This inspection took place on 9 and 14 August 2017 and was unannounced. We last inspected the home on 18 and 25 May 2016 when we found the provider to be in breach of one regulation of the Health and Social care Act 2008 (Regulated Activities) Regulations 2014, in relation to safe care and treatment. We also found the provider to be in breach of two regulations of the Care Quality Commission (Registration) Regulations 2009 in regards to failure to notify the Commission of the death of a person and other incidents.

George Mason Lodge is a care home registered to provide accommodation, personal care and support for up to 39 people, some of whom were living with dementia, mental health illness or had older people care needs. At the time of our inspection, 37 people were living in the home.

George Mason Lodge is a purpose built care home with 39 bedrooms across three floors with bathroom and shower facilities, and dining and lounge areas on each floor. The ground floor is a short stay and rehabilitation unit, and the first two floors accommodate people on a long term and permanent care placements. The first two floors are accessible via lift. The home has kitchen and laundry facilities and an accessible and secured garden with a patio area. There is a hair-dresser facility and a separate activity room that also doubles up as a staff training room.

The service had a registered manager who has registered with the Care Quality Commission (CQC) to manage the service. A registered manager is a person who has registered with CQC 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 the inspection on 9 and 14 August 2017, we found that the provider had made sufficient improvements and were no longer in breach of legal requirements.

People using the service told us they were happy living at the service and felt safe there.

The service maintained effective safeguarding procedures and staff knew signs of abuse and how to report abuse. People’s accidents and incidents were effectively monitored and systems were in place to learn from them to prevent recurrences. Risks involved in people’s care were appropriately identified and assessed, and people’s risk assessments gave information on how to mitigate those risks. Staff had a good understanding of risks involved in supporting people and how to provide safe care. The service regularly reviewed risks to people. Staffing rotas demonstrated the service had sufficient staffing levels to meeting people’s individual needs and people, relatives and staff confirmed this. People received safe medicines support. The service kept accurate records of medicines administered by staff that were well trained. The service was clean and met health and safety, fire safety and infection control requirements.

People were happy with the food and choices offered at the service and their nutrition and hydration needs were met. Staff kept detailed daily care records on how people were supported with their food and fluid intake. The service worked closely with various health and care professionals to support people with their health and care needs. People were supported to access GP services.

The service followed safe recruitment practices. Staff received induction and refresher training, and records confirmed this. Staff received regular one-to-one supervisions and yearly appraisal.

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.

People and their relatives told us staff were kind and caring and listened to their needs. Staff recognised people’s need to remain independent and encouraged and supported them wherever possible to remain independent.

People

We inspected George Mason Lodge on 18 and 25 May 2016. This was an unannounced inspection. At the last inspection in July 2013 the service was found to be meeting the regulations we looked at.

George Mason Lodge is a residential home that provides care for up to 39 older people some of whom may be living with dementia. There were 35 people using the service when we visited.

There was a registered manager at the service at the time of our inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

People had missed doses of their prescribed medicines, which may have affected their health and well-being. The arrangements for ordering medicines for people were not always robust. Medicines records were not always completed fully and accurately and we were not assured that appropriate arrangements were in place for the recording, using and safe administration of some medicines. Individual risk assessments were in place for people, to help protect them from harm. However, the assessments and care plans were not always comprehensive.

We found the provider had not sent us any statutory notifications for people authorised for Deprivation of Liberty Safeguards (DoLS) and people who had died. You can see what action we have asked the provider to take at the end of this report.

The service had appropriate systems in place for safeguarding people. Risk assessments were in place which provided guidance on how to support people safely. There were enough staff to meet people’s needs.

Staff were well supported, received training and one to one supervision. People were able to make choices about most aspects of their daily lives. People were provided with a choice of food and drink and supported to eat healthily. People had access to health care professionals and were supported to lead healthy lifestyles.

People and their relatives told us they liked the staff. We saw staff interacting with people in a caring way and staff had a good understanding of how to promote people’s dignity.

Care plans were in place and people were involved in planning the care and support they received. People had access to a wide variety of activities within the community. The provider had appropriate complaints procedures in place.

There was a clear management structure in the home. People who lived at the home, relatives and staff felt comfortable about sharing their views and talking to the registered manager if they had any concerns. Staff told us the registered manager was always supportive.

We were informed by the manager that people who use this service like to be called residents.

Due to their needs, many residents that we met during our visit were unable to share their views about the standards of care. The views of residents who were able to comment on their experience can be summarised as follows. “The staff are very good”,” The staff are kind” and “staff look after me well”.

Comments from residents were generally positive, indicating that staff were kind and helpful in meeting their care needs.

We spoke to a relative and they thought the care and support being given to residents was good.

We observed staff were aware of people’s preferences and routines so they could support people in their daily lives. For example they knew at what time people preferred to eat and what time they went to bed or got up.

Most of the staff had worked at the home for a number of years and knew the residents very well.

During the course of the inspection we saw staff interacting sensitively with the residents. Staff knocked on residents doors before entering their room and asked the residents if it was alright to go in.

Although some residents may not always be able to understand the treatment, care and support options available to them their views were taken into account in the way the service was provided and delivered.

When we visited the home was being refurbished and we were informed the work was due to be completed in August 2013.

People told us they felt safe. We found the service had an adequate safeguarding procedure in place to ensure the safety of people who used the service from the risk of abuse.

People had their needs assessed and their care files were reviewed on a monthly basis to ensure these needs were being met. One person we spoke with told us the care was "very good."

People who used the service and their relatives were involved in making decisions about their care and treatment. People were treated with respect and dignity by staff. People we spoke to told us staff treated them with respect and they were called by their preferred names.