Norfolk Lodge provides accommodation and personal care for up to 30 people. At the time of our inspection, 27 people were living at the home, of which most were living with dementia.

There was a registered manager in the home. 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 home is run.

At the last inspection, the home was rated Good. At this inspection we found the home remained Good.

Why the home is rated Good…

People received support to take their medicines safely. Staff knew how to keep people safe from harm, risks were clearly identified and actions to reduce these implemented. There were enough staff to keep people safe and meet their needs.

Staff were competent to carry out their roles effectively and received training that supported them to do so. People were supported to eat a choice of freshly prepared meals, and were supported with special diets. People were able to access and receive healthcare, with support, if needed.

People were able to make choices and were supported to make decisions. People were supported to have maximum choice and control over their lives and staff supported them in the least restrictive way possible; the policies and systems in the home complimented this practice.

Staff were kind and compassionate in the way they delivered support to people. People were treated with dignity and respect. Staff ensured that people were able to have visitors, and enabled people to maintain relationships with relatives and friends who did not live nearby.

People were supported to access a wide range of activities and hobbies that meant their leisure time was enjoyable. People and their relatives were confident that they could raise concerns if they needed to.

The registered manager ensured that the home was well run. Staff were committed to the welfare of people living in the home. They regularly engaged with people to seek their view about how they wanted the home to be run, and the activities on offer. The registered manager ensured they kept links within the local community and people were part of many regular events.

A single inspector for adult social care carried out this inspection. The focus of the inspection was to answer the 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, relatives and staff 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?

Records we looked at showed us that risk assessments were completed where a risk had been identified. Measures were described and in place to reduce or eliminate such risks. Requirements under the Mental Capacity Act 2005 were recognised by members of staff as were deprivation of liberty safeguards (DoLS). Staff confirmed that they had completed regular training and we saw a list of dates when the staff refresher training was due to be updated. This showed that people were supported by members of staff who knew how to provide support in a safe and appropriate way

Full information was on display to provide people with enough detail to take any concerns they may have to the relevant organisation. This information included details of the type of procedures and actions that would be taken by the supporting agency.

Records showed that equipment such as hoists had been regularly serviced and fire checks had been completed on extinguishers. This supported the safety of people who lived at the service, as well as the safety of visitors and staff.

Is the service effective?

Our observations showed us that people who lived at the service were relaxed and confident when they discussed matters with members of staff. Staff took action when they saw anyone who appeared to be in need of support.

Our discussions with people at this time and our review of documents showed us that nutrition was monitored by staff. They took note of how much each person ate at meal times. Alternative options were offered if a person did not want the choices available on the menu. People who were unable to express their choices were shown different meals on a plate to enable them to choose which they preferred. Regular checks on people's weight supported the early detection of any problems.

Is the service caring?

Our observations showed us that people who lived at the service were treated with respect at all times. Discussions with members of staff showed us that they knew the routines that people had chosen and were aware of their care and support needs.

We saw that people were dressed cleanly and appropriately for the weather on the day of our inspection. This showed that people’s support needs had been carried out. We also saw that staff spoke with respect and in an appropriate manner when they provided support or care to people in the home.

Is the service responsive?

We saw that people's individual physical needs were being met. People were gently encouraged to decide what they wanted to eat at lunch time. We observed the lunch time meal and saw this was a calm and relaxed time. People were shown meals already served on a plate to assist them to make a meal choice. Staff did not rush anyone and they allowed time for the individual to fully understand their meal choices and the options offered to them. This showed us that staff supported and involved people who lived at the service.

Is the service well led?

Staff explained that they undertook regular training and we saw a list of dates when the staff refresher training was due to be updated. This showed that people were supported by members of staff who knew how to provide support in a safe and appropriate way.

Quality assurance systems were in place and regular quality audits were completed for all areas of the service. We saw records that clearly documented the observations that had been made when any improvements were needed. The dates when tasks had been completed was also recorded to show when any follow up was needed.

During our inspection we spoke with four people who used the service and two people’s relatives. Not all of the people who used this service were able to communicate with us. We also spoke with eight members of staff.

One person we spoke with told us, “Staff look after me but there’s no conversation. There’s not enough to do here – colouring and writing for six year olds.” Another person said, “The girls are nice and it’s a nice place to live but I’m sitting around waiting for things to happen.”

We found that people were not always treated with dignity and respect and were not always involved enough in their care. Care records were not always up to date and did not always assess people’s needs to ensure their safety and welfare.

We observed food being prepared and served and found that people could be at risk of inadequate nutrition.

During our inspection we saw that medication was obtained, prescribed and administered safely. We found that there were high levels of dust on the tops of fridges and freezers. We also found that some mattresses needed replacing and raised toilet seats needed to be cleaned.

