Philia Lodge Rest Home is registered to provide accommodation and non-nursing care for up to 20 older people, who may be living with dementia or other neurological conditions. On the day of our inspection there were 18 people living at the service.

This inspection was unannounced and took place on 10 May 2017. At the previous inspection on 15 and 17 December 2014 the service was rated Good and we found that at this inspection, it continued to be rated Good.

People's experience of care at the service was very positive. They felt extremely well looked after by members of staff who genuinely cared about their well-being and took the time to talk with them and make them feel special. All staff were incredibly passionate about the care they provided people with. They worked hard to ensure that people's needs were met and exceeded, to ensure they had the best quality of life possible. Steps had been taken to ensure that people were involved in their own care. They were provided with all the information they needed to understand the service, their care package and ways of seeking additional support. Dignity and respect was very important to the service and members of staff worked hard to ensure this was promoted and that people had privacy when they needed or wanted it. Staff also worked with people to help develop their independence and increase their access to their local community.

The service kept people safe. Staff had been trained in recognising and acting on abuse and there were systems in place to ensure that all accidents and incidents were reported and followed up on. Risk assessments were in place to provide staff with guidance around areas of risk and the actions they should take to reduce the impact of those risks on people. There were enough staff on shift to meet people's needs and recruitment practices ensured that staff members employed were of good character to work with people. Systems were also in place to ensure the safe administration of people's medicines, including appropriate storage and recording.

Staff members received training and refresher sessions to develop and maintain their skills and were also supported in the form of regular supervisions. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. Staff members sought people's permission and consent before providing them with care and systems were in place to ensure the principles of the Mental Capacity Act 2005 were adhered to. People enjoyed the food at the service and they were supported to ensure their specific dietary needs were met. They were also supported to book and attend appointments with healthcare professionals as required.

People's care was provided in a way which was sensitive to their individual needs and preferences. Care plans were tailored to each individual and were reviewed on a regular basis to ensure the information within them was accurate and up-to-date. Activities took place to provide people with stimulation and the recently appointed activities coordinator had a number of ideas to help develop what was on offer for people. Feedback, including complaints, was welcomed and used to help drive improvements.

The service had an open and positive culture. Staff members were motivated to come to work and enjoyed their roles. They were well supported by the registered manager who was also looking at a number of different areas where they could develop the service. The provider was involved in the running of the service which gave the registered manager the support they needed. Quality assurance systems were in place to ensure checks and audits were carried out and these were used to help improve the service.

People told us that they were respected and were treated with dignity and we saw that this was the case. The home’s environment maximised people’s privacy and dignity because bathing and toilet facilities were provided with lockable doors and all bedrooms were used for single occupancy, unless these were shared by married couples.

The provision of social and recreational activities maintained and promoted people’s wellbeing. In addition, people’s health was maintained and promoted. This was because people were supported to access a range of health care services and their health was monitored and reviewed. People told us that their needs were met and that they were satisfied with how this was done.

People told us that they always had enough to eat and drink. They also told us that they were given a choice from the menu. People’s individual nutritional needs were also catered for.

People were provided with safe equipment to support their comfort, health and safety needs. Records demonstrated that equipment was safe for people to use and that Philia Lodge Rest Home was a safe place to live, work and visit.

Members of staff were trained and supported to safely do their job, which they said they liked and found it to be rewarding.

There were systems in place which enabled people to make their comments, concerns or complaints. People knew who they would speak with if they were unhappy, but said that they had no cause to do so.

Most of the people who lived at the home had dementia and we found that each person's ability to make everyday decisions had been assessed. If a person was unable to give their consent their nearest relative was consulted about decisions affecting their care. This ensured the provider acted in accordance with the person's wishes.

We used the Short Observational Framework for Inspection (SOFI) in the lounge area to help us understand the experience of people who could not talk to us. There was limited interaction or engagement with activities until one person began to play the piano. Most people responded positively although one person became a little agitated. Staff were aware of the person's needs and responded appropriately.

The home was clean and well maintained at the time of our visit and we found that some infection control practices were being improved. Soap and hand gel dispensers were not yet available in all areas and room cleaning checks were not yet in place. The manager had already taken some action to address these issues. although they had not been fully completed at the time of our visit.

We found that people were well cared for and there were sufficient numbers of skilled and experienced staff to meet their needs. Records were stored securely, accurate and contained up to date information.

We spoke with three people at the home who were positive about the improvements to the conservatory and outdoor area. One person told us they enjoyed using the outside decking area particularly when they had visitors.

People told us that staff were able to support them in the correct way most of the time. One person said that staff were, “Very kind” and knew how to care for them.

Another person who had lived at the home for a number of years said that they were,

” Very happy here,” and told us that staff were very friendly and helpful.

People told us they were satisfied with the quality of their care and that staff gave them the support they needed. They also told us they felt safe living at Philia Lodge. One person said, "Staff respond to me when I call for their attention and they have arranged for the Community Nurse to attend to me".

All of the people we spoke with said that they were warm and comfortable and were satisfied with their accommodation.

We visited Philia Lodge on two separate occasions, September and October 2011, and people told us they were generally satisfied with their care and accommodation and that staff were available when they needed assistance. The majority of people's comments were positive and included: “This is a good home and I like living here”'; “I am getting plenty to eat and the quality of the food is good”.

There were less positive comments made when we visited in September. One person said, “I have not had any hot water for a long time” and another person advised us that they had been offered the wrong medication.

This unannounced inspection was carried out on 15 December 2014 and 17 December 2014 and was completed by 2 inspectors. The previous inspection took place on 27 November 2013, during which we found no breach of the regulations we looked at.

Philia Lodge Rest Home is a care home registered to provide accommodation and non-nursing care for up to 20 people. There were 17 people living at the home at the time of our visit. The home had internal and external communal areas, including a lounge, dining area, conservatory and a garden for people and their visitors to use.

There was a registered manager in place. 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 Care Quality Commission (CQC) is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) and report on what we find. We found that there were formal systems in place to assess people’s capacity for decision making and appropriate applications had been made to the authorising agencies for people who needed these safeguards.

People who lived in the home were assisted by staff in a kind and respectful way that also supported their safety. People had support and care plans in place which recorded their individual needs and wishes. These plans gave staff guidance on any assistance a person may need as well as their individual choices and preferences.

Risks to people were identified by staff and plans put into place to minimise these risks and enable people to live as safe and independent life as possible.

There were arrangements in place for the safe storage, management and administration of people’s prescribed medication.

Staff cared for people in a warm and caring way. Staff took time to comfort people who were becoming upset or anxious in a patient and understanding manner.

There were a sufficient number of staff on duty. Staff were trained to provide effective care which met people’s individual support needs. They understood their role and responsibilities and were supported by the manager to maintain their knowledge and skills by supervision, appraisals and training.

People were able to raise any suggestions or concerns that they might have with staff members or the manager.

Staff told us that there was an open culture within the home and this was confirmed by our observations during this visit.

The manager had in place a quality monitoring system to identify areas of improvement required within the home. Where improvements had been identified there were actions plans in place which documented the action taken.