The inspection took place on 5 October 2017 and was unannounced.

Hatfield Lodge is a large detached house in a quiet residential area. It provides care and support for up to 34 older people some of whom are living with dementia. There were 29 people living at the service when we inspected.

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. This is the first inspection since a change of registration for the provider in October 2016.

People and their relatives told us they felt safe at the service. Staff had received training about protecting people from abuse and understood their responsibilities in reporting any concerns. Staff were confident that the registered manager would address any concerns reported to them. Risks to people were identified, assessed and plans were put in place which gave staff the guidance needed to manage and minimise the risks. People's medicines were managed safely and in the way they preferred. People were supported to be involved in managing their medicines if they wished to.

People were supported by staff who had built positive caring relationships with them. There were enough staff to meet people’s needs and keep them safe. Staff were recruited safely and all necessary checks were completed to ensure staff were suitable for their role. Staff told us they received the training and support they needed to do their job. Some staff had begun additional training to become a ‘champion’ in areas such as dignity or dementia. Staff completed a comprehensive induction and competency assessments before supporting people independently.

People were supported to have maximum choice and control of their lives and staff supported people in the least restrictive way possible; the policies and systems in the service supported this. Staff asked for people’s consent before giving support and explained to people what was happening. The registered manager and staff understood how the Mental Capacity Act (MCA) 2005 was applied to ensure decisions made for people without capacity were only made in their best interests. CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care services. These safeguards protect the rights of people using services by ensuring that if there are any restrictions to their freedom and liberty, these have been agreed by the local authority as being required to protect the person from harm.

Staff tailored their support to the needs of each individual, communicating with people in the way they preferred and understood. Staff knew people well, interactions between people and staff were affectionate and relaxed. Staff offered people reassurance and encouragement. People were laughing with staff throughout the day. People could have visitors whenever they liked and were supported to maintain relationships with family and friends.

People told us the food was nice and they always had lots of choice. There was a menu board displayed in the dining room with pictures of the meals on offer that day. When people needed their food in a specific way this was provided. When people needed support to eat their meal, staff offered this in a patient and dignified way. When people were unwell or were living with a health condition such as diabetes, staff supported them to book and attend any health appointments. Any recommendations from health professionals were recorded in the person’s care plan and followed by staff.

People and their loved ones were involved in developing and updating their care plans. People’s care plans were detailed and contained information about their life history, what they could do for themselves and the staff support