This inspection was unannounced and took place on 17 December 2015. At the last inspection in June 2014, we found the provider was meeting all of the requirements of the regulations we reviewed.

Wentworth Lodge Residential Care Home is registered to provide accommodation for up to 44 people who require personal care and support. On the day of the inspection there were 43 people living at the home. There was a registered manager 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.

People and their family members told us they felt safe. Staff knew how to keep people safe and were confident in reporting any concerns or suspected abuse. Risks to people were managed effectively and there were enough staff to meet people’s needs and provide them with effective care and support.

People medicines were managed safely so that people received their medicines as prescribed. Medicines were stored securely and there were clear audit trails for people’s medicines.

People spoke positively about the staff who supported them. Staff were trained and had the skills and knowledge to support people. A detailed training plan was in place to keep staff up to date with current practice.

People’s consent was sought before care was provided and appropriate assessments had been carried out around people’s capacity to make certain decisions.

People liked the food provided in the home and told us they received the food and drink they required. Staff knew people’s preferences and people with specific dietary requirements received the appropriate food.

People were supported to access appropriate healthcare according to their needs and staff responded without delay to changes in people’s health.

We saw that staff knew people well and had caring and friendly relationships with them. Staff had a good understanding of people’s needs and preferences. People were involved in making decisions about their care and support.

Staff acted in a way that protected people privacy and dignity. We saw staff supporting people sensitively and discreetly. People’s relatives were welcome to visit the home at a time of their choosing.

People’s care was tailored to their individual needs. Staff had a good understanding of people’s preferences and life histories and provided them with support that was responsive to their needs.

There were systems in place to manage complaints. People felt able to express their views to the management team. Where concerns had been identified, action had been taken to resolve issues, although some of these were on-going at the time of the inspection.

People, their relatives and staff felt the home was well managed. The provider was visible within the home and knew the people who lived there. Staff felt valued by the management team and felt they were listened to when they contributed ideas.

There was a quality assurance system in place that enabled the provider and the management team to ensure they provided people with high quality care. We saw that changes were made based on feedback from people and their families.

We carried out this inspection in response to concerns that we received about people’s care and welfare. At a previous inspection in November 2013 we found improvements were needed in respect of management of medicines. The provider wrote to us and told us what actions they were going to take to improve. We looked to see what improvements had been made in this area.

The summary is based on our observations during the inspection, discussions with six people using the service, three visitors, seven members of staff and the manager. We also looked at four records relating to people’s care and other records related to the running of the service.

If you wish to see the evidence supporting our summary please read the full report.

Is the service safe?

People told us they felt safe and secure.

The staff that we spoke to understood the procedures they needed to follow to ensure that people were safe. They were able to describe how they delivered care in a way that ensured risks were identified and responded to. The management were able to tell us different ways that people might experience abuse and the correct steps to take if they were concerned that abuse had taken place.

We looked at how the home managed medication and found that improvements had been made. This meant that medication administration was safe and people were protected from the unsafe use of medication.

We found that equipment was well maintained and regularly serviced and all health and safety records were up to date. These checks meant that people were not placed at unnecessary risk

We inspected the staff rotas which showed that there was sufficient staff on duty to meet people’s needs throughout the day. The staff rota reflected the number of staff we saw on duty. People received a consistent and safe level of support. A person told us that, “The staff are lovely, they are there when you need them”. Some relatives told us, “Normally seems to be plenty of staff around”.

Procedures for dealing with emergencies were in place and staff were able to describe these to us.

The provider and staff understood their responsibilities under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). This is legislation that makes provision relating to persons who lack capacity, and how decisions should be made in their best interests when they do so. At the time of our inspection no applications had been made. Although the management were able to describe the circumstances when an application should be made and knew how to submit one.

Is the service effective?

People all had an individual care plan which set out their care needs. People told us they received the care that they needed and some told us they had been involved in the assessment of their health and care needs, which in turn contributed to developing their care plan. Assessments included needs for any equipment, mobility aids and specialist dietary requirements. People had access to a range of health care professionals some of which visited the home. We saw that the manager made arrangements to ensure that healthcare appointments we made at times that were convenient for people.

This meant that people were sure that their individual care needs and wishes were known and planned for and that they had the equipment they needed to meet their individual needs.

Is the service caring?

People were supported by kind and attentive staff. We saw that staff showed patience and gave encouragement when supporting people. People commented, “The staff are very nice and they are clean and tidy, and the cook comes round to offer us a choice of meals”. A visitor said, “Since I’ve been coming here the care (provided by staff) has improved immensely, X has really benefited from looked after and has put weight on”.

Staff were aware of people’s preferences, interests, aspirations and diverse needs. Our observations of the care provided, discussions with people and records we looked at told us that individual wishes for care and support were taken into account and respected.

Is the service responsive?

