About the service: Newgate Lodge Care Home is a care home that provides accommodation with personal care for up to 55 older people, some of whom may have conditions such as dementia. On the day of our visit there were 47 people using the service.

People’s experience of using this service: People we spoke with told us they were very happy living at Newgate Lodge Care Home. People we spoke with and their relatives said they felt safe and there were enough staff to meet people’s needs.

Staff took steps to safeguard vulnerable adults and promoted their human rights. Incidents were dealt with appropriately, which helped to keep people safe. People’s health needs were identified and external professionals involved if necessary. People and staff were also supported with their well-being by the provider and management team.

People told us care staff were caring, supportive and kind. We observed staff members supporting people in a dignified and confidential manner. There was also lots of laughter and fun and people we spoke with and their relatives said that people enjoyed positive and therapeutic relationships with the staff team. The environment had been adapted to promote the needs of people living with a dementia in relation to colour, signage and lots of tactile and age appropriate displays.

The chef and staff had received training in relation to promoting good nutrition for older people. Staff were encouraging people who were under-weight to eat fortified foods. A fortified diet describes meals, snacks and drinks to which additional nutrients have been added through foods such as cream, butter, milk and milk powder. We found a range of menu choices were available and consideration had been given to ensuring people from different cultures received acceptable meals. We also saw that staff and visitors were invited to eat meals with people which promoted a sociable, family environment.

Care plans were detailed and showed people were involved in planning their own lives with staff support where able. Plans were person-centred, meaning people were at the heart of how they wanted their care and support to be provided. We discussed ensuring specific techniques used to support people when they became distressed were more clearly recorded for staff to follow and the management team agreed to address this straight away.

Staff told us they felt well trained and supported and spoke of the management team and provider in a positive light, stating that they felt listened to and always had access to managers or the directors. Checks were made on the ongoing competency of staff and we saw the service actively promoted staff to take further learning opportunities for their personal and professional development.

We saw staff upheld and promoted people’s rights relating to equality and diversity and people’s religious and cultural needs were well catered for.

People participated in a range of activities that met their individual choices and preferences. Staff provided the structured support people required and people we spoke with told us they enjoyed entertainment events and accessing the community with staff support. This promoted a good quality of life.

The service was well run. The management carried out lots of checks to make sure that the service was safe and of a good quality. People, relatives and staff said they found the management team approachable and people’s feedback was listened to and acted upon.

Why we inspected: This was a planned inspection based on the rating at the last inspection.

Rating at the last inspection: The service was rated as good and the report was published in August 2016.

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.

Newgate Lodge care home is registered for accommodation and personal care for up to 55 people, some of whom live with dementia. The home is situated in Mansfield, a town in North Nottinghamshire. All of the rooms were single rooms with en suite sink and toilets. The home was a two storey building with an enclosed garden. Each floor had two separate dining and lounge and an activity room. At the time of our inspection there were 53 people using the service.

A registered manager was in post at the time of the inspection. 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.

This inspection was carried out on 30 June and 1 July 2016 and was unannounced.

Staff understood the types of harm that can take place and were trained to report any incident of harm that people may experience.

Risk assessments were in place in order to support staff with reducing the risk of harm to people.

People were cared for by sufficient staff to support them with their individual needs. The necessary pre- employment checks were completed on staff before they were allowed to start work at the service.

People were supported to take their medicines as prescribed, and medicines were safely managed.

People had sufficient amounts of food and drink that they enjoyed. People were enabled to access a range of health care services and their individual health needs were met.

People’s rights to make decisions in relation to their support and care were respected and upheld. Where people were not able to make these decisions, their needs were decided in their best interests.

People were supported by staff who were trained and knowledgeable about their role. The CQC monitors the operation of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) which applies to care services. When required, DoLS applications had been made to the appropriate authorities to ensure that people's rights were protected.

People were supported by staff that were caring and kind. People and their relatives were involved in creating people’s individual care plans.

Care and support was given that was based on people’s individual needs by staff who knew them well.

People took part in a wide range of activities and interests, including going outside the home environment. There was a complaints procedure so that any concerns could be listened to and addressed.

People found the registered manager was approachable, and there was an open and caring culture. Staff, people and their relatives were able to make suggestions about the quality of care provided and actions were taken as a result. Regular checks were carried out in order to review and maintain the standard and quality of people’s care.

During this inspection there were fifty four people using the service. We spoke directly with three people who used the service and with five relatives. We also spoke with three care staff, a maintenance person, activities co-ordinator, deputy manager, registered manager and the provider.

We saw evidence that people were consulted before receiving care. One person who used the service told us, “I am independent and able to do things for myself; the staff don’t force me to do things.” A relative we spoke with told us, “The staff make sure they (family member) understand what is happening by talking to them.”

We saw that the building was safe, clean and adequately maintained. One relative told us, “The building is safe and seems to meet their (family member’s) needs.”

Staff were supported to deliver care and support safely and to an appropriate standard. One person who used the service told us, “The staff seem very knowledgeable, I have no complaints.”

We saw that records relevant to the management of the service were accurate and up to date and reflected the current needs of people who used the service.

We visited the service because we had concerns the home had not been inspected since 2008.

We asked people who used the service if they would like to comment about the quality of the services provided at the home, comments included, “They answer the call bells quickly, and we don’t have to wait long for help.” “The laundry is done beautifully.” “The staff keep my room clean and tidy.” The chef makes each of us a cake on our birthday, it’s nice that they care so much about us.”

We asked people who used the service if they experienced effective, safe and appropriate care, treatment and support to meet their needs and protect their rights. Comments included, “They look after us very well and help us in any way they can.”

“I’m happy here, the staff are really good. I get my medicines on time and there are lots of activities to take part in.”

During our inspection we spoke with six people who used the service and four relatives who were visiting. We also spoke with a practice nurse from a GP surgery, a GP and a district nurse. Everyone we spoke with had positive things to say about the service provided at the home. People told us they were kept informed and involved in the care provided.

People who used the service and the relatives we spoke with told us that the staff were very kind and caring. One relative told us, “I have every confidence in the staff and consider that we were very fortunate to find this place for our relative.”

A district nurse told us, “The staff are very prompt at referring people who use the service if they have any concerns about their health.”

A visiting GP told us that in their opinion staff at the home provided good care and good social activities for people using the service.

We found that the manager was ensuring that people were supported with dignity. The manager was also ensuring that the staff had access to training in dementia care.

Some records were not always accurately maintained and required improvement.