This inspection took place on 25 October 2016 and was unannounced.

Redcot Lodge Residential Care Home is in Cliftonville and has close public transport links. The service offers short and long term residential care for up to 18 people over 65 years old some of whom were living with dementia. There is a well-maintained, secure garden at the rear of the premises. On the day of the inspection there were 16 people living at the service.

A registered manager was in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 day to day running of the service was managed and overseen by the registered manager with the support of a manager and a human resources manager. They were all present during the inspection. The registered manager was the registered provider.

At the last inspection in September 2015, the service was rated ‘Requires Improvement’, there were breaches of the Health and Social Care Act 2008 (Regulated Activities) 2014. The provider did not provide sufficient guidance for staff to follow to show how risks to people were reduced. There was no system to analyse accidents and incidents. The provider did not always deploy sufficient numbers of competent, skilled and experienced staff to keep people safe and to meet their needs. Care plans were not updated and reviewed regularly. Quality assurance checks had not been consistently completed. We asked the provider to make improvements. The provider sent CQC a plan of actions to address the shortfalls. At this inspection the actions had been completed and the breaches had been met.

People felt safe living at the service. Staff knew how to respond to abuse and how to keep people safe. People were involved in making decisions about taking risks and staff explained risks to them in a way they could understand. Risks to people were assessed, monitored and reviewed.

Staff knew about abuse and knew what to do if they suspected any incidents of abuse. Staff were aware of the whistle blowing policy and the ability to take concerns to agencies outside of the service.

There were enough staff to meet people’s needs. The registered manager followed the provider’s recruitment process to make sure staff employed were of good character and safe to work with people. Staff completed regular training to keep them up to date with best practice. One to one meetings and annual appraisals were held to discuss their personal development.

People received their medicines safely and on time from staff trained to administer medicines. Medicines were stored, managed and disposed of safely.

Staff knew the importance of giving people choices and gaining people’s consent. Staff understood the requirements of the Mental Capacity Act and Deprivation of Liberty Safeguards (DoLS). CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. These safeguards protect the rights of people using services by ensuring that if there are any restrictions to their freedom and liberty, these have been agreed by the local authority as being required to protect the person from harm. The registered manager and staff understood their responsibilities in relation to DoLS and had completed applications in line with guidance. At the time of the inspection there was no-one living at the service with an authorised DoLS.

People enjoyed a choice of healthy of food and drinks. Snacks were available for people to help themselves to whenever they wanted. People’s health was assessed, monitored and reviewed. Staff worked with health professionals, such as, community nurses and the local hospice to make sure people’s health care needs were met.

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We made an unannounced inspection to Redcot Lodge and spoke with people who use the service, staff and the registered manager. There were 17 people using the service at the time of our visit.

Everyone we spoke with expressed that they were very happy living at Redcot Lodge. We observed interactions between the people and the staff and also people’s reactions to the staff.

People were asked to give consent and were involved in the decisions about the care and support they received. People told us that they were asked for consent before any care took place and their were wishes respected. One person commented, “Staff know what I can do for myself and help me with the things I can’t manage”.

People told us that they had the care and support they needed to remain well and healthy. They said they were involved in decisions about their care and support.

We observed that the provider had provided an environment that was suitably designed and adequately maintained. The home was clean and free from offensive odours.

Staff were supported and supervised to undertake their roles effectively and safely. People told us they thought the staff were very good and knew what they were doing. One person told us, “The staff are very good”.

Systems were in place to monitor the service that people received to ensure that the service was satisfactory and safe.

We made an unannounced visit to the service and spoke with the people who use the service, the registered manager and staff members. There were 17 people using the service at the time of our visit.

Everyone we spoke with expressed that they were happy living at Redcot Lodge. We observed interactions between the people and the staff and people’s reactions to the staff. We observed to see how people were.

People told us that they were well looked after, felt safe and would talk to staff if they had a problem. We were told “I am happy with everything here. My daughter visits me once a month”. Another person said “The staff are fine and the people are lovely”.

Everyone said that the food was ‘good’ or ‘excellent’.

People told us that the staff “are very kind” and “they staff chat to me and have friendly conversations”.

Staff engaged with people in a warm and positive way.

Redcot Lodge is a residential home in Cliftonville and has close public transport links. The service offers short and long term residential care for up to 18 people over 65 years old. There is a well maintained, secure garden at the rear of the premises. On the day of the inspections there were 17 people living in the service.

The service was run by two registered managers who split the workload between them, however, one of the registered managers had recently left the service and a manager had been employed who was working closely with the registered manager with a view to registering with the Care Quality Commission (CQC). The service is currently run by a registered manager who was also the registered provider and was present on the days of our inspection. The registered provider is a ‘registered person’ who has legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People told us that they felt safe living at the service. People looked comfortable with each other and with staff. Staff understood the importance of keeping people safe and knew how to protect people from the risk of abuse. People received their medicines safely and were protected against the risks associated with the unsafe use and management of medicines. Recruitment processes were in place to check that staff were of good character.

People were not fully protected from the risks of avoidable harm and abuse. Potential risks to people were identified and assessed but guidelines for staff were not always available, detailed or clear.

People told us that staff were sometimes rushed and that their call bells were not always answered in a timely manner. One person said, “It takes a while to answer call bells at night”. There was a risk that people may not receive the care and support they needed because the provider failed to deploy sufficient numbers of suitably competent, skilled and experienced staff to keep people safe and meet their needs.

Staff told us that training was offered to them that was relevant to the care needs of the people they were looking after. Staff had received initial training but refresher training had not always been completed.

People were provided with a choice of healthy food and drinks which ensured that their nutritional needs were met. One person told us, "I enjoy the food. I can't believe sometimes how much we get. I don't remember being asked what I would like today but I had a salad and there was an awful lot of it but I did eat it all". Meals looked appetising and were well presented. People’s physical health was monitored and people were supported to see healthcare professionals, such as doctors and chiropodists.

The registered manager and staff understood how the Mental Capacity Act 2005 was applied to ensure decisions made for people without capacity were only made when this was in their best interests. The CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. Arrangements were in place to check if people were at risk of being deprived of their liberty and to meet the requirements of DoLS.

Staff were kind, caring and compassionate and knew people well. People were encouraged to maintain their independence. People were happy with the standard of care at the service. People and their loved ones were involved with the planning of their care before they moved to the service. One person said, “They [staff] are very nice people” and another commented, “They treat me really well here”.

Each person had a care plan but these were not fully person centred and did not always give staff the guidance and information they needed to look after the person in the way that suited them best. Information in care plans was not completed and updated consistently.

There was a complaints system and people knew how to complain. Views from people and their relatives were taken into account and acted on. The provider used concerns and complaints as a learning opportunity and discussed them openly with staff.

The design and layout of the building met people’s needs and was safe. The atmosphere was calm, happy and relaxed. The risk of social isolation was reduced because staff supported people to keep occupied with a range of activities which included singing, crafts and exercises.

The registered manager coached and mentored staff through regular one to one supervision. The registered manager and manager worked with the staff each day to maintain oversight and scrutiny of the service. People told us that the service was well run. Staff said that the service was well led, had an open culture and that they felt supported in their roles.

There were systems in place to monitor the quality of the service. However, reviews and audits of care plans and associated assessments had not been completed consistently.

The provider had submitted notifications to CQC in a timely manner and in line with CQC guidelines.

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what actions we have asked the provider to take at the end of this report.