The inspection took place on 29 September and 3 October 2016 and was unannounced. Evergreen Lodge is located in the Rock Ferry area of Birkenhead. The home is registered to accommodate up to 40 people. The home has a car park at the front and a secure garden at the back.

At the time of the inspection, the home had a manager who was registered with the Care Quality Commission. 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 and associated Regulations about how the service is run.

The people accommodated at Evergreen Lodge were living with dementia-related conditions or had other mental health needs. Some people had challenging behaviour and required one to one support from staff to ensure their safety and/or the safety of others. We observed that people were treated with dignity and respect and support was provided in a non-judgemental manner.

The manager and staff had knowledge of the Mental Capacity Act (2015), and Deprivation of Liberty Safeguards (DoLS) had been applied for appropriately. People were supported to make everyday choices within their capacity to do so. People had a choice of meals and received the support they needed to eat and drink. Staff we spoke with had a good understanding and knowledge of people`s individual care needs. Family members visited during the day with no restrictions.

The home was clean, tidy, comfortable and safe. Adaptations had been made to support people with mobility difficulties. People’s medicines were managed safely.

We observed that there were enough staff on duty and people did not have to wait for staff to attend to them. The rotas we looked at confirmed that these staffing levels were maintained by some use of agency staff.

Care records we looked at showed that people's care and support needs were assessed before they moved into the home. Plans were in place for meeting people’s needs and these were reviewed regularly.

The home employed two social activities organisers who facilitated social support for people both in the home and in the community.

We saw evidence of regular staff meetings and meetings for people who lived at the home. A series of quality monitoring audits was carried out.

We spoke with four people who lived at the home. They told us they were treated with dignity and respect and they were well looked after. They said “it’s very good", “staff are great with me" are “nice people” and “very helpful”. We observed people were well cared for and treated kindly.

We saw that people's needs were assessed and regularly reviewed. Care records were personalised, contained information about a person's individual needs and preferences and promoted the person's independence where possible.

Where people had limited mental capacity, care plans detailed how to communicate with people so they were able to be involved in decisions about their day to day care. Staff we spoke with were knowledgeable about a person’s needs and understood the need to obtain consent prior to providing care and person’s right to refuse consent.

We reviewed three staff records and saw evidence that staff were appropriately trained and supported to care for people safely and to an appropriate standard. Staff records demonstrated staff received training in safeguarding as part of the provider’s mandatory training programme. Staff we spoke with had a basic understanding of safeguarding and the different types of abuse.

We saw the provider undertook a range of quality audits to check and monitor the quality of the service provided. We examined the provider's recent survey of people's views and opinions. The feedback received about the service was positive.

Oakwood unit on the first floor accommodated people with advanced dementia: Rosewood unit on the ground floor accommodated people with early onset dementia: Maplewood unit, also on the ground floor, provided a care and rehabilitation service for people with acquired cognitive impairment. All of the people living at the home had complex care needs.

People we spoke with said:

“I am 200% better than when I came here.”

“There are all kinds of activities going on.”

“I’m now making my own meals and doing my own washing.”

“When I leave here I would like to come back as a volunteer and help other people.”

“I go to all the meetings.”

“The staff treat us with respect and we are involved in everything.”

“Everyone is friendly here.”

“My mum and my advocate visit me.”

“I was in a wheelchair when I came here, I’m much better now.”

There was a care plan for each person and the documentation was tidy and easy to follow.

Evergreen Lodge is a three storey building that has been adapted for use as a care home. Bedrooms, lounges and bathrooms were on the ground floor and the first floor, and the kitchen, laundry and other staff areas on the second floor. There was a detailed development plan for the building which was scheduled to start in February 2013.

There were enough qualified, skilled and experienced staff to meet people’s needs. There was an effective complaints system complaints people made had been responded to appropriately.

The people living at Evergreen Lodge have Alzheimer’s, dementia or the onset of dementia. In light of some communication difficulties, we observed the way staff interacted with the people living at the home. Staff communicated with people in a professional, friendly and respectful way. There body language was positive and the people living at the home appeared comfortable in their company.

The Wirral Social Service Contracts and Commissioning Department had no concerns to raise about this service.

The community dietician had no concerns to raise about this service. She reported staff take on board her recommendations and take an interest in her suggested care plans.