There were not always enough staff to meet the care and welfare needs of the people they were caring for. However, staff and relatives we spoke with were very supportive of the new manager and were confident improvements were taking place.

People using the service were assessed and had care plans in place to tell staff what support they needed. People we spoke with told us that they received the right care and support to meet their needs.

Staff received regular training in a range of topics relating to the health, safety and welfare of the people using the service. Two people told us they thought staff were well trained.

During our inspection on 02 May 2012 we spoke with a small number of people who were able to make comments about their experiences of Norfolk Lodge. We spent time in the communal areas of the home, observing how staff interacted with people and how care was provided. We also spoke with three visitors.

We talked with people about how they consented to the care being provided. We were told that staff asked people if they wanted help and took notice if they said no. One person explained that if they did not want any help it would not be forced upon them.

People told us that they received good care at Norfolk Lodge and that staff understood what support they needed. One person described the care as, "A1," and another commented that they were looked after very well and would not want to move. People said that staff looked after them if they were unwell and arranged for them to see the doctor or the nurse.

People we spoke with had no concerns about how they were treated at Norfolk Lodge. One person told us, "The staff are all kind, there is no-one I don't get on with." Another person said, "The staff have been excellent, they treat me with respect."

One person told us, "The meals are sufficient but not wonderful." However, this was not the view of other people we spoke with, all of whom praised the meals at Norfolk Lodge. We were told that the food was good and people said they had a choice at each mealtime. One person said, "There are ample portions, we get plenty to eat." Another commented, "If I don't like anything I just tell them and they get me something else."

Most of the people we spoke with told us they liked Norfolk Lodge. We were told that people made their own decisions about their daily lives and routines. One person told us that they liked to go to bed early and another said they stayed up to watch television. People said they were given choices about what they wanted to eat, where they wanted to spend their time and what activities they wanted to do. One person commented, "They ask my opinion about everything." Some of the people living at Norfolk Lodge had difficulty communicating verbally. We noted that staff tried other ways to give people choices, for example by showing them a choice of meals or drinks.

We saw that staff addressed people respectfully and treated them with dignity. One of the people we spoke with said that they had a laugh with most of the staff and it was nice. Another told us that they thought staff were very good to them.

People told us that they were well cared for at Norfolk Lodge. One person said that staff knew them very well and if they thought they were unwell would ask if they wanted to see the doctor. Family carers were also satisfied with the care that their relatives received.

People told us that there were always staff around to help them when they needed it. There were staff in the lounges to assist people who might not be able to request help.

This inspection took place on 13 February 2015 and was unannounced. We arranged a return visit to the service on 16 February 2015 to complete our inspection.

Norfolk Lodge is a residential care home that provides accommodation, care and support for up to 30 older people, some of whom may be living with dementia. The home does not provide nursing care. There was a person in place who was managing the service. This person was in the process of becoming the 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 and associated Regulations about how the service is run.

All of the people we spoke with told us they liked living at the home and felt safe. They said that they were supported by staff when they needed it and that they were able to discuss things if they had any concerns or worries. People’s needs were met by staff who were friendly, caring and who spoke appropriately to people. We saw that staff treated people with respect and clearly knew the routines and preferences of each person. People also told us they were happy that they lived at Norfolk Lodge. They described various activities and special events that they had recently enjoyed.

Staff knew about how to keep people safe and also how to protect them from abuse. Staff had been trained and had the knowledge they needed to provide support to the people they cared for.

We were told that training had been booked with the local authority regarding the Mental Capacity Act 2005 and this was to also include Deprivation of Liberty Safeguarding (DoLS). This was to provide more current knowledge regarding these areas for members of staff. Our discussions with staff and people living at the service clearly showed that staff knew about the Mental Capacity Act (2005) and understood when the best interests of people required further discusson.

People we spoke with said that the food was good and that they always enjoyed their meals.

There were alternative meals offered at each meal time and the nutritional intake of people was noted. Staff worked together to ensure people had what they wanted at meals and they checked with people that they were happy with the food they had been provided. Staff were aware of the importance of good nutrition and hydration. They encouraged people to eat and drink what they preferred. Concerns found of people not eating or drinking were reported on and action was taken.

People and/or their relative were consulted and involved in reviewing their plans of care to ensure their needs were met. They had access to healthcare professionals when they became unwell or required specialist help with a medical condition. People’s independence was encouraged and developed wherever possible.

The provider completed an assessment of need for all people using the service. Records were held to guide both staffing levels as well as the care required for each person. These records had been updated to reflect current needs.

Surveys had been completed by people who lived at the service and also by relatives. These gained their view of the care and support provided to them. People told us that any concerns or worries were quickly dealt with and they could speak with staff at any time.

Regular checks and audits were completed to ensure the service provided was appropriate. The premises were maintained as a safe environment that met people’s needs. Medicines were securely stored and records showed that people had received them as prescribed.