This inspection took place on 24 and 26 April 2018 and was unannounced.

At the last inspection on 15 February 2017 the service was rated Requires Improvement. Following the last inspection, we asked the provider to send us an action plan to show what they would do to improve the key questions Safe, Responsive and Well-led.

Jennifer’s Lodge is a residential care home for older people with mental health needs and dementia. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The care home accommodates six people in one adapted building. At the time of the inspection there were six people living at the home.

The premises is laid out over three floors. Communal areas included a lounge, dining room, kitchen and a separate laundry area. There are shared communal bathrooms that are suitably adapted. At the rear of the home is a large garden that is accessible through patio doors.

The service had a registered manager who was available on both days of the inspection. 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.

Although the systems were in place to safeguard people from abuse and the correct action taken, the Care Quality Commission (CQC) had not been notified of an allegation of abuse when this had occurred. Sufficient guidance was in place about the actions staff needed to take to make sure risks were safely managed.

A routine fire safety inspection had been carried out in the service and the provider agreed to send us a plan of action. Health and safety checks had been carried out on the premises.

People received their medicines when this was needed and staff had received training on the safe management of medicines.

There were enough staff deployed to work in the service who had been suitably recruited. Training was available for staff to ensure they had the skills and knowledge to provide effective care for people. Staff had received regular supervision and appraisals.

People gave us positive feedback about the quality of the food. They were provided with sufficient food and drink; however, menus were not displayed during mealtimes so people could choose what foods they would like to eat. Information was not available in an easy read format so they could better understand the services they received.

Routine visits were carried out by health practitioners to offer advice and treatment for people to meet their medical needs.

People and their relatives told us staff were kind and caring and their privacy was respected. Advocacy services were accessible to ensure people had their views heard.

Systems were in place to monitor complaints and informal complaints that were raised had been resolved. The provider had discussions with people about end of life care and documented their advanced decisions in line with their wishes.

The CQC is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) and to report on what we find. Although the service was meeting these requirements, they had not notified the CQC where a person's liberty was restricted in their best interests.

People were supported to maintain positive relationships with their relatives and friends. They were provided with opportunities to participate in a programme of activities. People’s cultural and spiritual needs were met and their care plans were personalised to meet their assessed needs.

People’s feedback was sought about the quality of care. Checks were carried out and audits undertaken to monitor how care was being de

Jennifer’s Lodge provides accommodation, care and support for up to six older people. Some of whom have mental health needs, physical health needs or dementia. At the time of our inspection six people were using the service.

We undertook an unannounced inspection of this service on 15 February 2017. At our previous inspection on 26 March 2015 the service was rated Good. At this inspection, we found three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 that relates to safe care and treatment, fit and proper persons employed and good governance. You can see what action we have told the provider to take at the back of the full version of this report.

The service has a registered manager. 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.

There were no effective systems to assess and monitor the quality of service provided as concerns about the service had not been identified and resolved. We also found that records were not always maintained, updated and clear. Records relating to day to day care provided to people were not completed for the three weeks period before our inspection.

Risk assessments were not comprehensive to ensure risk associated with the care of people and their well-being were identified and action plan put in place to reduce such risks. Health and safety checks such as the weekly fire alarm and emergency lights test were not conducted to ensure they were functioning properly to keep people safe. There was a fire risk assessment in place. People had personal emergency evacuation plan in place for staff to follow in the event of an emergency.

The system for managing people’s finances was not robust at protect them from the risk of financial abuse. Records of financial transactions for people were not clearly documented to clearly show money received, money spent and balance. There was also no system to check and audit the account regularly so as to identify discrepancies in the account.

Recruitment checks were not fully completed for some staff. We found that references were not always obtained from volunteers. There was also no personnel file set-up for them to show who worked at the service, their experience, professional trainings and qualifications.

People were supported to had their individual needs and preferences met. Staff were aware of people’s support needs and what they were able to do independently. Staff communicated with people using the methods they understood. People were encouraged and supported to access the community and participate in activities of their choice.

Staff were knowledgeable about safeguarding adult procedures. Staff knew how to report concerns and how to escalate any concerns if not addressed by their manager.

