The inspection took place on the 24 November 2016 and was unannounced.

Lennox Lodge provides accommodation and personal care for up to 30 older people. On the day of our inspection there were 24 people living at the home.

There was a new manager at the home who was completing the process of registering with The Care Quality Commission. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered providers and registered managers 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 and their relatives said they were happy with the support staff provided. They told us staff were caring and promoted people’s independence. People told us they were able to maintain important relationships with family and friends. We saw people had food and drink they enjoyed and had choices available to them, to maintain a healthy diet. They were supported in a discreet and dignified way. People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage them. People told us they had access to health professionals as soon as they were needed.

Relatives we spoke with said they felt included in planning the support their relative received and were always kept up to date with any concerns. People living at the home were able to see their friends and relatives as they wanted. They knew how to raise complaints and felt confident that they would be listened to and action taken to resolve any concerns. The manager had arrangements in place to ensure people were listened to and action could be taken if required.

Staff we spoke with were aware of how to recognise signs of abuse, and systems were in place to guide them in reporting these. They were knowledgeable about how to manage people’s individual risks, and were able to respond to people’s needs. Staff had up to date knowledge and training to support people.

We saw staff treated people with dignity and respect whilst supporting their needs. They knew people well, and took people’s preferences into account and respected them. Staff respected people's rights to make their own decisions and choices about their care and support. People's permission was sought by staff before they helped them with anything. When people did not have the capacity to make their own specific decisions these were made in their best interests by people who knew them well and were authorised to do this.

Staff met people's care and support needs in the least restrictive way. When it was identified that people received care and support to keep them safe and well which may be restricting their liberty applications had been made to the local authority for authorisation purposes.

The manager promoted an inclusive approach to providing care for people living at the home. People who lived at the home and staff were encouraged to be involved in regular meetings to share their views and concerns about the quality of the service. The provider and manager had systems in place to monitor how the service was provided, to ensure people received quality care.

One inspector carried out this inspection. The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well-led?

Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at. We spoke with four people who lived at the home, three relatives who were visiting, and four members of staff. We also spoke with a GP and the hairdresser.

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

This is a summary of what we found

Is the service safe?

We found that the environment was safe, clean and hygienic. The home was bright and airy and the corridors were uncluttered and well lit. Medicines and cleaning equipment were all kept in locked cupboards. We looked at a number of care plans and found that they contained the relevant information about lifestyle, medical history and assessments of risk. Accidents and incidents were reported and appropriate action was recommended to improve safety.

There were sufficient appropriately trained staff on duty and we witnessed a helpful handover between their shifts.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While no applications have needed to be submitted, proper policies and procedures were in place. Staff had been trained to understand when an application should be made, and how to submit one.

Is the service effective?

The home had systems in place to assess and manage risks and to provide safe and effective care. The staff were appropriately trained and training was refreshed and updated regularly. Staff could also take the opportunities provided to study for additional qualifications and to develop their understanding of caring for people with conditions such as dementia and Parkinson’s disease. We also found evidence of staff seeking advice, where appropriate, from the GP or social services.

Is the service caring?

People told us that “the home is very friendly and everyone wants to help”. One relative we spoke with said “it is homely and not at all clinical”. We spoke with relatives who said they were able to visit at any time and they were “made to feel very welcome”. We saw that the staff were kind and sensitive and took time with people over lunch and when they were moving about within the home. We observed high levels of respect and people were treated with consideration and dignity.

We spoke with two people who were living in the home and both were positive about the care they received. One said ‘the carers are excellent, all of them are lovely; I can’t fault them."

Is the service responsive?

People’s needs were assessed before they moved into the home and detailed care plans and risk assessments were maintained and reviewed regularly. We saw that the staff monitored weight, nutrition and hydration and handover sessions were helpful and informative. Call bells were answered according to the home’s procedure and people had access to a programme of activities.

They were able to choose dishes from the menu and the chefs were happy to provide for special diets and additional options as requested. People living in the home also engaged with the manager and staff at regular meetings where they could express their views about all aspects of life at the home. They told us that their feedback was acted upon by the manager.

Is the service well-led?

People told us they were asked for their feedback on the service and their feedback was heard and changes were made as a result. One person had asked for a particular cake with the afternoon tea and that had been provided. We saw copies of the questionnaires completed by the people living in the home, their relatives and other healthcare professionals. We saw that incidents and accidents were reported and appropriate action was taken to prevent a repetition. The manager conducted a series of internal audits and took action promptly to resolve any issues.

There were 25 people living at the home on the day of our inspection.

We spoke with ten people and seven staff. One person told us, “The staff are really very good, very supportive.”

We found that people were shown respect and dignity. There was a range of activities for people to engage with.

We looked at three care plans and saw that they reflected the care that was provided to people. The home had systems in place to ensure people’s individual needs were met.

We found the found to be clean and tidy. One person told us, “My room is cleaned regularly.”

The home had effective staff recruitment systems in place.

The home had an effective complaints system. People we spoke to were aware of how to make a complaint.

We talked with eight people who spoke positively about the home and staff. They said that staff discussed and explained things to them about their care and support. Records viewed indicated that changes in peoples needs, were discussed with them.

Records viewed indicated that staff were appropriately recording incidents and accidents and, in discussion, they demonstrated an awareness of their safeguarding responsibilities.

We viewed all areas of the home. We checked that all outstanding improvement works had been completed. We found the home was maintained to a good standard, and records viewed supported this.

We spoke with three staff in addition to the manager. Staff confirmed they received some supervision. However, records viewed indicated supervision was primarily used to review individual training needs. Staff said their training was kept updated and records viewed supported this.

Staff reported that communication was good and they were kept updated through several sources. Staff meetings were held approximately twice per year, more if needed. One staff member commented the home was a happier place to work. They said the support and structure for staff had improved since the appointment of the new manager.

Auditing and monitoring systems had been introduced to highlight and address shortfalls. People in the home, relatives and other professionals were routinely asked for feedback, and any issues were addressed on an individual basis.

People we spoke with told us that they were very happy living at the home. They spoke positively about the kindness and compassion of staff, and said they enjoyed their environment and the food they received. We observed people making good use of all the communal spaces in the home and the garden during our visit.