We carried out an unannounced comprehensive inspection of Ridgewood Lodge on 21 November 2018. The previous inspection took place on 3 May 2016, we had no concerns and the service was rated as Good. At this inspection the service remains Good.

Ridgewood Lodge is registered to provide care and accommodation for up to six people who have a learning disability or mental health needs. At the time of the inspection there were five people living at the service.

Ridgewood Lodge is a ‘care home.’ People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

The home is situated in a residential area of Camborne close to shops and travel links. All accommodation at the home is provided on a single room basis. Communal space comprised of a conservatory and inner lounge area. The conservatory also acted as a dining room. There is an enclosed garden area at the front of the service. The kitchen was of a domestic nature in keeping with supporting people to make their own meals.

Ridgewood Lodge has a registered manager. 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. In addition to the registered manager, the service had a deputy manager and team leaders who oversaw the day to day running of the service.

The care service was established before the development of the CQC policy, 'Registering the Right Support' and other current best practice guidance. This guidance includes the promotion of values including choice, independence and inclusion. The service was working with people with learning disabilities and mental health needs that used the service, to support them to live as ordinary a life as any citizen. For example, people’s bedrooms offered space and privacy. There was access to activities both at the service and in the community. People were supported to make their own choices about all aspects of their life.

People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice. Where restrictions were in place to keep people safe the best interest process had been followed to check the restrictions were necessary, proportionate and the least restrictive.

We observed that people’s needs were responded to in a timely manner and saw evidence that their needs were reviewed regularly. We saw staff treating people with patience, kindness and affection. Two people told us they liked being supported by the staff working at Ridgewood Lodge.

The service had systems in place to record safeguarding concerns, accidents and incidents and take necessary action as required. Staff had received safeguarding training and understood their responsibilities to report unsafe care or abusive practices.

Risk assessments had been developed to minimise the potential risk of harm to people during their daily routines and delivery of their care. These had been kept under review and were relevant to the care provided.

Staff had been appropriately trained and supported. They had the skills, knowledge and experience required to support people with their care and social needs.

People told us they received their medicines as prescribed and when needed. We found appropriate arrangements were in place for the safe storage of medicines.

Staff on duty knew the people they supported well and provided a personalised service in a caring and professional manner. Care plans were organised and had identified care and support people required. We found they were in

Ridgewood Lodge is a small care home that can accommodate up to six people with learning and /or physical disabilities and mental problems. At the time of our inspection there were four people living in the service.

There was a registered manager in post who was responsible for the day-to-day running of the 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 and associated Regulations about how the service is run.

We carried out this inspection on 3 May 2016. The service was last inspected in October 2013 and was found to be meeting the Regulations.

Relatives told us they were happy with the care and support their family member received and believed it was a safe environment. Relatives said, “They [the service] look after [person’s name] perfectly. [Person’s name] is very happy” and “I have no concerns about the service at all.”

People living at the service had limited verbal communication and were not able to tell us their views about the care and support they received. However, we observed people were relaxed and comfortable with staff, and were supported by staff to make choices about their daily living.

Support was provided by a consistent staff team who knew people well and understood their needs. There were sufficient numbers of suitably qualified staff on duty. People were supported to access the local community and take part in a range of activities of their choice.

Staff completed a thorough recruitment process to ensure they had the appropriate skills and knowledge. Staff knew how to recognise and report the signs of abuse.

People were supported to maintain good health, had access to healthcare services and received on-going healthcare support. Specialist services such as occupational therapists and dieticians were used when required. Relatives told us they were confident that the service could meet people’s health needs. One relative said, “Staff noticed something recently about [person’s name] health that I might not have seen. They are very good at looking for any changes.”

People were supported to eat and drink enough and maintain a balanced diet. Staff had acquired knowledge of what people liked to eat and people were involved in menu planning as much as was possible. Menu planning was done in a way which combined healthy eating with the choices people were able to make about their meals.

Care records were up to date, had been regularly reviewed, and accurately reflected people’s care and support needs. Details of how people wished to be supported were personalised to the individual and provided clear information to enable staff to provide appropriate and effective support. Any risks in relation to people’s care and support were identified and appropriately managed.

Where people did not have the capacity to make certain decisions the registered manager and staff acted in accordance with legal requirements under the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards.

People and their families were given information about how to complain. There was a management structure in the service which provided clear lines of responsibility and accountability. There was a positive culture in the service, the registered manager and owner provided strong leadership and led by example. Staff said, “The manager and owner are very approachable”, “I am happy working here” and “People living here get a good service.”

There were effective quality assurance systems in place to make sure that any areas for improvement were identified and addressed. The owner was visible in the service and regularly visited to check if people were happy and safe living at Ridgewood Lodge.

We visited Ridgewood Lodge residential home to look at the care and welfare of people who used the service. We spoke with five of the six people who used the service, spoke with the provider, manager and two care staff. There was also contact with a police officer who attended for a specific matter. The matter was resolved which ensured that the person was kept safe. This showed us that there was a good working relationship with other organisations to ensure the welfare and wellbeing of people who use the service.

We went into the lounge where people told us what they liked about living at the home. Comments such as "it has to be quiet for me" "I have a visit every three weeks from my mother which I looked forward to". "I liked living here because I have my own room and I can lock it". We also observed a situation which was handled very well by the staff when someone refused a shower. Staff were seen to be sensitive to the person's needs and only helped when requested by them. People were seen to use all the facilities of the home in a free and uninhibited manner.

We contacted two relatives over the telephone who spoke very highly of the service. They said "the manager and staff involved them in reviews, care, treatment and they were satisfied with the level of communication they received from the manager and staff.

We read the Safeguarding policies and procedures which were supported by effective staff training.

We spoke with one of the five people who used the service, and they said they liked it at Ridgewood Lodge. We saw two others in communal areas interacting with the staff, and from the verbal and non-verbal communications seen we understood staff to be attentive, helpful and polite. The atmosphere in the home was warm and welcoming.

Care plans and associated documentation were in place, but not always detailed enough to direct and guide staff of the action they needed to take in order to meet people’s assessed care needs. People's records were personalised, and showed choices were made by people in respect of their daily lives.

People were protected from the risks of inadequate nutrition and dehydration.

People who used the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

People were protected from the risk of infection because people were cared for in a clean, hygienic environment.

The provider did not have an effective system in place to identify, assess and manage risks to the health, safety and welfare of people who used the service and others.

We reviewed all the information we hold about this provider, carried out a visit on 14 January 2012, observed how people were being cared for, talked with people who use services, talked with staff, and checked records.

Some of the people using the service were not able to comment in detail about the service they receive. We saw people’s privacy and dignity being respected and staff being helpful. There were no issues raised by people using the service or by staff. People who use the service were moving freely around the home. We saw that people who use the service were very happy to approach any member of staff. We saw that residents were spoken with in an adult, attentive, respectful, and caring way.

Staff told us that training was provided, and some more training was booked later this month.