The inspection took place on 17 and 23 November 2016 and was unannounced.

Kensington Lodge is a residential care home registered to provide accommodation and care for up to 18 older people with a variety of health needs, including people living with dementia and/or mental health needs. At the time of our inspection, 17 people were living at the home. Kensington Lodge is situated in a residential area of Rustington, with access to the seafront, local amenities and town centre. Except for one shared room, all bedrooms are of single occupancy with the majority have en-suite facilities. Communal areas comprise a large sitting room, quiet lounge and dining area, with easy access to outside space and patio area.

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.

People said they were safe living at the home and staff had been trained to recognise the signs of potential harm and abuse; they knew what action to take. Risks to people were identified, assessed and managed appropriately and were updated on a monthly basis or as needed. Staffing levels were sufficient to meet people’s needs and keep them safe. New staff were vetted before they commenced employment to ensure they were safe to work in a health care role. Medicines were managed appropriately and medication audits and staff competency to administer medicines were carried out.

Staff were trained in a range of areas to provide effective care to people. New staff completed the Care Certificate, a universally recognised qualification. Staff had regular supervision meetings and annual appraisals; they attended staff meetings. Staff had received training in the Mental Capacity Act (2005) and Deprivation of Liberty Safeguards and understood the requirements and their responsibilities to people under this legislation. People were supported to have sufficient to eat and drink and had a choice of food from a menu planned over a four weekly cycle. People had access to a range of healthcare professionals and services. The home had been adapted to meet the needs of people living with dementia.

People were looked after by kind and caring staff who knew them well. Relatives spoke highly of the staff and the management team. People were encouraged to be involved in all aspects of their care. When people became upset, anxious or distressed, staff supported them in a comforting and sensitive manner. People were treated with dignity and respect.

People’s care needs and the support they required from staff were documented in their care plans which were reviewed monthly. Activities were structured and included music and themed activities delivered by external entertainers, as well as activities organised by staff. Advice had been sought from the local authority on meaningful and stimulating activities for people living with dementia. Complaints were investigated, responded to and managed appropriately.

People and their relatives were involved in developing the service and their feedback was obtained through formal questionnaires. Staff were also asked for their views and felt supported by the management team. Quality was integral to the service’s approach and a number of compliments had been received from relatives and friends. A range of audits was in place to monitor and measure the quality of the service overall.

We spent time observing care delivery at Kensington Lodge. We also spoke with visitors and relatives about their perceptions of the care being provided at the home. We saw that staff responded to people’s needs in a kind, gentle and warm manner. There was good rapport between the staff and the people living at the home.

We looked at people’s care records and found that they provided a comprehensive account of the care that had been delivered to people. The records assured us that people were receiving the care they required and that they had good access to external healthcare professionals.

When we observed lunch being served, we saw that staff provided appropriate assistance whilst also encouraging people to do as much as possible for themselves. Lunch looked nutritious, with locally sourced meat and fresh vegetables.

The home was clean. We saw that bedding was freshly laundered and free from stains. We noticed that the clothes people were wearing were clean.

Lavatories and bathrooms were clean and free from unpleasant smells. Waste was disposed of safely and appropriately.

People’s records were well maintained and stored securely. Information that we requested was readily available and presented in a logical and easy to understand format.

We looked at feedback from relatives and saw that is was very positive. The majority of people living at the home were not able to talk to us about their experiences of living at the home but those that could told us that the home was a nice place to live. One person said, “This is a lovely place; the girls are kindness itself. I have to behave myself or they might ask me to move somewhere else. I wouldn’t want that.”

One of the relatives we spoke with told us that they visited regularly and had no concerns about the care and the way staff treated people. They said, “I think it’s a lovely place, not home but the next best thing.”

We had been contacted by a relative of a person who used to live at Kensington Lodge. They raised some concerns about the care people were being provided with at the home. We checked all the things they told us about and did not find any concerns about the issues they raised.

The people using the service had complex needs which meant they were not able to tell us their experiences. We used a number of different methods to help us understand their experience including observations of care and speaking with relatives. We spoke to the relatives of three people. One relative told us, "I have always been pleased with the care here." Another said, "The care is good, they get looked after well."

During our visit we observed care being given during the late morning and lunchtime period in the communal areas. We saw that staff treated people with kindness and patience. Staff were seen to be responsive to people's needs and wishes, treating them with respect as individuals.

We looked at the care records of four people. We saw evidence of up to date risk assessments and care plans based on the individual needs of each person.

We spoke with three members of staff who worked at the home. They all said they liked working there and felt there was always enough staff on duty for them to be able to meet people's needs.

When we looked round the home we saw that it was clean and well maintained. There was a calm and friendly atmosphere.

We spoke with people who used the service during our visit but it was not always possible to get their views on the care they receive due to their age related memory loss. People told us that they liked living at the home and that the staff were kind and patient. We spoke with one relative who said how kind the staff were , they said "it feels like a family" and "nothing is too much trouble".

We undertook observation of care using the SOFI tool during the late morning and lunchtime and found the care given to be appropriate and safe. There was good interaction between the staff and the people living there. We observed that staff responded appropriately to people's requests for support.

The staff we spoke with were happy working at the home. They had received training and were familiar with procedures for safeguarding vulnerable adults from abuse.

Staff were aware of how to respect people's privacy and dignity, however, we found that people's privacy and dignity could not always be respected with regard to using the toilet in their own room. Our review of records showed that people's care was not always planned and delivered in line with their individual care plan. We also had concerns that the premises was not being adequately maintained.

There was an effective complaints system available. People had their comments and complaints listened to and acted on

We spoke with people who use the service during our visit but it was not always possible to get their views on the care they receive due to their age related memory loss. People told us that they were treated well and said that staff were kind. From conversations with people it was clear they felt that were able to make choices in their day to day lives and said that they felt safe.

Relatives of people we spoke with were happy with the care provided to their relatives and said that their privacy and dignity was respected. They confirmed that they were consulted about the care and support their relative receives. They also told us that they knew how to make a complaint if they needed to and were confident that the manager would respond appropriately to any concerns that may be raised.

Family members told us that they were happy with the home and said that they were able to visit whenever they wished and that they were always made welcome by the manager and staff. They told us that they had no concerns about the staff at the home and said staff were kind and caring.

We spoke with staff and they told us that they receive training on a regular basis. Staff told us that they staffing levels were sufficient to meet people’s needs. Staff said that they all worked well together as a team.

We spoke with the community nurse service that visits the home and they told us that they visit on a regular basis. They said that the home was pro-active in contacting them for support and that they followed any advice given. We also spoke with social care professionals who have contact with people and they told us that Kensington Lodge provides a good service for people.