; the people we spoke with were happy with the number and variety of activities on offer.

We saw that people's consent was sought, wherever possible, before care and support was provided. We observed that the care given was safe and appropriate and based on effective care planning and risk assessments. This meant that people's individual needs were met and their preferences were taken into account.

People were protected from the risks associated with poor medication management. We saw that medicines were properly obtained, stored and administered in line with the provider's policy. We noted that there were adequate numbers of experienced staff to provide good care. We also found that systems were in place for people and relatives to make a complaint about the service if necessary.

During our visit to Claremont Lodge Nursing Home we spoke with five people who lived there. Four of these people told us that they were very satisfied with the level of care and support that they received at the home. They told us that they had been involved with the planning and delivery of their care; and that their wishes and preferences had been taken into account.

We spoke with two members of staff who were on duty. They were knowledgeable about maintaining the privacy and dignity of people and what was required of them to ensure that people's care needs were met. Staff told us that they were confident that the manager would listen to them if they had any concerns.

We observed staff on duty had a good relationship with the people living at the home. When talking to people, staff were friendly and professional. One person told us, "The staff are very good”.

We spoke with people living in the home, with relatives and with West Sussex county council. People told that they are very happy with the care in the home, that the staff are very kind and polite and that they are mostly happy with the food. One person told us “This is a very nice place to live and we do have choice”, another told us “Staff come quickly when I ring”

One person told us that menu can be a bit repetitive and another told us that “they do their best but it’s not like home cooking”

All expressed satisfaction with the activities and we were told the “activities coordinator is lovely and works hard”

We also spoke with two health professionals who told us that the home was well organised, that they were called in appropriately and that people were very well cared for.

The inspection took place on 12 and 13 May 2015 and was an unannounced inspection.

Claremont Lodge Care Home provides accommodation and nursing care for up to 35 people, although some double rooms were used for single occupancy. At the time of our visit there were 29 people living at the service. The home is purpose built and well-equipped. All of the downstairs bedrooms have patio doors and some upstairs rooms have balconies. One staff member told us, “The surroundings are nice. A lot of the residents think they are in a hotel”.

The service has 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.

We identified issues with the management of topical creams and found gaps in the topical medicine administration records. Other medicines were managed properly and safely. We have made a recommendation around written advice concerning ‘as needed’ medicines.

There was an open and friendly atmosphere at the home. People appeared relaxed and visitors were warmly welcomed. The registered manager was working to increase links with the local community by supporting people to go out and welcoming local people to join the home’s activities and outings.

People were full of praise for the activities at the home. There was a dedicated activities’ coordinator who organised a varied and interesting programme, tailored to people’s individual interests. Staff were encouraged to spend time with people and were able to assist them with tasks in their rooms, to enjoy the gardens or to chat. People told us that the staff were very kind.

There were enough staff to meet people’s needs. Staff had received training and were supported by the management through regular supervision and appraisal. They told us that the registered manager was approachable and that the home was well-led. Staff were clear on their roles and responsibilities and were kept up-to-date via handovers and regular staff meetings.

People were involved in planning their care and were supported to be as independent as they were able. Where there were changes in people’s needs, prompt action was taken to ensure that they received appropriate support. This often included the involvement of healthcare professionals, such as the GP, Speech and Language Therapist (SALT), Physiotherapist or specialist nurses. A GP told us, ‘I think Claremont is excellent all round’.

People felt safe. Risks to people’s safety were assessed and reviewed. Any accidents or incidents were recorded and reviewed in order to minimise the risk in future. Staff understood local safeguarding procedures. They were able to speak about the action they would take if they were concerned that someone was at risk of abuse.

People were treated with kindness and respect and were involved deciding how they wished to spend their time. Staff were quick to notice when they required assistance or reassurance. Staff understood how people’s capacity should be considered and had taken steps to ensure that people’s rights were protected in line with the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS).

Mealtimes were a sociable experience. Staff were attentive to people’s needs and supported those who required assistance to eat or drink. People’s weight was monitored and prompt action taken if any concerns were identified.

The registered manager had a system to monitor and review the quality of care delivered and was supported by monthly visits from a representative of the provider. The registered manager received regular feedback from people, their relatives, staff and visitors. This included direct feedback, meetings and annual surveys. Where improvements had been identified, action plans were in place and used effectively.

We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have told the provider to take at the back of the full version of the report.