We inspected Olive Lodge on the 14 and 16 November 2016. Both visits were unannounced. Our last inspection took place in April 2015 where we identified two breaches of legal requirements in safe and care treatment and consent. The provider sent us an action plan telling us what they were going to do to ensure they were meeting the regulations and a clear time frame in which they would complete this. On this visit we checked and found improvements had been made in all of the required areas.

Olive Lodge is a 40 bedded purpose built care home close to Horsforth Town Street in Leeds. The home has 36 single occupancy rooms and three apartments, all of which are en-suite and have a french door leading to a private balcony or patio.

At the time of our inspection the service had a 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 2008 and associated Regulations about how the service is run.

There were systems in place to ensure that people received their medication as prescribed.

There were enough staff to meet people’s needs. Robust recruitment and selection procedures were in place and appropriate checks had been undertaken before staff began work. Staff told us they received training to be able to carry out their role. Staff were given effective supervision.

Staff were aware of the processes in place to report incidents of abuse; and had been provided with training on how to keep people safe from abuse and harm. Processes were in place to manage identifiable risks and to promote people’s independence.

People were supported to eat and drink well and to maintain a varied and balanced diet of their choice. People had access to healthcare facilities and support that met their needs.

People had developed good relationships with the staff team who treated them with kindness and compassion. Systems were in place to ensure that their views were listened to; and their privacy and dignity was upheld and respected.

People's needs had been assessed and care plans outlined their preferences and how they should be supported. Staff showed a good knowledge of these preferences.

People were able to enjoy activities of their choice. Arrangements were in place for people to maintain links with the local community, friends and family.

The service had quality assurance systems in place which were used to drive continuous improvements.

The inspection was carried out by an individual inspector. We looked at five specific questions; Was the service safe? Was the service effective? Was the service caring? Was the service responsive? Was the service well led?

Was the service safe?

We spoke with five people who used the service. They all told us they were happy with the care and support they received. One person told us “This is a wonderful place; staff are so kind”. Another told us “I feel staff listen to me and act on what I say”. We spoke with two relatives and they told us “Staff are excellent and accommodating, we feel very involved”.

We saw evidence that staff received regular training in Safeguarding vulnerable adults, this meant they were able to protect people from the risk of harm. The service had an up to date Safeguarding Policy and on the wall in the office we saw information staff could use when reporting a safeguarding concern. Staff had regular training on a variety of subjects and the staff we spoke with told us they felt the training was important as it helped them keep their skills and knowledge up to date. The staff all received regular supervision and they felt that supervision was a good source of support for them.

The service was clean and well maintained. Equipment was well maintained and serviced regularly therefore not putting people at unnecessary risk.

The manager sets the staff rota and ensured that there was the right mix of skills on each shift. This meant that people were being cared for by staff that were qualified and experienced.

Recruitment practice was safe and thorough. There were policies and procedures in place for the service to manage any concerns about staff’s performance.

Was the service effective?

People had an assessment of their care needs prior to admission into the home. Once they had settled into the home, a further assessment of need was carried out and care records were developed. The resulting care records were then reviewed at regular intervals. This ensured that people were having their needs assessed on a regular basis. The care records were not detailed. One of the care records we looked at contained inaccurate information and in another person’s records we saw that assessment of need such as mobility had not been carried out. We have asked the manager to let us know how they would be addressing this.

People we spoke with knew who their keyworker was but some were not aware of their care plan.

Was the service caring?

We spoke with six members of the staff team. They told us they loved working at the home, one member of staff told us “This is a nice home to work in, we all get on”. The staff felt that there were enough staff on duty to support people.

There was a range of activities people could take part in each day. The activities co-ordinator told us that people would have the choice as to whether they took part in the activities. On the day of inspection we saw people taking part in a gentle exercise class and other people were painting in the conservatory.

We saw that interaction between staff and people who used the service was warm and respectful. People told us “Staff here are lovely, they are very patient with me”. We spoke with some relatives and they felt the service involved them in their relatives care. They told us “Staff are great, they understand my (relative’s) needs very well and they look so much better from the care here”.

Was the service responsive?

The manager told us they held regular meetings with people to encourage them to share their experiences of living at the home. People told us they knew who to talk to if they weren’t happy. One person told us that they felt they had been listened to when they voiced their concerns about a particular subject. Not all the people felt the same way and the manager was trying to address this through the meetings held at the home.

