About the service: Meadow Lodge Care Home is a residential care home that was providing accommodation and personal care to 25 people over the age of 65, some of whom were living with dementia.

People’s experience of using this service: People told us they felt safe and well supported. The provider followed robust recruitment checks, and sufficient staff were employed to ensure people’s needs were met. People’s medicines were managed safely.

All areas were clean and tidy. The rooms we looked at were nicely decorated in colours of people’s choosing.

Staff had received training and development around management of dementia and demonstrated a good understanding of dementia care. They worked with people’s individual strengths to ensure their independence, wishes and choices were promoted.

Communication was effective. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People enjoyed good food. Their health needs were identified and staff worked with other professionals, to ensure these needs were met.

Staff knew about people’s individual care needs and care plans were person-centred and detailed.

People participated in a wide range of activities within the service and in the community, they also enjoyed the company of others in the service.

People were able to see their families as they wanted. There were no restrictions on when people could visit the service. People were supplied with the information they needed at the right time, involved in all aspects of their care and were always asked for their consent before staff undertook support tasks.

The service was well-led; systems were in place to assess and improve the quality of the service and complaints were responded to thoroughly. There was an open culture and learning was encouraged to drive improvement.

More information is in the full report.

Rating at last inspection: Good (Report published 13 July 2016).

Why we inspected: This inspection was a scheduled inspection based on the previous rating. The service has remained good.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

This inspection took place on 14 and 16 June 2016. The last inspection took place on 7 May 2014 when the service was meeting all of the regulations we assessed.

Meadow Lodge Care Home provides personal care and accommodation for up to 25 older people, some of whom are living with dementia. The service has a communal lounge and dining area. There is one shared bedroom. Some bedrooms have en-suite facilities. The service has a secure garden and is situated on the outskirts of the village of Kellington.

At the time of our inspection there were 23 people living at Meadow Lodge Care Home.

The service has 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 registered manager and care staff understood how to safeguard people from harm. The registered manager had made some safeguarding referrals to the local authority. However, we saw other incidents which had not been referred. Although the registered manager had a clear rationale for this we could not see this decision making had been recorded. We have made a recommendation about the reporting of safeguarding concerns.

Risks to individuals were identified and steps were taken to reduce the risk of avoidable harm to people. Risk management plans contained step by step guidance for staff and health and social care professionals had been involved in the development of these as needed.

The service had sufficient staff available to meet people’s needs and staff were recruited safely. The service also benefitted from support of volunteers whose main role was to provide social stimulation. Volunteers were subject to the same recruitment checks and received the same support and training as employed care staff. The service had a stable staff team. Some staff had worked there for over twenty years.

Medicines were safely managed. There were robust systems in place for the ordering, storing and return of medicines. Staff were provided with medicines training and one person was provided with the support they needed to manage their own medicines.

Staff told us they were well supported and we saw evidence staff had undertaken essential training to ensure they provided safe care. The registered manager ensured staff were up to date with training and had regular supervision.

The service worked within the principles of the Mental Capacity Act and sought consent from people before they provided support. For people unable to consent to their care the service had completed mental capacity assessments and the relevant people had been consulted as part of the decision making process.

People told us the food was good. The menu offered people a variety of meals and the company who supplied the food had held tasting sessions so that people could make choices about the options they wanted on the menu.

Some communal areas of the service had recently been renovated and people’s bedrooms were personalised and had a homely feel. The service had a secure landscaped garden which people enjoyed spending time in. This had been designed with the needs of the people who used the service in mind and people told us how much they enjoyed spending time in it.

The service liaised with various health and social care professionals to ensure people’s changing needs were assessed and met.

People told us they received a good standard of care. Care staff knew people well. The service had a friendly, family atmosphere. Care staff treated people with dignity and respected people’s privacy.

Care was provided in line with people’s individual preferences. The service responded to people’s changing needs and sought advice from relevant health and social care professionals.

People were provided with meaningful ac

A single 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 told us, what we observed and the records we looked at.

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?

People we spoke with told us they felt they were treated as individuals and felt they were listened. We observed that people were treated with respect and dignity by the staff. People appeared to be supported well by staff. A person we spoke with said “I feel safe living here.”

The service had policies and procedures in place in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards (DOLS). There was no one currently using the service who had a DOLS in place. Senior staff had been trained in this area to help to protect people's rights.

