Courtlands Lodge is a care home situated in North Hykeham, on the outskirts of Lincoln. 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. Courtlands Lodge provides care for up to 29 men and women whose main needs are associated with mental health.

At our last inspection in March 2016, we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The service continued to provide safe care. Staff protected people from avoidable harm and abuse, whilst not unnecessarily restricting their freedom. They completed individual risk assessments and took steps to reduce risks to people’s health and safety. When incidents and accidents occurred, they were reported and investigated to identify themes and learning to reduce the risk of recurrence.

Sufficient number of staff with the appropriate skills and experience were available to care for people and people told us staff responded quickly when they required support. People received their medicines as prescribed and plans were in place to manage medicines prescribed for emergency situations such as when a person had a prolonged seizure.

The premises and equipment were maintained to ensure people’s safety and the required safety checks were completed regularly. Arrangements were in place to maintain good standards of hygiene and cleanliness and people were protected by procedures to prevent and control infection.

People continued to receive an effective service. Staff had the knowledge required to provide high standards of care and they used this knowledge effectively. They liaised with other professionals to ensure people had access to specialist care and treatment when required.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People had a choice of meals and staff were knowledgeable about their food preferences. People told us they enjoyed the meals provided and we observed staff monitored people who were at risk at mealtimes.

Staff showed understanding and compassion for the people they cared for. They provided reassurance and emotional support and encouraged people’s independence. People told us staff were kind and supportive and they enjoyed living at the home.

People continued to receive a service that was responsive to their individual needs and preferences. They were supported to maintain their interests and develop new ones. Staff had a good knowledge of the people they cared for and used this knowledge to ensure care and support was tailored to each person’s individual needs. People were treated equally and without discrimination. People knew how to raise a concern and make a complaint and they told us that when they had a concern staff responded promptly to resolve the issue for them.

The service continued to be well led by an experienced registered manager who had access to the provider on an ongoing basis. Staff and people using the service had confidence in the registered manager and they told us the registered manager was fair and approachable. People were encouraged to provide feedback on the service provided and were involved in planning future developments. Quality audits were undertaken to monitor the quality of the service provided and to encourage continuous improvement.

Further information is in the detailed findings below

The inspection took place on 16 March 2016 and was unannounced.

Courtlands Lodge is registered to provide accommodation for nursing and personal care for up to 29 people living with a mental health illness. There were 22 people living at the service on the day of our inspection.

There was a registered manager in post at the time of our inspection. 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 the legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated

The Care Quality Commission is required by law to monitor how a provider applies the Mental Capacity Act, 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. This is to protect them. The management and staff understood their responsibility and made appropriate referrals for assessment. One person at the time of our inspection had their freedom restricted under a DoLS authorisation.

People were kept safe because staff undertook appropriate risk assessments for all aspects of their care and care plans were developed to support people’s individual needs. The registered manager ensured that there were sufficient numbers of staff to support people safely. People were given their medicine safely.

People were cared for by staff that had knowledge and skills to perform their roles and responsibilities and meet the unique needs of the people in their care. Staff received feedback on their performance through supervision and appraisal.

People had their healthcare needs identified and were enabled to access healthcare professionals such as their GP and community mental health team.

People were supported to make decisions about their care and treatment and staff supported people to maintain their independence. People were treated with dignity and respect by kind, caring and compassionate staff.

People were treated as individuals and were supported to follow their hobbies and pastimes. People were involved in planning the menus and staff supported them to have a nutritious and balanced diet.

The registered provider had robust systems in place to monitor the quality of the service, including regular audits and feedback from people.

We spoke with seven people who lived at the home and with four members of staff. People told us that they were happy and that staff had helped them to be independent. A person told us, ‘’I am very happy here. I love my room and the staff are great.’’ Another person said, ‘’I could not ask for a better home. It is very comfortable and I feel I am at home.’’

People's needs had been assessed and care plans put in place to support people appropriately. We found that people had been consulted on how they would be supported.

Appropriate recruitment procedures were followed to make sure that suitable staff were employed to support the people that lived at the home.

There were systems in place to monitor the quality of service provided to people that lived at the home.

As well as talking with people who lived at the home, we used a number of different way to help us to understand people's experiences.

We looked at a sample of records including three people's personal care plans. We spoke with the manager and three staff and we observed how staff provided support to people. We saw people were enabled to make choices and decisions for themselves. There were appropriate systems in place to act in people's best interests if they were unable to do so themselves. People told us, "It's perfect for me here" and "I do as I wish."

We saw staff treated people with respect and dignity and people were comfortable to ask staff for support and advice if they needed it. People told us they would feel comfortable to raise concerns or complaints with staff and felt they would be dealt with. We saw there was information on display telling people how to do so if they wished. No-one raised any concerns with us and one person commented, "I don't think I have a single complaint.”

People told us they found their rooms to be comfortable and warm and we saw they were well personalised to their own taste and with their own personal possessions. Other areas of the home we saw looked clean and tidy.

People told us they received the help and support they needed and they felt safe. They told us they didn't have to wait long for staff to help them if they needed attention.

One person we spoke with told us “It’s ok here. I get looked after and it’s my home now.”

Another person said “I like living here. I go home to stay with family and go out with staff. The foods good here and I get something else if I don’t like what’s offered.”

One of the professional visitors said, “The home has a friendly atmosphere with mutual respect between staff and residents.”