The service had an up to date complaints policy and procedure that people could use if they needed to make a complaint. The service had not received any complaints over the past year.

Was the service well led?

The service had a quality assurance system that allowed them to address any shortfalls promptly.

Staff were clear about their roles and responsibilities and felt able to talk to the manager if they had any concerns.

During our visit, we had the opportunity to talk with five people who used the service and with two visitors. People told us they were happy with the care and support they received.

People said, “I’m very well looked after here. I like living here, I have no worries” and

“They always try and meet your needs and we can bring our own things in to personalise it.” Another person said, “I like it here; staff are so nice and I feel valued.”

A relative said, “I feel that my mother is safe here and they often stop and have a chat with her as they pass by.” Another relative said, “The place is always clean when I come.”

A resident said, “The staff are very friendly and helpful and I have no complaints.”

People who used the service told us that there were always plenty of staff on duty and they felt able to approach staff when they wanted to. Both relatives we spoke with told us that they felt staff listened to them. They told us they felt involved in decisions regarding their relatives care.

One person told us that, “They (staff) always treat me with great respect.”

We observed that people were treated respectfully and that staff were attentive to maintaining the privacy and dignity of those they cared for.

People we spoke with during the visit to the home felt the care and support provided was excellent and it felt like home. People commented that they felt supported and that staff were approachable. One person who used the service said: “Staff are friendly and I get the care I want” and another person said “I really like living here.”

We inspected Olive Lodge on the 24 April 2015 this visit was unannounced. We then visited on the 27 April 2015 which was announced. Our last inspection took place in April 2014 where we identified a breach of legal requirements in Regulation 20 HSCA 2008(regulated activities) Records. An action plan was implemented at the home and there were signs on inspection that the service had made improvements in this area.

Olive Lodge is a 40 bedded purpose built care home close to Horsforth Town Street in Leeds. The home has 36 single occupancy rooms and three apartments, all of which are en-suite and have a french door leading to a private balcony or patio.

The home had a registered manager in place, but was not at the home on both the days of 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.

People we spoke with told us they felt safe living at the home. We saw risks to people were managed appropriately whilst ensuring people were safe and given their freedom. We spoke with six staff who told us they understood how to recognise and report any abuse. Training records showed staff were trained in safeguarding.

Staffing levels were sufficient which meant people were supported with their care and enabled to pursue interests of their choice in the home and out in the community.

No-one at the home was subject to the Deprivation of Liberty Safeguards (DoLS). Staff had been trained and had a basic understanding of the requirements of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. We spoke to staff about Mental Capacity, but staff were vague in their responses to this. However, we found that one person at the home had been refusing their medicines and the home had not taken appropriate action with regard to this.

We saw that medicines were not always managed safely at the home. We looked at medication administration records (MAR) which showed people were not always receiving their medicines when they needed them.

People we spoke with told us they were mostly happy living at the home

We saw staff had developed good relationships with people and were kind and caring in their approach. People were given choices in their daily routines and their privacy and dignity were respected. People were encouraged to be as independent as possible in all aspects of their lives.

People’s nutritional needs were met and they received additional health care support when required.

People in the home told us that there had been recent failings in the nurse call system in place at the home. We were notified of this and the deputy manager had arranged the call system to be fixed. A thorough risk assessment had been carried out that indicated that most people were able to summon help using the internal telephone system in their room. To support those people who were unable to use the telephone an additional member of staff was on duty and documented 30 minute walk round checks were carried out. We spoke with people about the response times when they used the nurse call system to summon assistance from staff. One person’s relative told us their relative had to wait 20 minutes to be taken to the toilet.

We were shown records which showed a number of falls had occurred at the home. We spoke with the deputy manager and the care operations manager who told us there had been a number of referrals made to the falls team. They said some people now had sensors in place in their rooms which would alert staff to their movements.

From our observations it was clear the staff knew people well. We saw that staff were trained in supporting the people in the home. Staff told us they were supported and supervised in their roles. Supervision meetings should have taken place every two to three months however, we found evidence which showed that this was not being done as planned.

We saw there was evidence in place to show the home had made improvements to the care plans. The care plans were focused around the individual person and were person centred.

Records we looked at showed there were some systems in place to assess and monitor the quality of the service and the focus was on continuous improvement. There was good leadership at the service in the registered manager’s absence which promoted an open culture.

We saw there was a complaints procedure in place which was displayed in the home. People we spoke with told us they knew how to complain. The home had received complaints and these were dealt with promptly.

We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.