Dover Lodge is residential care home for up to seven people living with a learning disability. The service is situated in a purpose built large house with bedrooms on all floors. On the second floor there is a flat where a person lives independently within the service. At the time of the inspection there were six people living at the service, some with a mental health condition, autism and learning disabilities. Dover 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.

This inspection took place on 18 April 2018. The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

At our last inspection we rated the service Good. At this inspection we found the evidence continued to support the rating of Good. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Dover Lodge 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.

The registered provider had established safeguarding procedures. Staff knew what abuse was and how to protect people from harm and abuse. The provider had clear procedures for reporting allegations of abuse.

Staff identified risks to people’s health and wellbeing. Risk management plans recorded actions staff would take to mitigate and reduce risks for people.

Staff continued to manage people’s medicines in a safe way. The registered manager had systems in place that recorded the administration, ordering and storage of people’s medicines.

There was an infection control process at the service. This gave staff guidance on how to reduce the risk of infection to people. Staff used personal protective equipment and knew how to use effective hand washing techniques.

The registered manager and staff reported essential repairs appropriately to the local authority who was responsible for the maintenance of the building to ensure it was safe for people. We noted that there were maintenance works required to the stairs and ceiling within the service. After our visit we received an update from the registered manager that the maintenance works and repairs were being completed.

Staff were available in sufficient numbers to care for people effectively. When people required additional care from staff this was made available. The registered manager continued to support staff through training, appraisals and supervision.

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 continued to give staff their consent to the care and support they received. Staff understood how to care for people in line with the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards framework to avoid unlawful deprivation of liberty.

People’s meal choices and nutritional needs were met. People had food and drink provided by staff during the day and people contributed to the meal plan for the week.

People had access to services that met their health and wellbeing needs. Staff made referrals to health and social care services when people’s needs changed.

People and their relatives said staff treated them with compassion, ki

This inspection took place on 30 March 2016 and was unannounced. Dover Lodge is registered to provide accommodation for up to seven women who are living with a learning disability. At the time of the inspection there were five people living at the service.

At the last inspection on 14 April 2014, the service was meeting the regulations we inspected.

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.

The provider’s safeguarding policy gave staff guidance to protect people from harm and abuse. The registered manager and staff described their knowledge and awareness of the signs of abuse and followed the provider’s safeguarding processes to manage an allegation of abuse.

Staff identified risks to people and completed assessments of them. From this risk management plans were developed, and gave guidance to staff to reduce the recurrence of risks.

There were sufficient numbers of staff on duty to care for people and meet their support needs. The level of staff was flexible enough to meet the needs of people throughout the day.

People’s medicines were managed safely and they received them as prescribed. There were effective systems in place for the administration, storage, and disposal of medicines.

Staff had access to regular training, and supervision and appraisal, to support them in their role. The registered manager and team leader supported staff so they were able to provide effective care for people.

Staff actively sought from people their consent to care and support. The registered manager and staff were aware of their role and responsibilities in providing support to people within the principles of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS).

Staff knew how to support people with their nutritional needs for the maintenance of their health. Staff provided meals to people, which met their personal preferences. People had a choice in meals they wanted to eat and assisted staff in their preparation.

The management of people’s health needs were met by health professionals when required. People and staff were familiar with each other. Staff identified and documented people’s personal histories, which helped them to understand their likes and dislikes. People and their relatives were involved in making decisions about how they received care and support.

Staff supported people and their relatives in planning their care. Care and support needs were person centred and people were cared for in a way that included their personal preferences, and choices. Staff showed people kindness and compassion. Care and support delivered to people respected their dignity and privacy.

People and their relatives contributed to reviews of their care and support needs. Activities were provided in and outside of the service and people had an opportunity to take part in them if they chose. People were supported to be as independent as they were able and were supported to maintain relationships with friends and relatives that mattered to them.

People and their relatives had a copy of the provider’s complaint policy and knew how to make a complaint and make comments about the service, care, or support they received.

The service supported staff to be involved in the development of the service. The registered manager informed the Care Quality Commission of notifiable incidents, which occurred at the service. The provider had systems in place that monitored, and reviewed the service to improve the quality of care to people. Improvement plans were developed, and staff implemented any changes to the service to ensure people received effective quality of care.

During our visits we gathered evidence to answer our five questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led? Below is a summary of what we found. The summary describes what we observed, the records we looked at and what people using the service, their relatives and the staff told us.

Is the service caring?

People told us that staff were kind and supportive. We observed that staff engaged well with people and communicated with people using appropriate methods to meet their needs. Staff were aware of the individual needs and preferences of the people living at the home. We saw that people were supported to be independent within their local community and were encouraged to attend social activities outside the home.

Is the service responsive?

People told us that they were able to choose where they wanted to go on holiday. Staff supported people with their decisions and made arrangements with the person so that they were able to have their needs and wishes listened to. We saw that the service made arrangements with people for additional health and social care support when required. We saw that referrals had been made for mental health care and occupational therapy support for people, meeting their changing care needs.

Is the service safe?

People told us they felt safe, visitors told us that their relatives were safe and well cared for. There were systems in place to deal with emergencies. Staff told us that they were aware of how to manage people’s safety and we saw there was a system in place to record and manage accidents and incidents, complaints, concerns, whistleblowing, investigations and deal with emergencies. People were provided with sufficient support from staff and health professionals to ensure their safety, by providing equipment when necessary. Medicines were managed safely and there were systems in place to protect people from the risks associated with the storage, administration and disposal of medicines. There were sufficient staff on duty to meet people’s needs throughout the day and night.

Is the service effective?

People had an assessment of their needs before coming to the home, from this information individual care plans were developed. We saw that the care plans were made available to people and their relatives. Care plans identified people’s wishes, concerns, risk assessment and a management plan to minimise risks identified. Therefore peoples’ needs were assessed and appropriate support provided for people to meet those needs and reduce risks.

Is the service well led?

People told us that they felt able to raise and discuss concerns with staff or the manager as appropriate. There were quality assurance systems in place to improve the lives for people. We saw that staff had regular house meeting with the people living at Dover Lodge. People knew how to make a complaint if they were unhappy with any aspect of the service. There was a complaint form for people which was available in a format that people would be able to understand and use, with support if required. People, relatives and staff were asked for their views of their care provided.

During our inspection we spoke with all four people who were using the service and reviewed their care records. We spoke with four members of staff.

One person using the service told us, “I love it here.”

Peoples’ diversity, values and human rights were respected and people were treated as individuals. Staff demonstrated they understood peoples' care and mental health needs. People using the service had their physical health, mental health and social support needs assessed and monitored through the care planning process and regular one to one sessions.

People using the service told us they felt safe and we found that staff were knowledgeable in identifying potential signs of abuse. A system for monitoring the quality of the care provided was in place and there were regular discussions with people using the service and staff about how the service could be improved.