The inspection took place on 17 October 2016 and was unannounced. The previous inspection of April 2015, found the service required improvement. At this inspection we found that some improvements had been made. However, we found inconsistencies in the management of environmental and individual risks. For example the systems in place for checking and managing risks to individuals of scalding were ineffective. We have made a recommendation regarding the oversight of risks.

Cleaveland Lodge provides accommodation and care for up to 54 older people some of whom may be living with dementia. On the day of our inspection there were 52 people living in the service.

There was a registered manager in place. 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.

Checks were undertaken on staff suitability for the role for which they were employed but records were not maintained of interviews and we could not be assured that the checks were sufficiently robust.

Staff were visible and assessable and there were sufficient numbers of staff available to meet the needs of the people living in the service. Staff received an induction to prepare them for their role and additional training was provided to support their learning and development.

Medication was generally managed safely but we did find inconsistencies in the recording systems which need to be resolved to ensure a robust and accountable system.

People were offered a varied diet and could have alternatives to the menu if they chose. Where necessary, staff assisted people with eating and drinking. Systems were in place for staff to monitor people's nutrition and hydration with action being taking when concerns were identified. Staff ensured that people's health needs were effectively monitored. They supported people to access a range of health care services to maintain and improve their health and wellbeing.

The registered manager and staff were aware of their responsibilities in relation to the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). MCA and DoLS are in place to protect the rights of adults by ensuring that if there is a need for restrictions on their freedom and liberty these are assessed and decided by appropriately trained professionals. People's best interests had been considered when decisions that affected them were made. Applications for DoLS authorisations had been submitted where restrictions were in place. It was agreed that applications would be made for individuals on respite care where this was needed to keep them safe.

Relationships between people living in the service and staff were positive. Staff knew people well and were caring and kind. There were activities in place which people enjoyed and promoted their wellbeing. People were given choices in their daily routines and looked well groomed. There were systems in place to ensure that key information about people’s health and welfare were communicated between staff and families.

People expressed confidence their concerns would be listened to. There were systems in place to respond to complaints although most people told us that they had no cause to complain.

People and their relatives were complimentary of the care provided and how the service was managed. The manager and providers were assessable and actively involved in the day to day management of the service. Staff understood their role and were well supported. There were systems in place to ascertain people’s views and drive improvement.

The inspection took place on 17 October 2016 and was unannounced. The previous inspection of April 2015, found the service required improvement. At this inspection we found that some improvements had been made. However, we found inconsistencies in the management of environmental and individual risks. For example the systems in place for checking and managing risks to individuals of scalding were ineffective. We have made a recommendation regarding the oversight of risks.

Cleaveland Lodge provides accommodation and care for up to 54 older people some of whom may be living with dementia. On the day of our inspection there were 52 people living in the service.

There was a registered manager in place. 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.

Checks were undertaken on staff suitability for the role for which they were employed but records were not maintained of interviews and we could not be assured that the checks were sufficiently robust.

Staff were visible and assessable and there were sufficient numbers of staff available to meet the needs of the people living in the service. Staff received an induction to prepare them for their role and additional training was provided to support their learning and development.

Medication was generally managed safely but we did find inconsistencies in the recording systems which need to be resolved to ensure a robust and accountable system.

People were offered a varied diet and could have alternatives to the menu if they chose. Where necessary, staff assisted people with eating and drinking. Systems were in place for staff to monitor people's nutrition and hydration with action being taking when concerns were identified. Staff ensured that people's health needs were effectively monitored. They supported people to access a range of health care services to maintain and improve their health and wellbeing.

The registered manager and staff were aware of their responsibilities in relation to the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). MCA and DoLS are in place to protect the rights of adults by ensuring that if there is a need for restrictions on their freedom and liberty these are assessed and decided by appropriately trained professionals. People's best interests had been considered when decisions that affected them were made. Applications for DoLS authorisations had been submitted where restrictions were in place. It was agreed that applications would be made for individuals on respite care where this was needed to keep them safe.

Relationships between people living in the service and staff were positive. Staff knew people well and were caring and kind. There were activities in place which people enjoyed and promoted their wellbeing. People were given choices in their daily routines and looked well groomed. There were systems in place to ensure that key information about people’s health and welfare were communicated between staff and families.

People expressed confidence their concerns would be listened to. There were systems in place to respond to complaints although most people told us that they had no cause to complain.

People and their relatives were complimentary of the care provided and how the service was managed. The manager and providers were assessable and actively involved in the day to day management of the service. Staff understood their role and were well supported. There were systems in place to ascertain people’s views and drive improvement.

People were complimentary about the care and support that they received from the staff at Cleaveland Lodge. They told us that staff were very nice and supportive. They also told us that staff understood their care needs very well and always supported them in ways that were respectful and polite.

Relatives of people who lived in the home spoke positively about the care provided and received by their loved ones, responses in surveys indicated that relatives felt that the home was well run and organised.

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 joined by an 'expert by experience', a person who has experience of using services and who can provide that perspective and a professional advisor who has had experience of working in adult social care 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.

Relatives and people living in the home were positive about the service they received. One person told us “I have lived at the home for several years now and I still love it. There is a great atmosphere here” and another said “It is very comfortable and [the staff] are very kind.”