The inspection visit took place on 14 February 2017 and was unannounced.

Newfield Lodge Rest Home is registered to accommodate up to 32 older people who do not require nursing care. At the time of our visit there were 30 people who lived at the home. Newfield Lodge is part of a family owned and operated group of four care homes in the Lytham St Annes area. The home is situated close to St Annes centre.

At the last inspection in October 2014 the service was rated Good. At this inspection we found the service remained good. However a rating of requires improvement had been identified in the ‘safe’ domain. This was in relation to recruitment checks for staff not in place prior to employment. This had now been addressed by the management team. At this inspection we found the service remained good.

Improved systems of recruitment of staff were in place. Checks were carried out to ensure suitable people were employed to work at the home. Staff confirmed they only commenced employment when all checks had been completed.

The registered manager had systems in place to record safeguarding concerns, accidents and incidents and take appropriate action when required. Sufficient staff were on duty to support people. The management team were in the process of identifying times when extra staff would be beneficial for the service and people who lived at the home.

The registered manager understood the requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). This meant they were working within the law to support people who may lack capacity to make their own decisions.

Risk assessments had been developed to minimise the potential risk of harm to people who lived at the home. These had been kept under review and were relevant to the care and support people required.

Care plans were in place detailing how people wished to be supported. People who received support or where appropriate their relatives were involved in decisions and consented to their care. Further development of care plans had been implemented and a new system introduced. One staff member said, “They will be simpler and more informative when they are all completed.”

Staff responsible for assisting people with their medicines had received training to ensure they had the competency and skills required.

We observed regular snacks and drinks were provided between meals to ensure people received adequate nutrition and hydration. Comments from people who lived at the home were all positive about the quality of meals provided. One person said, “I have bacon, egg and sausage every day, lovely.” Also, “We have good cooks and always a choice. It is good food here.”

We found people had access to healthcare professionals and their healthcare needs were met.

People who lived at the home told us they were encouraged to participate in a range of activities that had been organised. An activities co-ordinator was employed by the organisation to encourage people to participate in their chosen hobbies or interests.

People who used the service and their relatives knew how to raise a concern or to make a complaint. The complaints procedure was available and people said they were encouraged to raise concerns.

The registered manager used a variety of methods to assess and monitor the quality of care at Newfield Lodge. These included regular audits of the service, annual surveys, ‘resident’ and staff meetings to seek the views of people about the quality of care at the home.

On the day of our visit we spoke with the manager, staff, relatives and residents. We also had responses from external agencies including social services .This helped us to gain a balanced overview of what people experienced living at Newfield Lodge.

During the inspection we looked at care planning, food preparation and staff training records. We also talked with residents and relatives about the home. Comments were positive and included, “I have spoken to you before, nothing has changed the care is excellent.” Also from a relative, “I could not ask for better care for my relative."

We spoke with people who lived at the home. They told us they could express their views and were involved in making decisions about their care. They told us they felt listened to when discussing their care needs. Staff confirmed to us they also involved people to ensure they received the right care and support.

We spoke individually with residents living at Newfield Lodge about their diet and how their nutritional needs were being met. They told us they were satisfied living at the home and that they felt cared for and the food good. One resident said, “The food is very good lots of choice and homemade cakes and pies.”

There were a range of audits and systems in place to monitor the quality of the service being provided.

Prior to our visit we contacted Lancashire contracts monitoring team. They told us they currently had no concerns with the service being provided by the home.

We spoke with a range of people about the home. They included the manager, staff, relatives and people who lived at the home. We also had responses from external agencies including social services. This helped us to gain a balanced overview of what people experienced living at Newfield Lodge.

We were able to speak with residents during the day of the inspection about their care and support. People we spoke with told us they could express their views and were involved in discussions about their care. They told us they felt listened to when discussing their care needs. One resident told us, “The care is very good from competent staff.” A relative we spoke with said, “I liked the way we were consulted when mum came here about all aspects of support she would receive.”

