We carried out an unannounced comprehensive inspection on 12 December 2016 and arranged with the provider to go back for a second day on the 15 December 2016. Manor Lodge provides care for up to 38 older adults. The service had recently had a large extension and increased their registration to accommodate more people (they had previously been registered to take 27 people). There were 24 people using the service during our inspection. The registered manager said they were increasing their occupancy in phases. They said they were ensuring they had the required staff in place first so they were ready to meet everybody’s needs and a smooth transition.

We last inspected the service in February 2014 and found they were compliant with the regulations inspected.

The service had a registered manager. 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 responsible person and the provider’s representative referred in the report as the owners were at

the service when we visited. The registered manager confirmed they were at the service most days and actively involved with the running of the service. Everyone was positive about the registered manager and owners and felt they were approachable and caring. The owners were very active at the service during our visit and were seen to be caring and supportive to staff.

People said staff treated them with dignity and respect at all times in a caring and compassionate way. Interactions between people and staff showed that staff were kind, friendly and caring towards people. Comments from people included, “They are all lovely” and “The care is absolutely excellent.”

People received their prescribed medicines on time and in a safe way. Where people were able to self-administer their own medicines systems were put into place to protect them.

There were sufficient and suitable staff to keep people safe and meet their needs. The staff undertook additional shifts when necessary to ensure staffing levels were maintained and there was flexibility. If additional staff were required due to staff shortages, agency staff were used from the provider’s local domiciliary service.

The registered manager had a clear understanding about their responsibilities in relation to the Mental Capacity Act (MCA) 2005. Where people lacked capacity, mental capacity assessments had been completed and best interest decisions made in line with the MCA. However these had not always been formally recorded. Staff had a clear understanding about maintaining people’s rights and about the MCA.

People were supported by staff who had the required recruitment checks in place. Staff had received a full induction and were knowledgeable about the signs of abuse and how to report concerns. Staff had received training and had the skills and knowledge to meet people’s needs.

The home was very clean and tidy throughout and had a pleasant welcoming homely atmosphere. People were supported to eat and drink enough and maintain a balanced diet. People and staff were positive about the food at the service. There was a high emphasis by the management team to ensure people had a positive dining experience at the home.

Activities formed an important part of people’s lives at the service. Staff treated people as individuals they took the time to ascertain their interests. Staff supported people to follow their interests and take part in social activities. Staff undertook activities at the home each day and external entertainers were arranged.

Risk assessments were undertaken for people to ensure their health needs were identified. Care plans reflected people’s needs and gave staff guidance about how to support them safely. They were personalised and pe

We obtained the views of nine of the 22 people who lived at the home when we visited. We spoke with others who due to memory problems were unable to give us their views of the service in detail. All spoke positively about the service and appeared comfortable. We observed some of the support people received from staff. We also talked with a visiting staff training assessor, seven care or ancillary staff, the registered manager and the home's owners.

We found care was planned and delivered in a way that was intended to ensure people's safety and welfare. When we asked people about their care, a typical reply was “We’re well looked after." They were protected against risks associated with medicines because there were appropriate arrangements for managing medicines. They were also protected from infection risks because appropriate guidance had been followed and the environment was clean.

There were enough qualified, skilled and experienced staff to meet people’s needs. Everyone we spoke with was positive about the support staff provided, typically describing staff as “very kind”. One person said “They all do their jobs very well.”

Comments and complaints people made were responded to appropriately. One person said “If there’s something I don’t like, I would complain to the staff…They take it the right way.” Most people told us that they had not had to make a complaint or that there were no issues, with one person adding “They even pull the curtains at the right time!”

At the time of our inspection 25 people were living at Manor Lodge. We spoke with six people. We spoke with the Registered Manager, the Provider by telephone and five members of staff. We also spoke with a visiting healthcare professional.

People we spoke with told us they were very happy living at Manor Lodge. One person said “I was not sure about moving to a home. I must say in doing so I feel safer and more confident.” People told us they were happy with the level of care and support they received from the staff. People told us they were supported to access any healthcare they needed.

People told us they were able to make choices as part of their daily lives and staff respected their wishes. We found that people's privacy was protected.

We were told that food at the home was excellent and people were very satisfied with the environment in which they lived.

People told us that they felt safe and knew who to speak with if they had any concerns. Staff knew what to do if they suspected poor practice. One person said “I can speak with anyone here, they are all wonderful.”

Staff said they felt well supported and had access to a wide variety of training. Staff were only recruited after robust pre employment checks had taken place.

The home was very well managed, records were well kept and there were systems in place to monitor the service provided and the safety of the home.