Medicines were handled and administered safely. Staff understood the organisation’s medicines procedure and followed it to ensure people received their medicines safely and in line with good practice. People were supported to eat and drink to meet their dietary and nutritional requirements.

There were sufficient numbers of staff on duty to meet people’s needs safely. Staff understood their responsibilities within the Mental Capacity Act 2005. Staff were supported through effective induction, supervision, appraisal and training to provide an effective service to people.

The service worked with social care and health care professionals. People were supported to arrange appointments to ensure their health needs were met. Staff followed the instructions and recommendations given to them by professionals to ensure people’s needs were met.

People, their relatives and staff were encouraged to provide feedback and to raise concerns. The regis

Jennifer’s Lodge provides accommodation, care and support to up to six older people. Some of whom have mental health needs, physical health needs or dementia. At the time of our inspection six people were using the service.

We undertook an unannounced inspection of this service on 26 March 2015. At our previous inspection on 6 January 2014 the service was meeting the regulations inspected.

The service has a registered manager. 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 were provided with an individually tailored service that met their needs. Staff were aware of people’s support needs and what they were able to do independently. Staff spoke with people to identify their hobbies, interests and wishes, and supported them in line with their preferences. People were encouraged and supported to access the community and participate in activities.

Risks to people’s safety were identified and people were supported to maintain their welfare and safety. Staff were knowledgeable about safeguarding adults procedures, and would escalate any concerns they had to their manager and the local authority as necessary.

Staff liaised with other healthcare professionals as required to maintain a person’s health and provide them with any specialist care and support they required. People safely received their medicines in line with their prescription.

Staff received regular training to ensure they had the knowledge and skills to meet people’s needs. Staff were supported by their manager and received supervision to reflect on their performance and support them with any areas of their role they found challenging.

The registered manager undertook reviews of the quality of service provision, which included checks on the medicines management process and people’s care and support to ensure people were provided with high quality care. The registered manager used feedback to further improve the quality of care delivery.

People who used the service were treated with respect and were involved in all aspects of their care, treatment and running the home. The manager said "It's their home and they have a right to know and have their views listened to."

We found people who used the service had their care needs assessed and reviewed and professional guidance was sort when required. This ensured peoples care and treatment was delivered in a way they wished and ensured their safety and welfare.

We saw from speaking to staff and checking staff records, they were given the opportunity to develop their professional skills and to obtain further relevant qualifications. The manager said they encouraged staff to develop further skills as this helped them provide good care to people who used the service.

We checked a variety of records relating maintenance of the home. All the records we saw including those relating to people who used the service were clear and well-kept and relevant.

People we spoke with who use the service said they knew there was a care plan for them, and that we could examine it if we needed to as part of the inspection. They said that they do speak with the staff when they need things to be done differently and that they were listened to.

Overall, the feedback we received from people who live at the home was very complimentary about the way staff respected their rights and encouraged them to get involved in the running of their home. They said that staff knew what care was needed and that they do things the way people who use the service want them to.

People told us staff always enabled them to express their views and respected their privacy and dignity. Three people who live at the home said the staff are really good and ask about their care and how they like it to be done. They said that staff knew what they are doing and that they feel safe in the home. We observed staff to be respectful when speaking with one person about taking medication, reminding them and explaining what it was for. Three people told me that the food is good and that they were asked about activities they would like to do such as going out to the shops and church visits.

These comments were reflective of the overall comments we received from the people who live at the home to whom we spoke.

People confirmed that the care and support they received met their needs, and was 'alright'. One person told us, "The staff are very good." Another person told us, "I prefer a small home like this to a large home."

We observed that people gave their verbal consent to receive care and support, and members of staff took time to explain and discuss their care and support needs.

Medicines were appropriately managed and the premises were suitably maintained. The provider met legal requirements relating health and safety and insurance. However some improvements were needed in the fire safety arrangements.

Staff with appropriate qualifications, skills and experience were employed and their background was checked to safeguard people from unsuitable workers.

People confirmed they knew how to make complaints. However, we found that the comments and complaints book, which was located in a communal area, held information that identified individuals concerned, so did not ensure their privacy was protected.