We spent time in areas of the home, including lounges and the dining areas. This helped us to observe the daily routines and gain an insight into how residents care and support was being managed. We observed staff treated people with respect and provided support or attention as people requested it. One staff member told us, “Respect is a big part of caring for people.”

We contacted the Lancashire contracts monitoring team. They told us they currently had no concerns with the service being provided by the home.

We spoke to the manager in charge ,staff ,people who live at the home, and received comments from other professional agencies such as social services and the environmental health agency. Responses we received were positive and reflected how well the home operates and supports people who live at Newfield Lodge.

Comments from people living at the home about there experiences, and support they receive included, “A pleasant experience when I moved here". Also, " The staff are all good at the job".

One person spoken to about the time moving into the home said it was a pleasant experience and the staff were sensitive and welcoming. The person said, "We had all the information about the home and my daughter and I visited a few times before I moved in".

Staff explained to us the importance of helping people living at Newfield Lodge maintain as much independence as possible and ensure people are treated as an individual and with respect. One staff member said, "Induction training gives us information around respect and dignity issues".

We talked to most of the staff individually on duty who confirmed they have a good knowledge of the individual care needs, social and cultural needs of people living at the home so that they are not disadvantaged in any way. We looked at care records of a person living at the home and one staff member spoken to was able to discuss the needs of that person and was aware of the care required and daily routines of the person.

Comments about the food were good and people liked the way the meals are served, One person spoken to said, "A good cook who always serves up good food".

This inspection took place over two days on 28 and 29 October 2014. It was unannounced on 28 October 2014 and announced on 29 October 2014.

Newfield Lodge Rest Home is registered to accommodate to 32 older people who do not require nursing care. At the time of our visit there were 29 people who lived at the home. Newfield Lodge is part of a family owned and operated group of four care homes in the Lytham St Annes area. The home is situated close to St Annes centre.

There was a registered manager in place. 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. To support the registered manager there was a home manager at Newfield Lodge and a management team with responsibilities to oversee quality assurance across the group of four care homes within the Lakeview Rest Homes organisation.

During our visit, we spent time in all areas of the home, including the lounge and the dining areas. This helped us to observe daily routines and gain an insight into how people's care and support was managed. During our visit we saw staff had developed a good relationship with the people they supported. Those people who were able to talk with us spoke very positively about the service and told us they felt safe and well cared for. One person told us, “The staff here are lovely, I am really well looked after.”

People were involved and consulted with about their needs and wishes. Care records provided information to direct staff in the safe delivery of people’s care and support. Records were kept under review so information reflected the current and changing needs of people.

Staff spoken with were positive about their work and confirmed they were supported by the management team. Staff received regular training to make sure they had the skills and knowledge to meet people’s needs.

Suitable arrangements were in place to protect people from the risk of abuse. People told us they felt safe and secure. Safeguards were in place for people who may have been unable to make decisions about their care and support.

We saw staffing levels were sufficient to provide a good level of care and keep people safe. However the planning of staff duties over the lunchtime period were not organised effectively to ensure people in the dining rooms received the support they needed. People told us staff were sometimes busy which meant they had to wait to be attended. We talked to the registered manager about our observations and found that on the second day of our visit, our concerns had been addressed.

We looked at how medicines were managed and found appropriate arrangements for their recording and safe administration. Records we checked were complete and accurate and medicines could be accounted for because their receipt, administration and disposal were recorded accurately. However we found best practice for administering medication was not always followed.

We looked at the recruitment and selection procedures the provider had in place to ensure people were supported by suitably qualified and experienced staff. We looked at four staff records. Suitable arrangements were not in place to ensure safe recruitment practices were followed. We recommend that the service consider current guidance to operate effective recruitment and selection procedures.

The registered manager was able to demonstrate that the views of people who used the service and other stakeholders were encouraged and welcomed. We saw a number of examples of changes and developments within the service, which had been made as a result of people’s suggestions and comments.

The management team used a variety of methods to assess and monitor the quality of the service. These included satisfaction surveys, ‘residents meetings’ and care reviews. Overall satisfaction with the service was seen to be very positive.