This unannounced comprehensive inspection took place on 9 March 2018.

Little Heath Lodge provides accommodation for people who require nursing or personal care for up to five adults with mental health needs. At the time of our inspection there were three people living at the home. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

At our last inspection of this service on 4 February 2016 the service was rated Good. At this inspection we found the service remained Good. The home demonstrated they continued to meet the regulations and fundamental standards.

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.

The service knew how to keep people safe. The service had clear procedures to recognise and respond to abuse. The registered manager and staff completed safeguarding training. Staff completed risk assessments for every person who used the service with detailed guidance to reduce risks. The service had a system to manage accidents and incidents to reduce reoccurrence.

The service had enough staff to support people. The service carried out satisfactory background checks of staff before they started working. Staff supported people so they took their medicine safely. The service had arrangements to deal with emergencies and staff were aware of the provider’s infection control procedures and they maintained the premises safely.

The service provided induction and training to staff to help them undertake their role. The service supported staff through supervision and appraisal.

People’s consent was sought before care was provided. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and the policies and systems in the service support this practice.

Staff supported people to eat and drink sufficient amounts to meet their needs. Staff supported people to access healthcare services they required.

Staff considered people’s personal choices, general wellbeing and activities. Staff supported people to make day to day life choices and maintain relationships with their family. Staff supported people in a way which was kind, caring and respectful. Staff protected people’s privacy and dignity.

Staff prepared care plans for every person that were tailored to meet their individual needs. Staff reviewed and updated people’s care plans to reflect their current needs.

The service had a clear policy and procedure about managing complaints. People knew how to complain.

The service sought the views of people. Staff felt supported by the registered manager. The provider had an effective system to assess and monitor the quality of the care people received. The service used the audits to learn how to improve and what action to take. The service worked effectively in partnership with health and social care professionals and commissioners.

This unannounced inspection took place on 04 & 05 February 2016. At our last inspection in May 2014 the service was meeting the regulations inspected.

Little Heath Lodge provides care accommodation and nursing care for up to five people with mental health conditions. At the time of our inspection five people were using the service.

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.

The service knew how to keep people safe. The service had clear procedures to recognise and respond to abuse. The manager and staff completed safeguarding training. Staff completed risk assessments for every person who used the service with detailed guidance to reduce risks. The service had a system to manage accidents and incidents to reduce reoccurrence.

The service had enough staff to support people. The service carried out satisfactory background checks of staff before they started working. The service had arrangements to deal with emergencies. Staff supported people so they took their medicine safely.

The service provided induction and training to staff to help them undertake their role. The service supported staff through quarterly supervision and yearly appraisal.

The manager considered to have mental capacity for every person who used the service. At the time of inspection no one was subject to continuous control and supervision and people could leave the service.

Staff supported people to eat and drink sufficient amounts to meet their needs. Staff supported people to access healthcare services they required and monitored their healthcare appointments.

Staff considered people’s personal choices, general wellbeing and activities. Staff supported people to make day to day life choices and maintain relationships with their family. Staff supported people in a way which was kind, caring and respectful. Staff protected people’s privacy, dignity and human rights.

Staff prepared care plans for every person that was tailored to meet their individual needs. Staff reviewed people’s care plans and updated to reflect their current needs.

The service had a clear policy and procedure about managing complaints. People knew how to complain and would do so if necessary.

The service sought the views of people who used the services and their relatives to improve the service. Staff felt supported by the manager. The service had an effective system to assess and monitor the quality of the care people received. The service used the audits to learn how to improve and what action to take.

We considered our inspection findings to answer questions we always ask. Is the service safe? Is the service effective? Is the service caring? Is the service responsive to people’s needs? 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 using 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 told us they felt safe and secure in the home. The staff we spoke with understood the procedures they needed to follow to ensure that people were safe. Staff were able to describe the different ways that people might experience abuse and the correct steps to take if they were concerned that abuse had taken place.

We saw that the home was clean and well maintained. All the people we spoke with told us that this was always the case.

We inspected the staff rotas which showed that there was sufficient staff on duty to meet people’s needs throughout the day. People received a consistent and safe level of support.

Procedures for dealing with emergencies were in place and staff were able to describe these to us.

Is the service effective?

All the people who used the service had an individual care plan which set out their care needs. People and their relatives we spoke with told us they had been fully involved in the assessment of their health and care needs and that they had contributed to developing their care plan. Assessments included people’s mental health requirements and the support that had been put in place for them.

People had access to a range of health care professionals including general practitioners (GP), community mental health teams, dentists and chiropodists. People’s care and support plans showed that they were escorted to healthcare appointments if needed. This meant that people were sure that their individual care needs and wishes were known and planned for and their needs met.

Is the service caring?

People were supported by kind and attentive staff. We saw that care staff showed patience and gave encouragement when supporting people. People commented, “I love it here, staff are caring and the home is always clean”. Another person said “I love it here, I’m going nowhere …it is my home.”

Staff were aware of people’s preferences, interests, aspirations and diverse needs. Our observations of the care provided, discussions with people and records we looked at told us that individual wishes for care and support were taken into account and respected.

Is the service responsive?

People told us, that they were able to participate in a range of activities both in the home and in the local community. People knew how to make a complaint if they were unhappy. People told us the service took complaints seriously and looked into them quickly. However, one person said more could be done.

Is the service well-led?

The service worked well with other agencies and services to make sure people received their care in a joined up way.

The home had a system in place to assure the quality service they provided. The way the service was run had been regularly reviewed. Prompt action had been taken to improve the service or put right any shortfalls they had found.

Overall, people using the service were happy living at Little Heath Lodge. People said that staff were “nice,” friendly” and “lovely. Two relatives we spoke with were complimentary about the quality of service provided. Relatives said that people were happy and “well fed”. People told us that the food was “nice” “delicious” and “alright”. Relatives told us that they were involved in the care planning and knew the support staff should provide. People said they were kept informed of any changes in care and that staff had a good knowledge of people’s needs. One person told us that their relative’s health and wellbeing had improved since they moved to the home.

We found that people’s care and support needs were met and staff understood each person and how to support them. People were provided with a choice of suitable and nutritious food and drink. People who used the service and their families knew how to complain if necessary. We found that the provider had policies and procedures in place to ensure that vulnerable adults were protected from abuse and staff had appropriate access to these policies. Support was in place to ensure that staff received adequate training and supervision. The provider had systems in place to learn from incidents and to make improvements to the service provided.

People who use the service told us that they were generally happy living at the home and felt comfortable there. They felt that staff were good and they told us they knew how to raise any concerns they may have. People told us they felt their health had improved since living at the home and some people told us they were shortly due to move on to more independent accommodation.

People told us they were involved in their care plan reviews and involved in other ways in order to contribute towards the running of the home, for example planning the weekly menus.