Derwent Lodge 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.

Derwent Lodge is registered to provide nursing and residential care and support for 16 people with mental health needs. At the time of our inspection there were 13 people using the service. The service is a detached, single storey property located within a residential area of Derby. The service provides communal rooms, which include lounges, dining room, activities room and two kitchens. The bedrooms are single occupancy with an en-suite facility. The service has a garden which can be accessed from the communal rooms.

At our last inspection 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.

Derwent Lodge did not have 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. The previous registered manager had resigned their post in May 2018.

The manager of Derwent Lodge had been in post for six weeks at the time of the inspection. The manager had completed their application form for the post of registered manager and had submitted an application to the Disclosure and Barring Service (DBS). The manager advised us that upon receipt of their DBS check they would submit their registered manager application to the Care Quality Commission (CQC) for consideration.

People’s safety was promoted by staff that had the appropriate training to monitor and support people to be safe. Potential risks were identified and action to reduce these was taken. There were sufficient staff to keep people safe and staff were aware of their responsibilities in monitoring people’s safety and well-being. Environmental risks were reduced, through regular maintenance of the service. People received their medicine and were supported by staff with the appropriate knowledge and skills in the management of medicine.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrict way possible; the policies and systems in the service supported this practice. People were supported by staff that had the necessary training and skills to provide care and support. Staff worked collaboratively with people using the service and health and social care professionals to monitor people’s health to maintain and promote people’s well-being.

People spoke very positively about the attitude and approach of staff towards them. People told us staff were available when they needed them and we saw staff respond to people when they became upset or distressed, having time to spend with the person talking about their concerns. People were encouraged to be involved in the development and reviewing of their recovery and support plans and were involved in meetings to review their care and treatment. People said confidentiality was maintained and that they were respected by staff.

Staff encouraged people to be involved in the development and reviewing of their care, treatment and support plans. People spoke to us about their involvement and setting individual goals of achievement for them. A nurse had been leading a project to review people’s care and support plans, with a focus on them being person centred, to promote people’s involvement and to further reflect

This inspection took place on 3 and 4 May 2016 and was unannounced.

Derwent Lodge is registered to provide nursing and residential care and support for 16 people with mental health needs. At the time of our inspection there were 15 people using the service. The service is a detached, single storey property located within a residential area of Derby. The service provides communal rooms, which include lounges, dining room, activities room, smoking room and kitchen. The bedrooms are single occupancy with an en-suite facility. The service has a garden which can be accessed from the communal rooms.

Derwent Lodge had a registered manager in post. 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.

People’s safety and welfare was promoted by staff that had a good understanding of the needs of people using the service. People had a key worker and co key worker who worked with them to develop plans of care which supported them with their recovery programme. People’s plans took account of potential risks to people and recorded how risks could be minimised whilst recognising people’s rights and choices in how they lived their lives.

Staff had access to an out of hours on-call system where they could seek advice from a manager or a member of the clinical team, to ensure concerns about people’s safety and well-being were managed well to promote their safety.

Recruitment procedures were robust and appropriate checks were carried out before people started work. Staff received a comprehensive induction and ongoing training. Staff were further supported through regular supervision and an annual appraisal to ensure they had the knowledge and skills to support people. Staff group supervisions were used to share information as to good practice and used as a learning opportunity to develop staff.

People’s rights and independence were fully understood by staff that had developed positive working relationships with people, which enabled them to provide the care and support people needed. People’s plans of care focused on their recovery and promotion of their independence across a range of topics, which included management of their own medicine and finances.

People were supported to develop cooking skills and to provide themselves with snacks and drinks. The main meal of the day was prepared and cooked by the chef and served by staff in the dining room. Staff encouraged people to eat their main meal in the dining room as part of people’s recovery to socialise.

People’s medicines were managed and administered safely following robust risk assessments to promote independence where possible. People’s consent had been appropriately obtained and recorded. Both staff and the managerial team understood the principles of the Mental Capacity Act and how they might apply to the people who used the service.

Staff worked in collaboration with people using the service and health and social care professionals to promote people’s health. People were encouraged to manage aspects of their own health and to attend appointments independently. People’s health care needs were regularly reviewed with the person using the service and a range of health and social care professionals.

Staff’s knowledge and understanding of the needs of people had enabled staff to develop working relationships with people, which meant people using the service were confident to receive support from staff. The atmosphere of the service was relaxed and people received the support they needed at a time that was appropriate to them.

People we spoke with told us how they managed aspects of their own lives and told us how staff supported them; they told us how their views were sought as to their individual

We found that people's care was reviewed regularly and their needs were met. People contributed to the development of their own care records and they were central to any care review.

People using the service were able to participate in activities in the community with support where needed. People told us they were able to join in local activities according to their interests.

People were cared for, or supported by skilled and experienced staff. This meant that people were kept safe because they received care from appropriately trained people.

The staff were friendly and professional in their approach and interacted confidently with people. There was a relaxed atmosphere in the home, and people were happy with the support they received.

Medicines were stored and administered safely, protecting people from the risks associated with them. People were encouraged to take responsibility for their own medicines when appropriate, which meant that people’s independence was promoted.

We spoke with eight people who use the service and three relatives.

People told us they were generally happy with the care and support they received, and felt that their needs were being met. Their key worker discussed their care with them on a regular basis, and they had agreed and signed their care plan.

Most people said they were satisfied with the meals provided, which included a choice of home cooked foods. One person told us ’’the meals were very good; the cook goes out of their way to provide foods that we like.’’ Another person said the meals were ''alright'' but they did not like some of the choices. An alternative option was available if they asked.

People said they liked the relaxed atmosphere and felt that the premises were clean, comfortable and safe.

People said they received care and support from regular staff who were aware of their needs and preferences. Most people felt that there was usually enough staff on duty to meet their needs. However one person felt that more staff were needed at times to enable them to go out more.

Relatives we spoke with felt that their family member received appropriate care and support, and felt involved in decisions about their care and treatment. Relatives told us that their family member was more settled and that their quality of life had improved since they moved to Derwent Lodge.

People told us they liked living at the service and were very happy with the care and support they received. One person commented, "I have lived here for a long time. It is nice here, nice food, I shower everyday. I am happy here, they made me better and took care of me.”

They told us they had lots of freedom to make decisions and said they were respected by the staff and treated with dignity. One person told us, “I think they respect my decisions here, I never feel forced into decisions that I don't want.”

People we spoke with told us they felt safe at the service and could raise concerns with confidence. They told us the staff listened and understood them and they felt they stayed well and improved because of the good quality care they received. One person said, "I have lived here for about eight years now. I was very unwell when I came here, but the staff have been brilliant.”