The inspection took place on the 22 and 23 May 2017 and was unannounced.

South Africa Lodge provides accommodation and nursing care for up to 94 older people. At the time of our inspection there were 75 people living at the home. People living at the home have high complex support needs in relation to their diagnosis of dementia, mental health conditions, learning disabilities and physical disabilities. The home is separated into six lodges that have dedicated staff teams.

Bedrooms are single occupancy with en-suite facilities and each lodge has communal areas. There is a well maintained and secure garden area to the rear of the building that is regularly used by people with support from staff. There is also a large bird aviary in the courtyard area that is overlooked by the main lounge.

The service had 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.

Individual care records were stored electronically and staff had access to update records accordingly.

The provider had systems in place to respond and manage safeguarding matters and make sure that safeguarding concerns were raised with other agencies.

People who were able to talk with us and relatives said they felt safe in the home and if they had any concerns they were confident these would be quickly addressed by the staff or registered manager

Assessments were in place to identify risks that may be involved when meeting people’s needs. Staff were aware of people’s individual risks and were able to tell of the strategies’ in place to keep people safe.

There were sufficient numbers of qualified, skilled and experienced staff deployed to meet people’s needs. Staff were not hurried or rushed and when people requested care or support, this was delivered quickly. The provider operated safe and effective recruitment procedures.

Medicines were stored and administered safely. Clear and accurate medicines records were maintained. Training records showed that staff had completed training in a range of areas that reflected their job role.

Staff received supervision and appraisals were on-going, providing them with appropriate support to carry out their roles.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. At the time of our inspection applications had been submitted by the managing authority (care home) to the supervisory body (local authority) and had yet to be authorised. The registered manager understood when an application should be made and how to submit one.

Where people lacked the mental capacity to make decisions the home was guided by the principles of the Mental Capacity Act 2005 to ensure any decisions were made in the person’s best interests.

People were involved in their care planning, and staff supported people with health care appointments and visits from health care professionals. Care plans were amended to show any changes, and care plans were routinely reviewed to check they were up to date.

People were treated with kindness. Staff were patient and encouraged people to do what they could for themselves, whilst allowing people time for the support they needed.

People knew who to talk to if they had a complaint. Complaints were passed on to the registered manager and recorded to make sure prompt action was taken and lessons were learned which led to improvement in the service.