About the service: Leah Lodge is a residential care home that was providing personal and nursing care for up to 48 older people, some of whom were living with dementia. At the time of our inspection there were 33 people using the service.

People’s experience of using this service:

• People told us they felt safe using the service.

• The provider had appropriate risk assessments in place with guidance for care staff mitigating these.

• The provider supported people to take their medicines safely.

• The provider maintained a clean and tidy home.

• The provider met people’s nutritional needs and people told us they liked the food on offer.

• People were supported with their physical and mental health needs and care records contained information on these.

• People gave good feedback about their care workers and told us they were kind and caring.

• People’s choices were respected in relation to their care and care staff supported people to be as independent as they wanted.

• People’s privacy and dignity was promoted.

• People’s end of life and complex care needs were appropriately met.

• People told us they were involved in the formulation of their care plans.

• The provider had an appropriate complaints procedure and people told us they would feel comfortable raising a complaint if needed.

Rating at last inspection: Requires Improvement. (report published 20 February 2018).

Why we inspected: This was a planned comprehensive inspection based on the rating at the last inspection. The previous inspection was a comprehensive inspection.

Follow up: Going forward we will continue to monitor this service and plan to inspect in line with our re-inspection schedule for those services rated Good. We may inspect sooner if any concerning information is received.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

This inspection took place on 19 and 20 December 2017 and was unannounced.

Leah Lodge Care Home is a ‘care home’. 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.

Leah Lodge Care Home is registered to provide care to up to 48 older people, some of whom were living with dementia. 18 people were using the service at the time of our inspection and two were in hospital.

The service has recently been refurbished. Bedrooms are located over three floors and are single occupancy with en-suite facilities. The ground floor is occupied by people who are elderly and the second floor with those living with dementia. The bedrooms on the first floor were not occupied at the time of our inspection. The provider was in the process of making new admissions to the home. There are several communal areas, a café, and hair salon and spa baths for people to use. There is a dining area and sitting room located on each floor and quiet areas where people can sit with their families or alone if they wish to do so. The building and accommodation are wheelchair accessible and there is a passenger lift. The service has three small gardens and the environment appeared well maintained, bright and welcoming.

The service had a registered manager who was also a general manager of the home. 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 who had complex needs were at risk of receiving care and treatment that was not responsive to their needs. Staff did not have sufficient knowledge and skills required to provide care to people at the end of their lives and those enduring a decline in their health because of dementia.

People were supported in line with the requirements of the Mental Capacity Act 2005 (MCA) and the restrictions placed on them by a supervisory body under the Deprivation of Liberty Safeguards (DoLS). Staff understood their responsibility to obtain people’s consent before providing care. However, records did not always show when consent had been given and where best interests decisions had been made. People who were unable to make decisions about their care were supported by their relatives where appropriate and health and social care professionals.

Staff maintained records of the care they provided to people. However, information about people’s daily lives did not always provide sufficient detail of the impact of the care and support being provided.

Appropriate quality assurance checks and audit systems were in place. However, had not been effective in identifying and resolving the shortfalls we identified about care provision at the service.

People were supported by staff who underwent regular supervision and a review of their practice. Staff had attended the provider’s mandatory training to enable them to undertake their roles.

People’s needs were met in a safe and timely manner because risks to their health and well-being were identified and managed. People received the support they required to take their medicines.

A sufficient number of suitably skilled staff were deployed at the service. New staff underwent appropriate recruitment checks before they started to provide care and support.

People were protected from the risk of harm because staff knew how to identify and report potential abuse. Staff minimised the spread of infection by following good hygiene practices. Incidents and accidents were monitored at the service to help staff in learning from mistakes.

People’s nutrition and hydration needs were met. People had meal choices that took into account their pr