This was an unannounced inspection carried out on the 29 and 30 January 2018. At out last inspection 15 November 2015 the service was rated good. At this inspection the service remained Good overall but some improvements were needed with the management of medicines.

Mendip Lodge as a care home provides accommodation and personal care to people as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The home can accommodate 16 older people, some of whom are living with dementia. On the days of our inspection there were 14 people and a new admission into the home on our second day making it 15. The home is a detached property set out over two floors and is situated in a residential area of the village of Claverham.

The service has a registered manager. This 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.

All the people we spoke with said they felt safe at Mendip Lodge. Staff supported people to be as independent as they wanted to be and protected them from risks to their safety. Staff were trained in protecting people from abuse and understood their responsibilities to keep people safe.

There were enough staff to keep people safe and to support them with activities. The provider's recruitment procedures ensured as far as possible that only staff suited to work at the service were employed.

People received their medicines at the right times but the arrangements for the management of medicines were not always safe. Medicine records were not accurate and some medicines had gone missing.

The premises were clean and hygienic. Staff practised effective infection control.

People's choices were respected and they were not restricted in any way. People spent their time the way they wanted. 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. The service ensured peoples human rights were protected and their cultural needs promoted.

Staff completed a range of training to help ensure they had the skills and knowledge they needed to provide effective care. The registered manager and staff had a working knowledge of the Mental Capacity Act 2005 and understood the importance of people consenting to their care.

People had a choice of meals which they said they enjoyed. Mendip Lodge was decorated to people's taste and their personal accommodation was personalised.

People told us the staff were caring and kind. Staff communicated with people in a positive and compassionate manner and in ways that met people's communication needs.

People and their relative’s views were sought and acted upon. People were treated with dignity and their privacy was respected. People consistently experienced care and support that was planned to meet their present and future needs.

People experienced positive outcomes as a result of the support they received. The registered manager and staff shared the same vision which placed people using the service at the centre of decision making.

The service worked closely in partnership with other services to support people to achieve their aspirations. The registered manager worked on making people feel the service was their home.

The inspection took place on 11 November 2015 and was unannounced.

Mendip Lodge is a care home providing accommodation for up to 16 older people, some of whom are living with dementia. During our inspection there were 16 people living in the home. The home is a detached property set out over two floors and is situated in a residential area of the village of Claverham.

There was a registered manager in post at the service. 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 was not permanently located in the home; they appointed a manager for the day to day running of the home. The registered manager visited fortnightly and held regular telephone contact with the manager.

There were systems in place to monitor the quality of the service provided. Audits covered a number of different areas such as care plans, infection control and medicines. We found audits identified shortfalls in the service but these were not always followed up by the manager.

People and their relatives told us they or their relatives felt safe at Mendip Lodge. Systems were in place to protect people from harm and abuse and staff knew how to follow them. The service had systems to ensure medicines were administered and stored correctly and securely.

We received mixed feedback from staff about staffing levels in the afternoons, in response to this the registered manager was going to speak with staff and review their staffing levels. People appeared calm and relaxed during our visit; call bells were answered promptly and people were not waiting for long periods for assistance.

A recruitment procedure was in place and staff received pre-employment checks before starting work with the service. Staff received training to understand their role and they completed training to ensure the care and support provided to people was safe. New members of staff received an induction which included shadowing experienced staff before working independently. Staff received supervision and told us they felt supported.

People’s rights were protected as the correct procedures were followed where people lacked capacity to make decisions for themselves.

People and their relatives told us they were happy with the care they or their relative received at Mendip Lodge. One person told us, “It’s amazing here, I am enjoying every minute, I have been pleasantly surprised”. Staff interactions with people were positive and caring. However on one occasion we observed staff entering a person’s bedroom without knocking on their door which meant people’s privacy was not always respected.

People were complimentary of the food provided and had access to food and drinks throughout the day. Mealtimes were a relaxed and sociable experience. Where people required specialised diets these were prepared.

People and relatives were confident they could raise concerns or complaints with the manager and they would be listened to. The provider had systems in place to collate and review feedback from people and their relatives to gauge their satisfaction and make improvements to the service.

The home offered a range of activities to meet people’s individual needs and had links with the local community.

At the time of our inspection 12 people were living in the home. During our inspection we spoke with people receiving care, spoke with staff and examined the care records for people living in the home. The provider also supplied some information via email that we required, due to the absence of the manager at the time of our inspection.

Overall people we spoke with who used the service were happy with the service they received. Comments included; “I am treated with respect”, “I am happy here” and “I am very happy with my care here, staff are very nice”. People we spoke with were aware of how to make a complaint should the need arise.

Staff we spoke with told us they felt supported by the management team and received the training required to support people that used the service. Comments included; “we are a good team, we support each other just like a family extension”. “We are proud of the care we can provide here”.

We found the provider had systems in place to effectively monitor the service provided and gain people’s views on the quality of the service.

At the time of our visit there were nine people living at Mendip Lodge. We spoke with people that use the service, staff that were on duty throughout the day, and observed staff interactions with people that used the service.

We observed positive staff interactions that were delivered in a calm manner and people that used the service appeared relaxed in their own environment.

We spoke with seven people that used the service and five members of staff throughout the inspection to gain an understanding of the service being offered. Some people we spoke with told us “It’s nice they are good here”, “Its lovely here I have lots of choice”, “I feel safe they are very kind to me”.

Staff told us “This is not just a job it’s a way of life for me”, “I love it here it’s very homely” “We have good support within the team”, “the people are lovely”.

People who used the service also said that their families and friends were always made welcome and could visit at any time. They were always offered refreshments and the cook would also offer them food if it was a mealtime

At a compliance visit to the service we met and talked to most of the people who use the service. The service users said that they were “very happy” at the home and that “the staff cannot do enough for me”. The service users said that they were given “excellent” food and were given plenty of choice and that staff knew are cared about what they liked and did not like.

Service users also said that the felt that the staff knew about their history, families and backgrounds, and this was evidenced in conversations with staff and in observing care.

We were told that staff were “polite and caring” and wanted to make them comfortable and safe. We were also told that the home was clean and tidy and that their rooms were comfortable and warm and that staff made efforts to make communal areas welcoming and attractive.

Service users also said that their families and friends were always made welcome and could visit at any time. They were always offered refreshment and the cook would also offer them food if it was a mealtime.

We were also told that staff were generally friendly with service users and one another and that the manager supported both the service users and members of staff well. Service users also said that they were well cared for when the manager was not present and care did not change, and remained of “high quality”.