This inspection took place on 27 October 2016 and was unannounced. We last inspected the home on 26 June 2014 when we found the provider was meeting all the regulations inspected.

Friary Lodge is a care home registered to provide accommodation, personal care and support for up to 15 older people. At the time of our inspection, 11 people were living in the home.

Friary Lodge has a dining and lounge room on the ground floor with a conservatory used as additional dining and lounge space. The conservatory opens up to a large accessible garden with a patio area. The home has 15 bedrooms with three double bedrooms capacity, spread across three floors with bathroom facilities. Six bedrooms are with ensuite facilities and nine bedrooms have a washbasin facility. The first floor is accessible via chairlift. The home has kitchen and laundry facilities.

There was 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 using the service told us they felt safe at the service. Staff had a good understanding of the safeguarding procedure and their role in protecting people from harm and abuse. The service had systems to identify and manage risks. Risk assessments were individualised and regularly reviewed. The care records were well maintained detailing information on people’s nutrition and hydration needs. Care plans and risk assessments supported the safe management of people's medicines.

The service kept accurate records of medicines administered by staff and maintained effective systems in medicines management. The service was clean and had measures in place to prevent cross contamination.

People and their relatives were very happy with the quality of food. There was choice of food at meal times, and staff supported people to eat when this was needed. People and their relatives told us staff were always available and easy to get hold of. The service had sufficient numbers of staffing to meet people’s individual health and social care needs. The service worked closely with various health and care professionals to support people with their needs and wishes. People received a GP visit on a weekly basis.

The service followed safe recruitment practices. Staff received induction and regular training, and records confirmed this. Staff told us they found supervision useful and received regular one-to-one and group supervisions and six monthly performance review assessments.

The service operated within the legal framework of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). People told us staff asked their consent before supporting them. The registered manager and staff demonstrated a good understanding of the procedures under MCA and DoLS.

The service was exceptionally caring. People told us they had good relationship with the staff and found them considerate, thoughtful, kind and caring. Staff knew people very well, treated them like individuals and provided person-centred care and had built strong trusting relationships with people. Staff recognised people’s need to remain independent, and enabled and supported them wherever possible to remain independent. The service supported and empowered people in maintaining their relationships with family and friends, this ensured people were not isolated. The service had pet animals and people enjoyed their company.

The care plans were personalised and people’s life histories, individual needs and likes and dislikes were recorded. People and their relatives were involved in planning their care. People and their relatives were asked about their views. The service supported people with a range of activities. People and their relatives told us

We considered our inspection findings to answer questions we always ask; 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 is based on our observations during the inspection, speaking with people using the service, the staff supporting them and from looking at records. If you want to see the evidence supporting our summary please read the full report.

There were eleven people living at the home at the time of the inspection. We spoke with eight of them and two people visiting people at the home.

Is the service safe?

People told us that they felt safe within the home, with support from competent staff. They told us “Staff are excellent,” “They are on the ball,” and “It’s a very well run place.” It was a hot day on the day of our visit, and we saw staff offering people drinks on a regular basis throughout the day.

The GP visited the service at least once weekly, and people were confident that they could always be seen if needed. Appropriate systems were also in place for the safe administration of medicines at the home.

Recruitment systems were sufficiently rigorous to ensure that all necessary information was available about new staff and that they were of good character for the protection of people living at the home.

Is the service effective?

People told us that staff were very competent at meeting their individual needs effectively. One person told us “I couldn’t wish for better care.” Staff said that they received appropriate support and training to enable them to deliver care and support to people to an appropriate standard.

People were supported to pursue their own hobbies, and join in social groups outside of the home, although there was room for further development of group activities within the home. People were satisfied with the “freshly cooked” food provided and described “amazing cakes” made at the home. They were happy with the laundry service, noting “My clothes are always clean.”

Is the service caring?

