About the service: Ravensworth Lodge provides support for up to 24 older people in a large adapted building spread over four floors. Twenty-four people were receiving support at the time of this inspection.

People’s experience of using this service: Staff were kind, caring and attentive to people’s needs. People consistently told us they felt safe and praised the care staff provided. Staff treated people with dignity and respect.

The environment was homely and welcoming; there was a positive atmosphere and community amongst the staff and people who used the service. Regular meaningful activities were on offer for people to join in.

Improvements were needed to make sure medicines were managed safely, and to ensure risks were consistently assessed and managed.

We have made a recommendation about developing more robust systems to record and analyse accidents and incidents.

People were kept safe by staff who were trained to recognise and respond to safeguarding concerns. Enough staff were on duty to safely meet people’s needs.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The registered manager agreed to develop the policies and systems in the service to support good practice in relation to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards.

A varied choice of meals and snacks were available. Staff monitored people’s weights and provided help when needed to make sure people ate and drank enough.

Staff received regular training, supervisions and an annual appraisal of their performance. Staff provided effective care; they were confident in their knowledge and skills, and knew how best to support people. They worked closely with other professionals and sought their advice to make sure people’s needs were met. Staff provided compassionate care to people reaching the end of their life.

The registered manager and provider completed audits. We have made a recommendation about developing these to reflect changes and improvements identified as needed during this inspection.

The registered manager was approachable, supportive and responsive to feedback.

People routinely made choices about all aspects of their care. They felt able to speak with staff or the registered manager if they were unhappy about anything or wanted to complain. The registered manager listened and learned from people’s feedback and was committed to providing person-centred and high-quality care.

More information is in the Detailed Findings section below. For more details, please see the full report which is on the Care Quality Commission’s (CQC) website at www.cqc.org.uk.

Rating at last inspection: At the last inspection service was rated Good (report published 21 July 2016).

Why we inspected: This was a planned inspection to check that this service remained Good.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

The inspection took place on the 17 May 2016 and we returned to give feedback on 23 May 2016. At our last inspection on 30 January 2014 the service was meeting all the regulations we looked at.

Ravensworth Lodge is a care home that provides accommodation and personal care for up to 24 older people who do not require nursing. There were 23 people living at the service on the day of our inspection. It is a converted house over four floors with a passenger lift. It is located in a quiet area of Scarborough within a short, level, walking distance of the local amenities.

There was a registered manager employed at this service. 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.

Staff were recruited safely with appropriate checks carried out of their background. There was sufficient staff on duty to meet people’s needs. They had been trained in safeguarding adults and could tell us how they would recognise and report any abuse.

There were health and safety safeguards in place ensuring that people lived in a safe, clean and hygienic environment. These were supported by clear policies and procedures. Risks to people’s health were identified and there were management plans in place to guide staff. Any accidents and incidents were recorded and analysed to identify any trends.

Medicines were managed safely by staff who had been trained.

Staff were skilled and knowledgeable about the people they provided care for. They received an induction when they started work at the service and were supported by senior staff through supervision and an annual appraisal.

Staff were trained in and worked within the principles of the Mental Capacity Act (MCA) 2005.

People’s nutritional needs were recorded in their care plans. Where people developed any problems around eating and drinking support was sought from allied healthcare professionals.

The environment was appropriate for the needs of people who lived at this service. There was ramped access to the house and a passenger lift to each floor.

Staff were caring and friendly towards people. They supported people’s dignity when caring for them. When people required palliative or end of life care staff had completed training and worked with clinical nurse specialists to ensure best practice.

Care plans and risk assessments were in place and these were reviewed regularly. They reflected the needs of people but would be enhanced if they were more detailed. This work was on-going.

Activities were organised at the service. The service employed an activities co-ordinator and people’s key workers supported people to go shopping or on outings.

There was a complaints procedure and people knew how to make a complaint. There had been no complaints during the last year. The registered manager explained that any minor issues were dealt with immediately.

People told us they had confidence in the registered manager. Feedback collected through surveys was positive about the service provided. People’s views were also sought at residents meetings, staff meetings and through daily conversations. There was an effective quality assurance system in place with audits carried out to identify any areas where the service could improve. Policies and procedures supported the management of the service providing guidance to staff.

People using the service spoke positively about the care and support they received at Ravensowrth Lodge.

They praised care staff and management and said they were provided with a reliable service and continuity of care. Their comments included, “They know me very well,” and “My family know I am being well looked after.” One person said “I used to visit here so when the time came I knew it was the right place for me.”

People described all the staff as 'friendly' and 'helpful' and the activity organiser was singled out by several people for special mention. Comments included “Nothing is too much bother” and “She’s grand, she will do anything for you.”

Overall, we found effective management systems were in place to promote people’s safety and welfare.

As this was a follow up inspection to check on specific shortfalls related to records we did not speak with the people who lived at the home. We found that the home had suitable systems in place to gain and review people's consent to care and treatment. We found that the home appropriately consulted with specialists to ensure people benefitted from their advice and support. We saw that risk assessments were in place to protect people from harm.

We spoke with three people who lived at the home. They told us that the staff consulted them about their care. They added that they were enabled to live their lives as they wished, have outings and that visitors were made welcome. People told us they had good care and that they enjoyed the entertainment and activities. They told us that there were enough staff to care for them without rushing and that staff had time to sit and chat.

People said that their care was explained to them in reviews but also at any time they wanted to discuss it. They were invited to reviews and could attend or give their opinions for consideration. People said the home consulted them over many areas of daily life, such as activites, outings, meals and the way personal care was offered. One person said: 'We suggested going down to the sea so the home rents a chalet every year to let us get some air and make friends with other people.'

People said the staff understood their care needs and that they received the care they needed. One person said: 'I know the staff are here to help and they often ask me what extra help I need.'

People said they felt safe and well cared for at the home. One person said. 'I find the buzzer reassuring because someone always comes quickly when I use it.' Another person said she saw the staff helping other people, anticipating their needs and making sure they were safe when they moved about the home.

One person said :' I'm happy for the staff to look after my medication. I trust them to do it properly.'

People said that the home was clean and that it was safe for them. One person said: 'The lift is a real help and there are always staff around to help people who need assisance to their rooms.'

People said the staff were confident and seemed knowledgeable in their roles. One person said: 'I think the staff are wonderful, they all know what they're doing and it makes you feel reassured to know they're all there to help.'