Systems were in place to make sure that managers and staff learnt from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduces the risk to people and helps to service to continually improve.

There were effective systems in place for staff to follow in regards to medication. This helped to protect all parties.

Is the service effective?

People’s health and care needs were assessed with them or with their chosen representative. People were encouraged to live their life even if there were risks attached to this. People living at the home told us that they valued this.

Help and advice was gained from relevant health care professionals in regard to the people currently living at the home. We spoke with a visiting health care professional during our visit. They said “The care people receive here is good. Staff contact me if there are any issues. They ask for help and advice, which they follow.” This helped to protect people's wellbeing.

People’s needs with poor memories were taken into account. There was helpful signage in place and the layout of the service enabling people to move around freely and safely.

Is the service caring?

People were seen to be supported by staff who appeared to be patient and kind. Staff were skilled at allowing people to be as independent as possible. They also knew if a person required assistance. We saw that people were visited by relevant health care professionals. One person said “I am looked after by pleasant attentive staff, nothing is too much trouble. If I was unwell they would take me to the GP, or the GP would come here.” This helped to maintain people’s health and wellbeing.

We saw staff spent quality time with people. For example we saw staff giving people manicures, dancing or singing with them. People we spoke during our visit said they could not have found a better place to live. We spoke with two visitors who said “We visit on different days and at different times. Always the care is good. We have never seen anything that is worrying.”

People using the service were asked to complete a satisfaction survey. Where any shortfall or concerns were raised about the service the issues were addressed, to the complainant's satisfaction.

Is the service responsive?

Information was provided to people about how to make a complaint. This was available in a format that met people’s needs. Staff spent time observing people and asked people for their views. We saw that staff acted upon comments made to them to ensure they remained happy with the service they received.

We looked at how a complaint had been handled. This had been investigated and the complainant had been satisfied with the action taken to resolve the issue raised. People can be assured that complaints are investigated and action is taken as necessary.

Is the service well led?

The service worked well with other health care professionals to ensure that people could receive the care they needed.

Quality assurance systems were in place. We saw that the staff took pride in delivering a quality service to people. This was constantly being reviewed and where necessary the service was improved.

Staff are clear about their roles and responsibilities. They told us they would not want to work anywhere else because the provider cared about the residents and their staff. The ethos of the home was to provide a good quality service to ensure that people living there were supported to live the life they chose, to the full.

We spoke with three people who lived at Meadow Lodge Care Home, three relatives and five members of the care team on the day of our inspection. We also spent time observing people in their surroundings as not all could tell us about their experiences. Some of the people who lived in the home were busy doing things they liked, these included hoovering and washing up. They were very happy and pleased 'to help'.

We saw people being supported in a calm, polite and courteous way. People appeared relaxed and comfortable with their surroundings; with staff and the activities they were engaged in.

People’s needs were assessed and care and treatment was planned and delivered in line with their individual care plan.

We found people were protected from the risks associated with inadequate nutrition and hydration.

We found people were safe from abuse because the provider had taken reasonable steps to prevent abuse from happening.

The provider had systems in place to identify, assess and manage risks to the health, safety and welfare of people using the service and others.

We spoke with four people who live at Meadow Lodge Care Home. They told us, “There is a nice atmosphere”. Another person we spoke with told us, “I was glad to be coming home,” after a recent hospital stay. This was added to when another person we spoke with said “I feel safe here.”

People living at the service told us that they enjoyed their life at Meadow Lodge Care Home. One of the aspects of life here they highlighted was being able to see their friends whenever they wanted to. One person told us that, “Friends can come and see me at any time.” People told us that they have the opportunity to go on outings, if they choose and recently enjoyed being part of the Jubilee celebrations.

People and staff we spoke with told us that there was enough staff to deliver effective care; people did not have to wait for support.

People and staff we spoke with told us that there was enough staff to deliver effective care; people did not have to wait for support.

All the people we spoke with were complimentary about the service. They told us they were very happy living at Meadow Lodge. One person said ‘I like it here. The staff are very kind. And the food is very good too’. Another person told us ‘I’m highly satisfied. I couldn’t wish for anything better’. And a third added ‘The care is good. I couldn’t pick one carer out who wasn’t good. The manager comes and talks with me and tells me what’s going on. I’m very happy here’. Other comments include ‘the staff are polite and ‘I feel very safe here and trust the care staff. They know what they’re doing’.