This comprehensive inspection was carried out on 15 November 2018. The inspection visit was unannounced.

K Lodge is a residential care home situated in Rushden, Northamptonshire. The home provides accommodation and personal care for up to 40 older and younger adults, including people with learning and physical disabilities and people living with dementia. On the day of our inspection 32 people were using the service.

At the last Care Quality Commission (CQC) inspection, the service was rated Good in all domains.

At this inspection we found the ratings under ‘Safe’ had changed to requires improvement. The overall rating remains Good.

Policies and procedures were in place for controlling the risks of infection. However, arrangements for keeping the home in a clean and hygienic state did not always follow best practice infection control guidance. At weekends care staff were required to attend to cleaning and laundry tasks. This had the potential to overstretch care staff, and negatively impact the quality of care provided for people and diminish standards of hygiene throughout the service. Following the inspection, the provider arranged for housekeeping staff to work weekends and confirmed they were recruiting an additional member of care staff to ensure sufficient cover was provided during evenings and weekends. The changes to the staffing arrangements now need embedding into practice.

People were encouraged to personalise their bedrooms. There was an on-going programme of refurbishment of the premises including the replacement of worn fittings and furnishings. The service provided care for people living with advanced dementia and visual impairments. The environment lacked features to help people negotiate the environment, to aid remaining capacity, and enable people to independently orientate themselves around the building.

We have made a recommendation about the provider seeking information on creating dementia friendly environments, based on current best practice.

Since the last inspection a new registered manager had been appointed and their application to register with the Care Quality Commission was completed in September 2018. 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 and associated Regulations about how the service is run.

Staff received training to enable them to recognise signs and symptoms of abuse and they knew how to report abuse. People had risk assessments in place that were regularly reviewed. Accidents and incidents were closely monitored and when things had gone wrong lessons were learned and communicated to staff to further improve people’s safety and welfare. People’s medicines were safely managed.

Effective recruitment processes were practiced, and staff received induction training and on-going training. The staff received support through regular supervision meetings and team meetings.

People were supported to make decisions about all aspects of their life; this was underpinned by the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. Staff were knowledgeable of this guidance and correct processes were in place to protect people. Staff gained consent before supporting people. People were supported to maintain good health and nutrition.

People had positive relationships with staff. The staff were caring and treated people with respect, kindness and courtesy. They knew people well, and where people had the capacity they are involved in the planning of their care and support.

Care plans were developed with people and their families, to identify what support they required and how they wanted their care to be provided. People participate in activities to keep them active and entertained. People knew how to complain and there was a complaints procedu

K Lodge is a residential care home that provides accommodation and personal care for up to 34 people. At the time of our inspection, the service was caring for 28 people. At the last inspection in August 2015, the service was rated Good. At this inspection we found that the service remained Good.

People continued to receive care that was safe. We saw that staff had been appropriately recruited in to the service and security checks had taken place. There was enough staff to provide care and support to people to meet their needs. People were consistently protected from the risk of harm and received their prescribed medicines safely.

The care that people received continued to be effective. Staff had access to the support, supervision, training and on-going professional development that they required to work effectively in their roles. People were supported to maintain good health and nutrition.

People told us their relationships with staff were positive and caring. We saw that staff treated people with respect, kindness and courtesy. People had detailed personalised plans of care in place to enable staff to provide consistent care and support in line with people’s personal preferences. People knew how to raise a concern or make a complaint and were confident that if they did, the management would respond to them appropriately. The provider had implemented effective systems to manage any complaints that they may receive.

The service had a positive ethos and an open and honest culture. The registered manager and the care manager were present and visible within the home. People, their relatives and other professionals told us that they had confidence in the management to provide consistently high quality managerial oversight and leadership to the home.

K Lodge is registered to provide accommodation and personal care for up to 34 elderly people. The home is situated in a residential area of Higham Ferrers, near Rushden, Northamptonshire. At the time of our inspection the service was providing support to 31 people, with a range of needs.

We carried out our unannounced comprehensive inspection on 11 August 2015. After that inspection, we had received concerns in relation to the care people were receiving. As a result we undertook a focused inspection to look into those concerns. This report only covers our findings in relation to this topic. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for K Lodge on our website at www.cqc.org.uk”.

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.

Staff treated people with kindness, dignity and respect and spent time getting to know them and their specific needs and wishes. People felt that they were able to develop positive relationships with staff members.

People were involved in their own care planning and were able to contribute to the way in which they were supported. Care plans reflected people's individual likes, dislikes, personal history and preferences.

The staff responded to people's individual needs, as and when required. People received the care and support they needed in a timely manner.

The service had a complaints procedure in place to ensure that people and their families were able to provide feedback about their care and to help the service make improvements where required. The people we spoke with knew how to use it and were confident that they would be responded to in a prompt manner.

K Lodge is registered to provide accommodation and personal care for up to 34 people. The home is situated in a residential area of Higham Ferrers, near Rushden, Northamptonshire. At the time of our inspection the service was providing support to 29 people, with a range of needs.

