This inspection took place on 18 May 2017. This was an unannounced inspection which meant that the provider and staff did not know we would be visiting.

Saxon Lodge provides accommodation for up to nine people with complex needs such as learning and physical disabilities. At the time of our inspection there were nine people using the service. Accommodation was provided over two floors. Bedrooms had ensuite facilities and if required specialist moving and handling equipment.

At the last inspection on 20 March 2015, the service was rated good. At this inspection we found the service remained good.

Medicines were stored and managed safely with people receiving their medicines as prescribed.

There were systems and processes in place to protect people from the risk of harm. Staff were aware of types of abuse and signs to look for. They also understood their responsibility to report anything they may be concerned about. The registered provider had a whistleblowing (telling someone) policy in place and staff had knowledge of this.

Risks to people’s safety had been assessed and risk assessments were personalised to each individual. Accidents and incidents were appropriately recorded and regularly analysed to minimise the risk of reoccurrence. Appropriate checks of the building and maintenance systems were undertaken to ensure health and safety.

There were appropriate staffing levels to meet the needs of the people using the service. We saw evidence of safe recruitment and selection procedures and appropriate checks were undertaken prior to staff starting work.

Staff had been trained and had the skills and knowledge to provide support to the people they cared for. Staff were given effective supervision and a yearly appraisal.

Staff understood the requirements of the Mental Capacity Act 2005 (MCA) and the Deprivations of Liberty Safeguards (DoLS) which meant they were working within the law to support people who may lack capacity to make their own decisions.

People were supported to maintain a healthy diet and to access healthcare appointments.

There was a lively and homely atmosphere in the service. Staff had a clear understanding of people’s needs and how they liked to be supported. People were supported by kind and attentive staff and we observed positive interactions between staff and people using the service. Relatives spoke positively about the care their loved ones received.

Support plans were individualised and person centred. They were well-written and contained a high level of detail about people’s needs and preferences.

People were supported to take part in activities within the service such as watching films and listening to music. Staff also encouraged and supported people to access activities within the community. These included days out walking in the countryside and visits to the theatre.

Relatives and staff described the registered manager as approachable and felt there was an open culture. Effective quality assurance was taking place to monitor the quality of the service and drive positive change.

The inspection visit took place on 20 March 2015. This was an unannounced inspection which meant that the staff and provider did not know that we would be visiting.

We last inspected the service on 10 October 2013 and found the service was not in breach of any regulations at that time.

Saxon Lodge is a purpose built home which provides accommodation for up to eight people with complex needs such as learning and physical disabilities. The home is within walking distance of Norton town centre with a number of local facilities close by. Accommodation is provided over two floors. Bedrooms have an en-suite toilet, wash basin and a shower and appropriate ceiling hoists in place. On the ground floor there is a communal lounge, large kitchen/dining room, an activities lounge and space for arts and crafts. The home is close to shops, pubs and public transport.

There is 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.

One person told us they felt safe at Saxon Lodge and we observed the care and support other people received who could not communicate directly with us. We discussed safeguarding with staff and all were knowledgeable about the procedures to follow if they suspected abuse. Staff were clear that their role was to protect people and knew how to report abuse including the actions to take to raise this with external agencies.

There were policies and procedures in place in relation to the Mental Capacity Act (MCA) 2005 and Deprivations of Liberty Safeguards (DoLS). The registered manager had the appropriate knowledge to know how to apply the MCA and when an application should be made and how to submit one. This meant people were safeguarded.

Staff had received a range of training, which covered mandatory courses such as fire safety, infection control, food hygiene as well as condition specific training such as working with people with epilepsy and providing person centred support. We found that the staff had the skills and knowledge to provide support to the people who lived at the home. People and the staff we spoke with told us that there were enough staff on duty to meet people’s needs. We saw that five staff routinely provided support to 8 people.

There was a regular programme of staff supervision in place and records of these were detailed and showed the home worked with staff to identify their personal and professional development. We also saw a regular programme of staff meetings where issues were shared and raised.

The service encouraged people to lead a safe and active lifestyle. People were supported to be involved in the local community as much as possible. People were supported to access facilities such as the local G.P, shops and leisure facilities as well as to use the facilities in the service such as the kitchen for cooking meals.

