Newstead Lodge nursing home provides accommodation, nursing and personal care for up to 26 older people, who might live with dementia. Twenty five people were living at the home at the time of our inspection visit. At the last inspection, the service was rated good. At this inspection we found the service remained good.

There was a registered manager in post. 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.

Staff understood their responsibilities to protect people from the risk of abuse. The registered manager checked staff’s suitability for their role before they started working at the home and made sure there were enough staff to support people safely. Medicines were stored, administered and managed safely.

Risks to people’s individual health and wellbeing were identified and care was planned to minimise the identified risks. The registered manager regularly checked that the premises and equipment were safe for people to use and the provider took action to improve safety when issues were identified.

People were cared for and supported by staff who had the skills and training to meet their needs. The registered manager and staff understood their responsibilities in relation to the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. People were supported to eat and drink enough to maintain a balanced diet that met their preferences People were referred to other healthcare services when their health needs changed.

The manager and staff understood people’s individual needs and preferences for care and support. People were encouraged to maintain an interest in life, to take part in social activities and maintain relationships that were important to them. Staff promoted people’s independence and respected their privacy and dignity.

People and relatives knew the manager well and were confident any concerns or issues they raised would be dealt with promptly. The manager checked the quality of the service by working with staff and encouraging staff to support and engage with people as individuals.

People and their relatives were encouraged to share their opinions about the quality of the service. Staff were inspired by the registered manager’s leadership, skills and experience to provide a quality service. The service people received was in accordance with the fundamental standards of care.

Further information is in the detailed findings below.

This inspection took place on 14 May 2015 and was unannounced.

Newstead Lodge Nursing Home is registered for a maximum of 26 people and provides accommodation for people who require nursing or personal care. At the time of our inspection there were 19 people living at the home. Most of the people had high level care needs and some people were living with dementia or receiving end of life care.

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 a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. A registered manager was in post, however this person was on special leave at the time of our inspection and had been away for a few weeks. A quality manager worked at the home and was there on the day of our inspection. This person was covering the registered manager duties in their absence alongside the provider and we have referred to them as ‘the manager’ in the report.

People told us care provided at Newstead Lodge was good and the staff were caring and kind. We saw examples of this during our visit. People were treated as individuals and their preferences were met where possible. Staff knew people’s likes and dislikes and treated people with dignity and respect when providing care. All the people we spoke with were positive about staff.

People told us they felt safe, and staff knew about safeguarding and what to do if they suspected abuse.

People’s health and social care needs were reviewed regularly with appropriate referrals made to other professionals. Risk assessments were completed and management plans minimised any identified risks so care was provided safely. Medicines were stored securely and systems ensured people received their medicine as prescribed.

Staff understood the Mental Capacity Act, and Deprivation of Liberty Safeguards (DoLs) had been applied for where people’s liberty was restricted. We saw that when there were concerns about people’s capacity to make decisions or consent, appropriate assessments had been made. However, the provider had fitted CCTV at the home as a security measure, but some people told us they did not like this and had not consented to this.

Checks were carried out prior to staff starting work at the home to ensure their suitability to work with people who lived at the home. Staff told us that they felt supported in their roles and that they had undertaken relevant training in order to meet people’s care and support needs. We saw that staff had put this training into practice.

People told us they liked living at the home. There was a variety of food available and snacks and drinks could be accessed at any time of the day. People with special dietary needs were catered for and relatives could enjoy a meal with their family member if they wished to.

People told us they enjoyed some of the activities at the home but some people felt there could be more to do. There were additional charges for some of the activities provided and some people told us they did not like this aspect. People were given the opportunity to feedback about decisions and changes at the home.

Everyone we spoke with was positive about the management of the home. The manager knew the people at the home well and was able to tell us about people’s needs. We saw good systems were in place to monitor the quality and safety of the service provided. People knew how to complain if they wished to actions were taken in response to these complaints to people’s satisfaction.

When we visited Newstead Lodge, we saw there were 23 people living at the home. We looked at three people’s care records and we spoke with two people who used the service and two relatives. We also spoke with a nurse, the administrative officer and two care assistants.

