Pathfields Lodge is registered to provide care for up to 48 people with learning and physical disabilities and people living with dementia. At the time of our inspection the registered manager informed us that 31 people were using the service.

The inspection took place on 16 September 2016 and it was unannounced, further documentation to complete the inspection was received from the provider on 20 September 2016.

The service had 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.

People were protected from the risks of abuse. Staff understood what constituted abuse and the safeguarding procedures to follow to report abuse both internally and externally. People were supported to express their autonomy and make informed choices when taking risks.

Staff were employed following safe and robust recruitment procedures. There was sufficient numbers of suitable staff to meet people's assessed needs. Staff received appropriate training to ensure they were equipped with the right skills and knowledge to support people using the service. Staff supervision systems ensured that staff had regular supervision meetings to reflect on their work practice and plan their learning and development needs.

Suitable systems were in place to safely manage medicines. Medication risk assessments took into account people's capabilities to manage their own medicines and when staff needed to take on the responsibility. Regular medicines audits ensured that any areas for improvement were identified and action was taken to address them.

People's consent was sought before staff provided their care. People who lacked capacity to make decisions were supported following the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS).

People had a balanced and varied diet and their dietary needs were assessed and monitored. They had regular access to healthcare professionals and were supported to attend health appointments to ensure their health and well-being needs were met.

Staff treated people with kindness, compassion, dignity and respect. Independence was promoted and people were enabled to make and maintain relationships. Individualised care plans were in place that reflected people's needs and choices on how they wanted their care and support to be provided.

People and their representatives were encouraged to provide feedback on the service and their views were listened to and acted upon. Suitable arrangements were in place to receive and respond to complaints.

The vision and values of the service were person-centred. People and their representatives were supported to be involved and in control of their care.

Suitable governance and quality assurance management systems were in place to monitor all aspects of the service provision.