There was a system in place for dealing with people’s concerns and complaints. One person told us they would talk to staff if they were unhappy with anything. The staff we spoke with all told us they could recognise if people they supported weren’t well or were unhappy and what measures they would take to address any concerns. Two relatives also told us they would know if their relative wasn’t happy and that they could discuss anything with the registered manager and deputy manager.

People were encouraged to help prepare food with staff support if they wished and on the day of our visit some people had helped prepare a corned beef pie. We saw people had nutritional assessments in place and people with specific dietary needs were supported. Specialist advice was sought quickly where necessary not only for nutritional support but any healthcare related concerns.

We saw that detailed assessments were completed, which identified people’s health and support needs as well as any risks to people who used the service and others. These assessments were used to create care plans which were detailed and person centred. Care plans were regularly reviewed and involved the person as far as possible.

We reviewed the systems for the management of medicines and found that people received their medicines safely and there were clear guidelines in place for staff to follow.

We found that the building was very clean and well-maintained. Appropriate checks of the building and maintenance systems were undertaken to ensure health and safety. We found that all relevant infection control procedures were followed by the staff at the home and there was plenty of personal protective equipment to reduce the risk of cross infection. We saw that audits of infection control practices were completed.

We saw that the manager utilised a range of quality audits and used them to critically review the service. They also sought the views of people using the service and their families on a regular basis and used any information to improve the service provided. This had led to the systems being effective and the service being well-led.

Accidents and incidents were also reviewed by the registered manager and appropriate measures taken to reduce the risk of any further re-occurrence.

We saw that staff members were recruited safely using appropriate identity checks and people were involved in the recruitment process.

The inspection visit took place on 20 March 2015. This was an unannounced inspection which meant that the staff and provider did not know that we would be visiting.

We last inspected the service on 10 October 2013 and found the service was not in breach of any regulations at that time.

Saxon Lodge is a purpose built home which provides accommodation for up to eight people with complex needs such as learning and physical disabilities. The home is within walking distance of Norton town centre with a number of local facilities close by. Accommodation is provided over two floors. Bedrooms have an en-suite toilet, wash basin and a shower and appropriate ceiling hoists in place. On the ground floor there is a communal lounge, large kitchen/dining room, an activities lounge and space for arts and crafts. The home is close to shops, pubs and public transport.

There is 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.

One person told us they felt safe at Saxon Lodge and we observed the care and support other people received who could not communicate directly with us. We discussed safeguarding with staff and all were knowledgeable about the procedures to follow if they suspected abuse. Staff were clear that their role was to protect people and knew how to report abuse including the actions to take to raise this with external agencies.

There were policies and procedures in place in relation to the Mental Capacity Act (MCA) 2005 and Deprivations of Liberty Safeguards (DoLS). The registered manager had the appropriate knowledge to know how to apply the MCA and when an application should be made and how to submit one. This meant people were safeguarded.

Staff had received a range of training, which covered mandatory courses such as fire safety, infection control, food hygiene as well as condition specific training such as working with people with epilepsy and providing person centred support. We found that the staff had the skills and knowledge to provide support to the people who lived at the home. People and the staff we spoke with told us that there were enough staff on duty to meet people’s needs. We saw that five staff routinely provided support to 8 people.

There was a regular programme of staff supervision in place and records of these were detailed and showed the home worked with staff to identify their personal and professional development. We also saw a regular programme of staff meetings where issues were shared and raised.

The service encouraged people to lead a safe and active lifestyle. People were supported to be involved in the local community as much as possible. People were supported to access facilities such as the local G.P, shops and leisure facilities as well as to use the facilities in the service such as the kitchen for cooking meals.

There was a system in place for dealing with people’s concerns and complaints. One person told us they would talk to staff if they were unhappy with anything. The staff we spoke with all told us they could recognise if people they supported weren’t well or were unhappy and what measures they would take to address any concerns. Two relatives also told us they would know if their relative wasn’t happy and that they could discuss anything with the registered manager and deputy manager.

People were encouraged to help prepare food with staff support if they wished and on the day of our visit some people had helped prepare a corned beef pie. We saw people had nutritional assessments in place and people with specific dietary needs were supported. Specialist advice was sought quickly where necessary not only for nutritional support but any healthcare related concerns.

