The inspection of Heywood Lodge took place on 2 March 2017 and was unannounced. At the last inspection on 15 December 2015, the service met all but one of the regulations we assessed under the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At that inspection the service was rated 'Requires Improvement' in safe because the registered provider was in breach of Regulation 19 HSCA RA Regulations 2014 Fit and proper persons employed. This was because the registered provider had not had not protected people against the risks of employing people without appropriate checks relevant to their employment.

Heywood Lodge provides accommodation and personal care for up to seven older people, on the day of inspection there were four people using the service.

A registered manager was 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. The registered manager was also the provider.

At this inspection the registered provider had made sufficient improvements to show they were no longer in breach of any of the regulations and had the necessary employment checks in place.

People told us they felt safe and secure in a homely environment. Arrangements were in place to protect people from risk of abuse. Staff had knowledge of safeguarding procedures and were aware of their responsibilities for reporting any concerns.

There were sufficient numbers of staff with the relevant skills and knowledge to meet people’s needs. The service had retained a strong core team of staff who knew people at the service well.

Individual needs and requests were responded to promptly, and people told us there were enough staff available to meet their care needs.

Suitable arrangements were in place for managing and administering medicines. Stock was well organised and regular audits of medicines were carried out to ensure systems were being followed correctly.

Feedback on the quality of food provided was extremely positive from both people who lived at the home and relatives. People were happy with the variety, quality and choice of meals available to them. People's nutritional needs were addressed and monitored.

Care plans were in place for people who lived at the service. Care plans covered support needs and personal wishes. People and relatives said they were involved in the care planning process. Plans were reviewed and updated at regular intervals.

Staff were caring and had good relationships with people and were attentive to their needs. People’s privacy and dignity was respected at all times.

The registered provider had good oversight of the service and monitored the standards effectively.

We have made a recommendation to the provider related to their responsibilities about notifications.

The inspection was completed on 11 December 2015 and there were six people living at the service when we inspected.

Heywood Lodge provides accommodation and personal care for up to seven older people and people living with varying degrees of dementia.

A registered manager was 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.

Recruitment procedures were not thorough so as to ensure that staff underwent the appropriately checks and processes before being offered employment at the service.

People and their relatives told us the service was a safe place to live. Staff understood the risks and signs of potential abuse and the relevant safeguarding processes to follow, so as to keep people safe. Risks to people’s health and wellbeing were appropriately assessed, managed and reviewed.

There was sufficient staff available to meet people’s care and support needs. Staff were able to demonstrate a good understanding and knowledge of people’s specific support needs, so as to ensure their and others’ safety and wellbeing.

Medicines were safely stored, recorded and administered in line with current guidance to ensure people received their prescribed medicines to meet their needs. This meant that people received their prescribed medicines as they should and in a safe way. People told us that their healthcare needs were well managed.

Staff received opportunities for training and this ensured that staff employed at the service had the right skills to meet people’s needs. Staff demonstrated a good understanding and awareness of how to treat people with respect and dignity.

The dining experience for people was positive and people were complimentary about the quality of meals provided. People who used the service were involved in making decisions about their care and support. The registered manager understood and complied with the requirements of the Mental Capacity Act 2005 (MCA) and the associated Deprivation of Liberty Safeguards (DoLS). Staff were aware of their role in relation to MCA and DoLS and how to support people so not to place them at risk of being deprived of their liberty.

Care plans accurately reflected people’s care and support needs and people received appropriate support to follow their personal interests and have their social care needs met.

People told us that if they had any concern they would discuss these with the management team or staff on duty. People were confident that their complaints or concerns were listened to, taken seriously and acted upon.

The service had a positive culture that was person centred, open and inclusive. Although quality assurance systems were not formally completed the registered manager demonstrated that they were aware of all aspects of the service and knew the people who lived there, and the staff supporting them, well.

When we visited Heywood Lodge we found that people's care and support requirements had been assessed prior to them living there, to ensure that the provider could meet their needs. Care plans had been written in a personalised way, reviewed regularly and contained health care information, personal preferences and risk assessments.

One person spoken with said, "I am very happy here. It has been wonderful for me. All my washing and ironing is done and the staff are kind and caring."

The provider had effective infection control procedures. People's rooms were clean and tidy and staff wore personal protective equipment to keep them safe. The kitchen area was hygienic and maintained to a good standard. Hot food temperatures were monitored as were the operating temperatures of the fridge and freezer.

Medicines were managed and administered safely and in line with published guidance. There were ready supplies of medication and this was stored securely. Only qualified staff were permitted to administer medication. Reviews of medication took place by a GP every six months to ensure treatments were effective.

Staffing levels had been maintained to ensure that the care and treatment needs of the people living there were being met on a daily basis. Staff were appropriately trained, qualified and experienced.

The provider had an effective complaints policy in place that was made available to people in leaflet form. There had been no complaints made since our last visit.

The people we spoke to were very happy living at Heywood Lodge. They told us that it was a happy home with good owners. They also told us that they were listened to, the staff were kind and considerate, they had choice in their day to day lives and felt safe and well cared for.

We found that the care provided at the home was in line with people's needs and that the staff were generally well trained and supervised to provide the care and support people required. The provider had systems in place to monitor the standard of care provided, primarily through feedback from the people living in the home and visiting professionals.

People living at Heywood Lodge told us that they felt well treated. They said that the home had given them good information about the service before they moved in. People told us that they had discussed their wishes on a daily basis as the owner/manager was always available. They said that a full assessment of their needs had been carried out before they moved in.

People told us that they were often asked if they needed anything done differently and if they were happy with their care. They said that the food was good and that they were given a choice of meals. They told us that staff frequently asked them if they wanted something different to the meal offered. They said that the meals were plentiful and that they could always have more if they wanted it.

People said that they felt safe living in Heywood Lodge. They told us that the staff treated them well and were on hand whenever they needed them. They said that the staff gave them their medication and that they were happy for them to do so. People appeared very relaxed and happy in the company of the owner/manager and her staff.

People said that they were happy with their rooms. They told us that they contained everything they needed and that they had been able to bring some personal items from home if they had wished. They said that they liked the staff and that they were all very nice. They told us that they thought that the staff knew what they had to do to meet their needs.

People told us that they talked with the owner/manager every day. They said they felt able to ask them anything about the home and to have their say on how it was run. One person told us that they were very happy living at Heywood Lodge and that the owner/manager made sure that they did everything they could for them.