The inspection was unannounced and took place on 11 August 2015.

The registered manager of the service had left the day before our inspection. A new general manager had been appointed and we were advised that plans were in place for someone to register with the Care Quality Commission. 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 felt safe because of the care and support they received from staff.

Staff were knowledgeable about the risks of abuse and knew how to respond appropriately to any safeguarding concerns to ensure people’s safety and welfare.

Risk assessments identified hazards which people may face and provided guidance to staff to manage any risk of harm.

People were cared for by sufficient numbers of well trained staff who were recruited into their roles safely. Staff had undergone appropriate checks before commencing their employment.

Suitable arrangements were in place for the safe administration and management of medicines.

Staff received on-going training and supervision which enabled them to provide appropriate care to people.

Staff were aware of their responsibilities under the Mental Capacity Act 2005 (MCA 2005) and the Deprivation of Liberty Safeguards (DoLS) codes of practice.

Mealtimes were relaxed and the food served was nutritious; people had a variety of choice and were given support when required.

People were supported to see health and social care professionals as and when required and prompt medical attention was sought in response to sudden illness.

People were happy with the care they received and told us that staff were kind and caring and listened to them.

Staff understood people’s privacy and dignity needs. They knocked on people’s doors before entering rooms and asked people discreetly if they needed to go to the bathroom.

Members of staff were able to describe to us the individual needs of people in their care and worked hard to ensure they received their preferences, choices and wellbeing.

People’s care plans were based upon their individual needs and wishes. Care plans contained detailed information on people’s health needs, preferences and personal history.

People were encouraged to raise any concerns they had about the quality of the service they received, complaints were taken seriously and responded to appropriately.

Quality assurance systems were carried out to assess and monitor the quality of the service. The views of people living at the home and their representatives were sought.

Before this inspection we, the Care Quality Commission, (CQC) received some information of concern regarding infection control and staff working at K Lodge who were inexperienced and not trained.

This inspection was carried out in response to these concerns.

We considered all the evidence we had gathered under the outcomes we had inspected to answer questions we always ask; Is the service safe? Is the service effective? Is the service caring? Is the service responsive? 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 who used the service, their relatives, the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

People were being cared for in an environment which was clean and hygienic. People’s needs had been assessed on admission to the home and risk assessments were in place.

Is the service effective?

It was clear from our observations that staff had a good understanding of the needs of the people who used the service. We found that care plans were written in a ‘person centred’ style which reflected people’s personal needs and preferences.

Is the service caring?

One person who used the service told us “They are very nice girls; you can have a laugh with them”. We observed positive interactions between staff and people who used the service. Staff showed patience and understanding and encouraged people to be as independent as possible.

Is the service responsive?

People’s care plans were reviewed and updated monthly or more regularly if required.

Is the service well led?

Records showed that staff had attended training and were supported with regular supervisions by the manager. There was a registered manager in post.

We spoke with people who used the service, their relatives and care staff.

People who used the service told us that they were well looked after and happy with the service received. They were positive about the staff that supported them.

We found that staff were attentive and had a caring attitude towards the people who used the service. One visitor we spoke with said, ‘’My relative receives care with love and affection, they treat all residents like family.’’

The care records we looked at showed that people had been assessed before they began to use the service. People who used the service had a care plan in place which described the support they needed and how care staff would provide this support.

Care staff received the support they needed to enable them to meet the needs of the people who used the service. One staff member we spoke with said, ‘’The management is very supportive of our training needs. I have just commenced a nine month training course that will lead to a diploma in dementia care.’’

There were systems in place to monitor the quality of the service.

At the time of this visit the provider told us that they had stopped providing domiciliary care service and supported living service to people that lived in their own homes although they were registered to provider this service. We have asked the provide to deregister this service with the CQC if they no longer intend to provide this service.

There were 25 people living at K Lodge when we visited on 1 August 2012. We spoke with one person living at the home and three relatives about their experiences.

One person said they were happy with the level of care they received. They said they would give the care staff, “top marks in everything”.

A relative said they, “couldn’t ask for a better home”. Another said they “couldn’t have picked anything better.”

Some of the people living at the home had complex needs, which meant they were not able to tell us their experiences. We used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.

The content of this report is based on information available on the day of the inspection visit on 1 August 2012.

People we spoke to during the review all said that they were satisfied with their service.

People we spoke to who did not have a dementia were able to confirm that they had been and are always consulted about how their care is provided. Other people with a dementia were not able to make comments about this aspect of their care.

During our visit people said that their care was adequate and that staff were helpful. It was difficult to establish the views of people that had a dementia. Relatives of one person using the service said that they were happy with the care of their relative since the person using the service had moved in.

Several people confirmed that the menu was adequate, but it lacked choice. The majority of meals were well cooked, but it depended on who was in the kitchen. There is always plenty to eat.

People who were able to respond said that they felt safe living at Kings Lodge, but told us that they had witnessed other people who lived there falling over. Most people were unable to confirm whether they were invited to comment about the service they received. Others were new to the service and had not so far been involved in the review process.