We saw that detailed assessments were completed, which identified people’s health and support needs as well as any risks to people who used the service and others. These assessments were used to create care plans which were detailed and person centred. Care plans were regularly reviewed and involved the person as far as possible.

We reviewed the systems for the management of medicines and found that people received their medicines safely and there were clear guidelines in place for staff to follow.

We found that the building was very clean and well-maintained. Appropriate checks of the building and maintenance systems were undertaken to ensure health and safety. We found that all relevant infection control procedures were followed by the staff at the home and there was plenty of personal protective equipment to reduce the risk of cross infection. We saw that audits of infection control practices were completed.

We saw that the manager utilised a range of quality audits and used them to critically review the service. They also sought the views of people using the service and their families on a regular basis and used any information to improve the service provided. This had led to the systems being effective and the service being well-led.

Accidents and incidents were also reviewed by the registered manager and appropriate measures taken to reduce the risk of any further re-occurrence.

We saw that staff members were recruited safely using appropriate identity checks and people were involved in the recruitment process.

At the last inspection we found that people's care records were not always accurate or kept up to date.

At the inspection we went back to check the action staff had taken to ensure the records were being maintained appropriately. We looked at six of the eight sets of care records. We found that the care records contained evidence to confirm that the person and their relative had been involved in drawing up the plan of care and keeping it up to date. People were unable to communicate so staff told us how they involved people and their relatives in developing care plans and how they shared their ideas about care and support.

Where people were highlighted as being at risk, for example, with epilepsy, care plans had been developed. We found evidence of accurate nutritional screening. We found that care records contained up to date assessments, care plans and risk assessments. We found that care plans were reviewed monthly.

We found that people were protected from the risks of unsafe or inappropriate crae and treatment because records were maintained.

We spoke with two relatives of a person who used the service. They told us that their relative had been at Saxon Lodge for over six years and that, “It’s down to the staff; they are like an extended family.” They also said that they had, “No problems with the care provided” and felt that their relative was safe at the home.

We observed staff providing support to people in a kind and caring manner. We found that people experienced care and support that met their needs.

We found that there were enough staff to meet people’s needs and people were supported by suitably qualified, skilled and experienced staff.

Staff were up to date with training, however we found that although staff had previously received regular supervision sessions these were now overdue. We also found that appraisals were not up to date.

People were not protected from the risks of unsafe or inappropriate care and treatment because care records were not always completed properly.

People living at Saxon Lodge were unable to tell us what they thought about the care they received. Therefore in order for us to understand the views and experiences of people living at the home, we carried out observations to see what people were doing. We also observed the interactions taking place between people living and working at the home..

We saw that people were well cared for and supported by a team of staff who were very knowledgeable about the care and support that people needed.

People's needs were assessed and their rights were respected by the staff. We saw that people were able to make decisions about how they wanted to spend their time and how they wanted to be supported and cared for.

People had support plans and risk assessments in place which helped staff to understand and meet people's needs and wishes. We observed staff helping people to maintain their independence and make choices for themselves, for example what activities they wanted to participate in during the day and what some people wanted for their lunch.

We saw that contact with families and friend is maintained and staff support people to do this. There was lots of involvement with local community groups and people had the opportunity with the support from staff to visit a variety places, attend social events and go on holidays.

People living at Saxon Lodge were unable to tell us what they thought about the care they received. So that we could gain an understanding of their views and experiences of living Saxon Lodge, we spent time observing what people were doing during the day. We also used observations of the interactions between people living at the home and the staff to inform the judgements reached within this report.

During our visit, all interactions we observed between the staff and the people living at the home were open, respectful and courteous.

We saw numerous occasions where the people living at the home communicated that they wanted assistance. We saw the staff providing whatever was wanted in a way that demonstrated a good knowledge of each individual person. Where appropriate, we saw staff providing support and encouragement to the people to do things as independently as possible.

We observed people being spoken with and supported in a sensitive, respectful and professional manner. We saw that staff included people living at the home in the day to day running of the home and that, whenever possible, it was the people living at the home that made decisions on what happened through the day and when. We saw that people's needs were met in a calm and unhurried way, with enough staff available to meet any needs as they arose.

During the inspection we spoke to a relative. The relative said "We are really pleased with the level of care. They have blossomed since they have been here, they are happier."