People were highly satisfied with the way they were cared for at the home. They told us “I’m very pleased about the way I’m treated here,” “They are such nice people – very kind - whatever my whim,” “They are always attentive,” “They’re really kind,” and “I always seem to be getting pampered.”

Visitors told us that they always felt welcome, with a cup of tea offered when they arrived. People were particularly appreciative of the birthday celebrations arranged for people living in the home, and the "extra little touches" they described such as individual Christmas presents provided to each person and “leaving Easter eggs at the side of your bed.”

Is the service responsive?

People told us that they were able to make choices about their lives within the home. They noted “I get up when I like,” “We are asked what we like,” “I go out when I like,” and “They will make you something else if you don’t like what’s on the menu.”

The manager was clear that she was careful to assess people’s needs before admission to ensure that they could be met effectively by the home. We saw that staff had identified people’s cultural and religious needs, and taken steps to address these, for example identifying a cultural social group for one person to attend in the local area.

Is the service well-led?

Staff told us they were clear about their roles and responsibilities. Staff we spoke with showed that they understood the needs of individual people they cared for. People living at the home had strong confidence in the home’s management. They told us “I couldn’t wish for better,” “It’s like living in a five star hotel,” “It’s excellent,” “A very well run place,” and “The Manageress is very nice – you can talk to her if you have any trouble.” We saw that appropriate quality assurance systems were in place to ensure that the home’s standards were maintained.

We spoke with eight people who use the service and a visitor. People praised the service and the care provided. Comments included, “it’s very good here, they do look after us” and “I’m very pleased to be here.”

We found that people were treated with respect and dignity. People’s comments included, “staff try their best to help” and “they treat me well.” People indicated to us that they made choices about their care and that staff were responsive. “They never rush me,” one person said.

People said they received the care and support they needed. Comments included, “there’s always a drink here and I can ring the bell if I’m thirsty.” We found that care was planned and delivered in a way that was intended to ensure people's safety and welfare.

We found there were systems to assess and monitor quality and risk at the service. These included consideration of people’s views. Comments included, “any problems, I talk to them and they try to sort it out.”

There were a number of arrangements in place for the management of people’s medicines. However, when we checked medicines supplies against records, we found some discrepancies. This meant that there were occasions when people may not have received their medicines as prescribed and records of administration were not accurately kept.

We also found that recruitment procedures were not effective at demonstrating that new staff were of good character. This may have put the safety of people who use the service at risk.

We spoke to five people who use the service. They informed us that they were satisfied with the services provided and they were well cared for. They said staff had treated them with respect and dignity. Their views can be summarised by the following comment, “I am more than happy, they look after us very well!”

The healthcare needs of people had been met. Medication had been administered as prescribed. Comprehensive assessments, including risk assessments had been carried out. Appropriate care plans had been prepared for people. These were regularly updated. We observed that people who use the service appeared comfortable and relaxed.

Arrangements were in place to ensure that people who use the service were protected from abuse. People who use the service stated that they felt safe in the home. Staff had been provided with safeguarding and other essential training. They were knowledgeable regarding their roles and responsibilities.

The home had arrangements for monitoring the quality of care provided. Regular audits and checks had been carried out. A consumer survey had been organised and the results indicated that people and their representatives were very happy with the care provided.

People who use the service were satisfied with the care provided and they indicated that their needs had been attended to. They spoke positively of staff and stated that staff had treated them with respect and dignity. Their views can be summarised by the following comments :

" Staff are very, very good indeed!”

“Staff treat me very well and they are very helpful.”

We observed that people who use the service were well cared for. Staff were observed to be interacting regularly and talking with people who use the service. They responded promptly when people who use the service requested their assistance.

People who use the service said they were happy with the accommodation and facilities. We noted that the home was clean, tidy and felt cosy and welcoming.

The required health and safety checks had been carried out.

We were able to speak to a relative and a healthcare professional. The feedback received was positive and indicated that people who use the service were well cared for and their needs had been met. Their views can be summarised by the following comment:

“They take good care of residents and keep us informed if there are any changes.”