This unannounced inspection took place on 8 February 2017. At our last inspection visit in November 2015 we found the provider was meeting the requirements of the law. Oxley Lodge is a residential care home which provides accommodation and personal care for up to 58 older people some of which may have dementia. At the time of our inspection 48 people were living at the home.

At the time of our inspection there was not 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. The provider had appointed a home manager who told us they had recently submitted the appropriate documents to register them as the registered manager for the service.

People told us they felt safe living at the home. Staff knew what action to take if they had any concerns about people’s safety. People’s risks had been assessed and were appropriately managed and staff had a good understanding of how reduce the risks to people. People received their medicines as prescribed by trained staff and there were systems in place to ensure people’s medicines were managed safely.

People were supported by sufficient numbers of staff who had been safely recruited. People were supported by suitably skilled staff received appropriate support and training to enable them to effectively meet people’s needs

People were asked for their consent before staff provided care. The principles of the Mental Capacity Act were not being applied and we found the provider was in breach of Regulation 11 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, need for consent. People had sufficient to eat and drink and had access to healthcare professionals when required.

People were supported by staff who were kind and caring and respected people’s choices. People’s right to privacy and dignity was promoted and people were encouraged to maintain their independence.

People were supported by staff who understood their needs and preferences. Care needs were regularly reviewed and people and their relatives were invited to contribute to the care review process. There had been improvements made to the range of activities available for people to participate in. People and their relatives knew how to complain and felt confident that their concerns would be appropriately managed and resolved.

The provider did not have systems in place to ensure people’s rights were upheld where they lacked capacity. Staff understood their roles and responsibilities and felt supported by the registered manager. There were processes in place to gather feedback from people, their relatives and staff, which was used to make improvements to the service. Audit systems were effective at identifying the improvements required and appropriate action was taken to ensure improvements were made.

This unannounced inspection took place on 8 February 2017. At our last inspection visit in November 2015 we found the provider was meeting the requirements of the law. Oxley Lodge is a residential care home which provides accommodation and personal care for up to 58 older people some of which may have dementia. At the time of our inspection 48 people were living at the home.

At the time of our inspection there was not 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. The provider had appointed a home manager who told us they had recently submitted the appropriate documents to register them as the registered manager for the service.

People told us they felt safe living at the home. Staff knew what action to take if they had any concerns about people’s safety. People’s risks had been assessed and were appropriately managed and staff had a good understanding of how reduce the risks to people. People received their medicines as prescribed by trained staff and there were systems in place to ensure people’s medicines were managed safely.

People were supported by sufficient numbers of staff who had been safely recruited. People were supported by suitably skilled staff received appropriate support and training to enable them to effectively meet people’s needs

People were asked for their consent before staff provided care. The principles of the Mental Capacity Act were not being applied and we found the provider was in breach of Regulation 11 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, need for consent. People had sufficient to eat and drink and had access to healthcare professionals when required.

People were supported by staff who were kind and caring and respected people’s choices. People’s right to privacy and dignity was promoted and people were encouraged to maintain their independence.

People were supported by staff who understood their needs and preferences. Care needs were regularly reviewed and people and their relatives were invited to contribute to the care review process. There had been improvements made to the range of activities available for people to participate in. People and their relatives knew how to complain and felt confident that their concerns would be appropriately managed and resolved.

The provider did not have systems in place to ensure people’s rights were upheld where they lacked capacity. Staff understood their roles and responsibilities and felt supported by the registered manager. There were processes in place to gather feedback from people, their relatives and staff, which was used to make improvements to the service. Audit systems were effective at identifying the improvements required and appropriate action was taken to ensure improvements were made.

A pharmacist inspector from the Care Quality Commission visited the home. This was in order to look at medicine management. There were 30 people living in the service during this inspection. We looked at the medicine administration records for 12 people and at how the service stored and managed medicines.

The service had regular support from health care professionals. We found that people’s medicines were reviewed and changes made when necessary. One member of staff told us, “We always ensure people have their medicines reviewed and will take people to the doctor to ensure this happens’’. The service had recently changed to a new supplying pharmacy who had visited to check medicine management. We found that action had been taken following this visit to improve medicine management systems. This showed that the service had support from a professional healthcare team to ensure people were given medicines based on their current needs and lifestyle.

We found that arrangements were in place to ensure that medicines were managed safely.

During our inspection we spoke with seven people, three visitors, an external healthcare professional, three members of staff and the manager. We looked at four people’s care records.

People received care which reflected their needs as individuals. One person told us, “I’ve got no complaints about this place. I’m well looked after and I’m attended to when I need. I feel safe as houses”.

People received support from staff who were subject to robust checks prior to employment, to ensure they were of suitable character to care for people. One person told us, “Staff treat me with respect”.

We saw improvements in the content and accuracy of care records, although some records still needed improving so that staff had specific guidance to support people with their needs.

During our inspection we spoke with nine people, one relative, three members of staff and the manager. We looked at five people’s care records.

We found that people were supported in making day to day decisions about the care they received. One person told us, “I choose my own clothes to wear”. People’s values and diversity were respected.

The care people received was not always reflected in their care plans. Some people were not receiving the support they required in connection with their health conditions.

People were provided with enough to eat and drink, including snacks, throughout the day. One person told us, “Food is very good”.

Spot check observations on staff were being completed to ensure they followed correct medication procedures. However, medications audits were not being carried out to ensure people were receiving their correct medication.

We found that staff recruitment checks were not always completed before staff began work to ensure their suitability to care for people.

The service had a clear complaints procedure. The service told people about the complaints procedure so people would know how to make a complaint. One person told us, “I haven’t made a complaint, but I can make a complaint to my care worker”.

Records did not always accurately and fully reflect information about people, or how they should be supported.

During our inspection we spoke with three people, three relatives of two people, two members of staff, a visiting professional and the deputy care manager.

We found that people were involved in making day to day decisions about the care they received. The care people received was reflected in their care plans. A relative told us staff, “tell me meaningful updates”.

The home was a safe environment for people to live. We saw that maintenance activity was taking place and that the home was reacting to any issues as they arose. One person told us that they “do feel safe” living at the home.

We saw that staff were properly supported to carry out their duties safely and effectively. We saw evidence of staff meetings and individual assessment of their work by managers at the home. One staff told us, “I just enjoy working at the home”.

The home carried out audit work which meant that they could be assured of the quality of their service delivery and the safety of equipment and premises.

Care records show that people’s needs are regularly reviewed and discussions held about their care, treatment and future medical appointments.

People who use the service confirmed the undertaking of a needs assessment before they moved into the home, so staff know how to meet their care needs on admission.

One person who uses the service said, “I’m happy with the care given to me.”

Another person informed us, “It’s alright living here, the staff look after you.” “When you need help, they will help you but they don’t impose themselves on you.” “If I ask them to do anything for me, they do it.”

Another person told us, “They look after me well.”

One person who accesses the service told us, “When I’m poorly they call the doctor for me.”

We saw that appropriate written information was in place to ensure staff are aware of abuse and how to protect people from this, staff also had a good understanding of their role to safeguard people from potential abuse.

The environment was suitable to meet people’s needs but the inappropriate storage of chemicals could place them at risk of harm.

One person who uses the service said, “The staff are like my family.”

Another person told us, “The staff are very good, they are the best.”

One person said, “The staff are polite.”

Information contained within staff personnel files showed that appropriate safety checks were carried out to ensure staff’s suitability to work with vulnerable people.

Records show that a number of quality assurance audits were in operation to monitor the quality of service provided to people.