This unannounced inspection took place on 9 January 2019.

At our last comprehensive inspection of Dunheved Lodge in July 2016 we rated the service ‘Good’ overall. At this inspection we found the service continued to be ‘Good’.

The service is registered to accommodate and support 14 people. At the time of our inspection 12 people were living in Dunheved Lodge. 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.

The service 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 living at Dunheved Lodge continued to be safe. Staff were trained to safeguard people by recognising signs of abuse and reporting concerns appropriately. People’s risks were assessed and reduced and there were enough suitable staff available to keep people safe. Medicines were administered in line with the prescriber’s instructions. The home was clean and staff followed the provider’s infection control and food safety procedures.

People participated in their assessments and staff made referrals were necessary for people’s specific needs to be assessed by healthcare professionals. Staff were trained and supervised and the registered manager evaluated their performances. People ate well and were supported to access health and social care services whenever they needed to. The registered manager ensured people were treated in line with the Mental Capacity Act 2005 and care records were in place to show that restrictions in place were lawful and in people’s best interests.

Staff and people knew each other well and in some instances shared positive relationships for decades. Relatives were made to feel welcome when they visited family members and people were supported to maintain friendships. Staff respected people’s privacy and promoted their dignity.

Detailed care plans were in place to provide staff with guidance on meeting people’s needs and preferences. People’s autistic spectrum, behavioural support and communication needs were met and people were active. The service recognised the need to increase the quality and quantity of activities for people who were at home and did not attend the provider’s day service and had created the role of activity coordinator to lead this. Complaints were dealt with appropriately.

There was an established leadership and good governance at the service. The service worked cooperatively with external agencies to meet people’s needs. Staff felt supported and thought an open culture existed at the service. The provider gathered and acted on the views of people, relatives and staff. The registered manager oversaw quality assurance processes which monitored care and support and drove improvements at the care home.

Dunheved Lodge is a residential care home that provides 24 hour care and support for up to 14 adults. The home specialises in caring for adults with a learning disability. At the time of our visit 14 people were using the service.

The home 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.’

We carried out an unannounced comprehensive inspection of this service in August 2016. A breach of legal requirements was found. After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breach.

We undertook this focused inspection to check that they had followed their plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements. We found improvements had been made and relevant notifications had been sent to the Commission and we have revised our rating to good for the Well led section

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Dunheved Lodge on our website at www.cqc.org.uk.

The inspection took place on 14 and 15 July 2016, day one of the inspection was unannounced. The service was last inspected in January 2014, it met all the regulations it was inspected against.

Dunheved Lodge is a residential care home that provides 24 hour care and support for up to 14 adults. The home specialises in caring for adults with a learning disability. At the time of our visit, there were 12 people using the service, two people were using the service for respite care.

The home 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.’

At this inspection we found that the service had not sent the CQC notifications in relation to the outcomes of Deprivation of Liberty (DoLS) applications. This was a breach of Regulation 18 of CQC (Registration) Regulations 2009.

People liked staying at Dunheved lodge and found staff who supported them were caring and kind towards them. There was a relaxed and friendly atmosphere when we visited.

There were systems and processes in place to protect people from the risk of harm and staff were aware of safeguarding procedures. People received assistance to stay safe from potential harm and injury. Appropriate recruitment procedures were followed and staff were fully vetted before they started work. There were sufficient numbers of qualified staff to support people and meet their individual needs.

People were supported to have their health needs met. Staff worked with the person to access the GP and other local health services as appropriate to help make sure the individual’s health needs were met. People requiring assistance with taking their medicines received their medicines safely. Prescribed medicines were stored securely and managed safely.

Staff received training which gave them the knowledge and skills to support people effectively. Newly recruited staff received induction and foundation training to prepare them for the role. Staff received training in the Mental Capacity Act (MCA) 2005 and the Deprivation of Liberty Safeguards (DoLS). Staff worked within the principles of the Mental Capacity Act 2005 (MCA). People were asked for their consent to the care and support they received.

There was a system in place for responding to people’s concerns and complaints. People told us they knew how to complain and felt confident that staff would respond and take appropriate action.

The registered manager understood their role and responsibilities and positive feedback was received from staff about their leadership and management. There were effective systems in place to identify areas for improvement and to help ensure the safety and quality of the service provided.

We spoke with people using the service and although some conversations were limited we were able to establish that people’s wishes were respected. One person told us ''I go to keep fit and see my sister, I like music and we do news things at the centre.'' Through speaking with relatives we were able to establish that discussions and meetings involving them were held to ensure people's best interests were represented.

People experienced safe and appropriate care and support that met their needs. One relative we spoke with said ''I see them once a week and whenever I go to the home they are always dressed appropriately, that tells me a lot. I don’t usually tell them (the staff) I am coming so I know it isn’t done to please me.'' Risk assessments had been completed for each person and the records we saw stated how the risks would be managed and reviewed. There were arrangements in place to deal with foreseeable emergencies.

The premises and grounds were adequately maintained. The premises were warm, well lit and secure. We saw records that showed essential maintenance and safety checks had been carried out such as testing of emergency lighting and water temperatures.

People received care from staff that had been properly trained supervised and appraised. Records were accurate and fit for purpose and kept secure to ensure confidentiality.

On the day of our inspection there were eight permanent residents and two people staying for respite care.

We were able to speak to three people briefly before they went to the day centre and two others throughout the course of the day.

Everyone we spoke to liked living at Dunheved Lodge. One person told us, “like it here, friendly”. Someone else said “like staff, like it when everyone comes back” (from day centre).

One person who uses the service gave us a tour of the building, including showing us their bedroom.

The home provides respite care for people who need to be away from their permanent home for short period. The respite care provided is usually for a two week period, although can sometimes be extended by the funding authority.

We spoke to three people before they went to the day centre. They all told us they enjoyed going to the day centre, as well as other activities such as keep-fit.

We also spent time with four other people. One person showed us the garden and told us about the work they enjoyed doing in the garden. We were also told that they had a barbeque in the summer. Another person told us they enjoyed going shopping. Some people talked about visits from relatives and their summer holiday.

All of the people we saw and spoke to indicated that they were happy with the way they were cared for.

The home also provides respite care for people for an average stay of two weeks.

We spoke to one person who was staying at the service for respite care. This person indicated that they were happy at the service.

Two people who live at the service showed us their rooms and told us they were happy with the new furniture which had recently been provided. Both rooms had also been redecorated and appeared clean.

People living at the service confirmed that staff treated them well and could go to staff if they were not happy about anything.