We inspected this service previously on 17 June 2013 and identified that improvements were required in three areas. We found that people’s records were not always accurate. Some records did not contain detailed information about the individual person and care was not delivered in line with people’s care plans. We found that there was no effective system to assess the risk and control the spread of infection in the home. We found that the provider did not have an effective system to identify, assess and manage risks relating to people’s health and welfare.

We found that the provider had made changes since our previous inspection and that improvements had been made in all areas of concern.

We found there was a new infection control policy in place and staff were aware of this and followed it. Staff had received training on infection control. We saw that the laundry was clean and tidy and staff followed a new laundry procedure.

We looked at people’s care records and found that the information they contained was person centred, which meant that it contained detailed information about the individual person. We saw that care was delivered in line with people’s care plans.

We found that the provider had introduced new systems to identify, assess and manage risks relating to the health, welfare and safety of people within the home. These included new health and safety audits which were done on a regular basis.

During our visit we observed the care that was given to people by staff. We saw that staff treated people with dignity and respect.

When we visited Newstead Lodge, we saw there were 25 people living at the home. We spoke with four people who lived at the home, one relative and a close friend of someone living at the home. We spoke with three members of staff delivering care, including a nurse, a care assistant and a senior care assistant. We also spoke with the registered manager and the provider.

During our last inspection of this service in January 2013 we made a compliance action due to concerns around the planning and delivery of care to people. During this inspection, we found that some improvements had been made, however there were still areas of concern.

We found that the home had not taken reasonable steps to assess the risk to people regarding infection control.

We read the care records for seven people who lived at the home. Many of the people were not able to tell us about their care and support because of their complex needs, so we observed care practice and staff's interaction with people when they were delivering care.

During our inspection we saw several people having aromatherapy. People appeared to enjoy it. One person we spoke with told us that, “It’s wonderful we have lots of laughs, it’s very homely.”

During our visit we observed that the care staff were polite and asked people’s permission before they supported them.

When we visited Newstead Lodge Nursing Home, we saw there were 25 people living at the home. The people who lived at the home had complex needs which meant they were not able to tell us in detail about their experiences. Therefore we observed care practice and staff’s interaction with people when they delivered care to people.

We spoke with four relatives, three members of staff delivering care, the deputy manager, the home’s administrator and the home’s nominated individual (healthcare manager). We read the care records for three people who lived at the home.

Relatives we spoke with were complimentary of the care and support being provided. They told us: "I am happy with the care the staff are giving X” their family member was “always clean and tidy.” Another relative told us that they were “very pleased, everybody is nice” and that their family member ”is supported a lot” and they got “everything they wanted.”

We saw that the provider had assessed people’s needs. However the care records were not consistent. Therefore the care and treatment that was delivered to people, was not always in line with their individual care plan.

We observed moving and handling practice in the home. Most moving and handling practice we observed was satisfactory and we saw staff support people with dignity and respect. However not all moving and handling practice was delivered in a way that ensured people’s safety and welfare.

On the day of our visit, we spoke with two people who live at Newstead Lodge and three visiting family members. We asked them for their views about the service provided. They told us they were satisfied with the care they were receiving. Comments included: "The care is wonderful, all the staff are excellent,” and “I can’t fault the care here.”

During our visit we spent time observing staff interacting with people who live in the home, all the interactions we saw were kind, respectful and unhurried. Some people were observed using the home's two lounges. Others chose to spend time in their own rooms. People appeared very relaxed in the company of staff. One visiting family member told us, “I sit in the lounge with my relative and I can see that everyone is treated with care and compassion by the staff.”

We asked about making complaints and what people would do if they felt unhappy about anything. We were told that they would see the manager or the director of the organisation. One person said that they would raise any concerns with their family in the first instance.

People said that they were happy with their personal rooms and communal areas. A visiting family member said, “It is always clean with no nasty smells.”

Staff spoken with were knowledgeable about the people they were supporting and were aware of the importance of maintaining people's independence where possible. We saw that people had been provided with mobility aids to help them move around the home safely.