The inspection took place on 4 October and 6 October 2016 and it was unannounced.

Sunkist Lodge is registered to provide accommodation and personal care for up to 26 people. At the time of the inspection 21 people were living at the home. People at the home were living on-going mental health issues, such as schizophrenia, personality disorder or a history of substance and alcohol misuse.

Sunkist Lodge is an older styled property situated close to the centre of Worthing with easy access to shops and the seafront. Communal areas included a lounge area and dining room leading to further dining seating in a conservatory. An outside patio area to one side of the building was used by people as a social meeting place and smoking area. People were also able to smoke in their own rooms if they so wished. The home was undergoing building works to improve the environment. Some areas of the home, including the dining room and some people’s bedrooms had been decorated. There was an action plan in place which included areas of the home which remained in need of decorating. All bedrooms were personalised and single occupancy and some had en-suite facilities. We have made a recommendation regarding the refurbishment of the premises in the main body of the report.

A registered manager was in post and had been registered with the Commission since July 2013. 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.

People told us the home was safe and there was enough staff to meet people’s needs. Staff were able to speak about what action they would take if they had a concern or felt a person was at risk of abuse. Risks to people had been identified and assessed and information was provided to staff on how to care for people safely and mitigate any risks.

People’s medicines were managed safely and administered by staff who had received specific medicine training. The home followed safe staff recruitment practices and provided a thorough induction process to prepare new staff for their role. New staff followed the Care Certificate, a universally recognised qualification.

Staff implemented the training they received by providing care that met the needs of the people they supported. Staff received regular supervisions and spoke positively about the guidance they received from the registered manager.

People could choose when, where and what they wanted to eat and were supported to maintain a healthy diet. People had access to drinks and snacks outside of mealtimes and staff knew people’s preferences. Staff spoke kindly to people and respected their privacy and dignity. Staff knew people well and had a caring approach.

People received personalised care. Care plans reflected information relevant to each individual and their abilities, including their mental health needs. Keyworkers advocated on behalf of the people they supported. Staff were vigilant to changes in people’s health needs and their support was reviewed when required. Handover meetings between shifts were an opportunity for staff to discuss any ongoing issues relating to people's care and support. If people required input from other health and social care professionals, this was arranged.

People were able to choose how they spent their day and come and go from the home as they pleased. People were supported to access the local community, some people did so independently. Activities organised within the home were being reviewed by keyworkers with people to ensure the programme was what people wanted to do. All complaints were treated seriously and were overseen by the registered manager.

People were provided opportunities to give their views about the care they recei

In this report there is one name of a registered manager who appears who was not in post and not managing the regulatory activities at this location at the time of the inspection. Their name appears because they were still a Registered Manager on our register at the time.

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask;

Is the service safe?

Is the service effective?

Is the service caring?

Is the service responsive?

Is the service well-led?

This is a summary of what we found-

Is the service safe?

People were treated with respect and dignity by the staff. People told us they felt safe. Safeguarding procedures were in place and staff understood how to safeguard the people they supported. People told us they were able to report any concerns they had. Systems were in place to make sure that both managers and staff learn from events such as accidents and incidents, complaints and concerns.

The Care Quality Commission monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. While no applications have needed to be submitted, policies and procedures were in place. Relevant staff had been trained to understand when an application should be made, and how to submit one.

Is the service effective?

People we spoke with told us they were happy with the care they received and felt their needs had been met. From what we observed and from speaking the staff it was clear that they understood people’s care and support needs and they knew them well. Staff had received training and development to meet the needs of the people living at the home.

Is the service caring?

We saw that staff were attentive and kind to the people who needed support. Staff told us they encouraged people to maintain their independence. People’s preferences, interests and diverse needs had been recorded in the care plans we reviewed.

People using the service were offered a client questionnaire to complete. Where shortfalls or concerns were raised they had been addressed and discussed with the person.

Is the service responsive?

People’s needs had been assessed before they moved into the home. Information had been recorded on detailed care plans. People told us they regularly discussed their needs with their key worker.People knew how to make a complaint if they were unhappy. The complaint’s policy was displayed on a notice board to remind people. People living at the home completed a range of activities. One person we spoke with told us “You can choose what you want to do".

Is the service well-led?

The service worked with other agencies and services to make sure people received their care in a joined up way. A quality assurance system was in place and where issues had been identified these had been rectified by the manager. Staff told us they were clear about their roles and responsibilities. Staff had a good understanding of the ethos of the home and quality assurances that were in place.

On the day of our inspection there were 23 people living at the service. We talked with five people who used the service, three members of staff, the manager and the deputy manager.

One person told us they were “quite happy here, it’s all worked out quite well.” People told us that they received good care and that their key worker assisted them with any issues they needed to resolve. People told us that staff understood their needs and that they provided appropriate care and support. One person said “Staff are really good.” We observed that staff were responsive when people asked for assistance and offered people choices about how their care was provided.

Sufficient numbers of staff with the relevant training, skills and experience were employed to meet peoples’ needs. The service took account of peoples’ views on how the service was provided and people told us that suggestions people made in residents’ meetings such as improvements to the environment had been acted upon. The provider monitored the quality and safety of the service provided and took action where needed.