About the service: We carried out an unannounced comprehensive inspection of Durnsford Lodge on 05 February 2019. Durnsford Lodge is a ‘care home’ that provides care for a maximum of 28 older people. At the time of the inspection 23 people were using the service. 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.

People’s experience of using this service: The management team and staff knew people well and understood their likes and preferences and health needs. Staff were caring and spent time chatting with people as they moved around the service. Relatives told us they were welcome at any time and any concerns were taken seriously and responded to. Records showed the registered manager arranged to meet with people, and their relatives, privately to discuss any worries they might have.

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 and relatives said the service was safe. Staff demonstrated a good awareness of each person's safety and how to minimise risks for them. The environment was safe and people had access to appropriate mobility and moving and handling equipment as needed. There was enough staff on duty at the right time to enable people to receive care in a timely way.

Staff had the knowledge and skills to administer people’s medicines safely. The registered manager and senior staff had good oversight of relevant procedures through monitoring and auditing. This ensured people received medicines safely.

People were supported by staff who had the skills and knowledge to meet their needs. Staff understood and felt confident in their role.

People's health was well managed, and staff had positive links with professionals which promoted wellbeing for them.

The registered manager used the same safe recruitment procedures we found at our last inspection.

Staff were well supported by a system of induction, training, supervisions, appraisals and staff meetings. They had opportunities to raise concerns or suggestions and be involved in the development of the service. Quality audits were carried out to identify any areas for improvement.

Rating at last inspection: Good (Report published 18 August 2016)

Why we inspected: This was a planned inspection based on the rating at the last inspection. At this inspection, the service remained rated Good overall.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

The inspection took place on the 12 and 13 July 2016 and was unannounced.

Durnsford Lodge Residential Care Home provides care and accommodation for up to 28 older people. Durnsford Lodge Residential Care Home provides care who may also have mental health needs, including people living with dementia. On the day of the inspection 24 people were using the service.

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.

There was a calm, friendly and homely atmosphere. Friendly conversation and gentle background music helped create a relaxed and homely atmosphere. People and their relatives all spoke highly of the care and support Durnsford Residential Home provided. One person said, "I am very happy here; all the staff are kind and caring".

Staff interacted with people in a caring and compassionate way. For example, staff spent time

sitting with people and checked they were comfortable and happy. One staff member walked slowly alongside a person as they mobilised around the home. They chatted about the day and made the person feel unrushed and relaxed.

The design and décor of the building had been carefully thought out and took account of people's needs. People were able to move safely around the building and had sufficient space to enjoy time on their own or in the company of others. The garden area had been developed to include an area specifically designed for people living with dementia.

People told us the staff were caring and they felt they mattered. They said staff listened to them and respected their wishes. Staff we spoke with were clear about the importance of respecting people. They consistently spoke about people being individuals and treating people as they would like to be treated. A Comment from onestaff was that, “All the staff are here for the right reason,we are passionate about the work we do”.

A range of activities were available to meet people's needs and particular interests. Staff had considered ideas to evoke memories and trigger reminiscent thoughts and conversation. For example, memory frames had been put together and included pictures and objects relevant to the person concerned.

The service had an open door policy, relatives and friends were welcomed and people were supported to maintain relationships with those who mattered to them.

Staff were supported through induction, supervision and on-going training. Staff were encouraged to enhance their skills and professional development was promoted. Staff told us they were supported and encouraged to question practice. Staff said they were aware of the

values of the service and these were regularly discussed and promoted. Staff were inspired and motivated to provide a good quality service and had a clear understanding of their role and what was expected of them.

People medicines were managed safely. People received their medicines on time and in a way they preferred. The practice was reviewed through regular audits and the staff traing and competency were up to date.

People were fully involved in planning and reviewing their care. This meant their care was personalised and reflected the person’s current wishes and needs. Care and support focussed on each person's individual needs, their likes, dislikes and routines important to them. Staff understood their role with regards to the Mental Capacity Act (2005) and the associated Deprivation of Liberty Safeguards (DoLS). Applications were made and advice sought to help safeguard people and protect their human rights. When people were unable to consent to their care or support discussions took place to ensure decisions were made in their best interests. When people's needs chang