We heard from some people that they were able to pursue individual activities. We also saw that there were some impromptu activities such as a sing a long during the inspection. We saw that staff recorded activities people participated in but visitors told us that they did not see many activities when they were there.

The manager told us how they planned to increase the hours of the home’s activity co-ordinator and they had made activity boxes available for use with individual people, for example items relating to reminiscence. This showed that the manager was aware that this was an area that needed further development so as to improve stimulation for people.

People told us they were kept informed when their care needs changed. One relative had stated in a survey form returned to the home, ‘The staff are very helpful and courteous, with smiling faces and information when you ask and talk to them’.

People knew how to make a complaint if they were unhappy. Two people said that they had made a complaint and both were satisfied with the outcomes. The manager told us that they took complaints seriously and looked into them quickly and we heard from some people that staff were responsive to matters they raised.

The registered manager told us the service worked well with other agencies and services to make sure people received their care in a joined up way. We heard from other agencies that they had found the service to be responsive to suggestions they had made to the manager.

Is the service well-led?

The home’s owner was also the registered manager. Senior staff were trained appropriately to undertake the roles that they were delegated as part of the management team. This meant that senior staff had key areas of responsibility, for example care planning and medication which helped with management oversight.

The home had a system to assure the quality service they provided. The way the service was run had been regularly reviewed and people’s views were sought. Prompt action had been taken to improve the service or put right any shortfalls they had found, or those we identified on the day of our inspection.

Information from the analysis of accidents and incidents had been used to identify changes and improvements to minimise the risk of them happening again.

People’s personal care records, and other records kept in the home, were accurate and complete. We only found one risk assessment that was inaccurate and this was updated before we completed the inspection.

We spoke with eight people, one relative, five staff members and the home manager who was also the owner.

People received care that met their individual needs. We saw people being supported appropriately by staff throughout the day. One person said, “The care is good here, I am really happy.”

Arrangements were in place to minimise risks around infection control. One relative said, “The room is always clean and tidy.”

Systems were not always in place to ensure the safe handling of medicines. Records were not maintained appropriately to minimise the risks around medicines.

Staff were supported so they had the relevant skills, qualifications and experience to carry out their role. One staff member said, “They really support me to get all the training I need.”

Systems were in place to monitor the quality of the service. Complaints and comments were taken seriously and action was taken to make improvements. One person told us, “I have no complaints whatsoever.”

Records we looked at were fit for purpose, easily accessible and accurate.

We carried out this inspection to check on the care and welfare of people. There were 34 people living at the home on the day of the inspection. We spoke with six people, three relatives, six staff, and the home manager who was also the joint home owner.

We found that people were asked for their consent before care was delivered. One person told us, “Yes, they always ask me.” We found that arrangements were in place for people who lacked capacity to make decisions.

We saw that people were well presented and wore clothes that reflected their own preferences, style, and gender. We found that people received care that met their needs. One person said, “The staff are caring and look after us.” People had regular access to see other health professionals, when needed.

We found that arrangements were in place to ensure that people were safeguarded from harm.

We found that recruitment and section processes were consistent. Arrangements were in place to ensure that only staff suitable to work with vulnerable adults were employed.

People and relatives we spoke with knew how to complain. One person said, “There is nothing to complain about here.” We found that people's comments and complaints were taken seriously.

We carried out this review to check on the care and welfare of people using this service.

We spoke with the majority of the people who used the service, two visiting healthcare professionals, six visitors, the management of the service and a group of members of staff.

We spent time sitting in each of the four lounge areas observing how staff and people got on with one another. We saw staff were chatting with people and assisting them when help and support was needed. We did not see or hear anyone waiting for assistance when they needed help. We saw staff being very patient with people, taking the time to explain what was happening and helping people to make decisions of what they wished to do. People’s body language indicated they were at ease and comfortable in their surroundings.

People we spoke with who used the service told us of their satisfaction with the staff, the care provided, their own bedrooms and the food provided.

One person told us they were unaware they had a plan of care. We selected this person's plan and saw that they had signed several documents indicating they had been involved in discussions. Relatives told us the staff always contact them if there were any concerns that related to the health and welfare of their relative. They told us the staff were very friendly, kind and “knew what they were doing”.

We saw a variety of activity, both in house and in the community, had been arranged for people to enjoy and participate in. People told us they enjoyed singing and dancing to music. One person told us additional activities that were directly related for people with dementia would be useful. We saw books and other items for helping people to remember were available and in use.

Visitors told us they always felt very welcome when at the home. One person told us that they were always offered a drink on their arrival. One person told us the care was “superb” and “the staff go the extra mile to make sure people are well cared for”. The healthcare professionals were complimentary about the care provided and told us they had “no concerns”.

We saw the way the service monitored the quality of the service. The management evaluated the returned completed satisfaction surveys and acted on any suggestions for improvement.

Staff told us they had very good support from the management and felt able to talk with the manager and/or deputy at any time. Staff told us “We all know one another and work well as a team”.