Woburn Sands Lodge is a nursing care home for up to 10 people with mental health support needs. At the time of our inspection, the service was providing support to 8 people.

At the last inspection in December 2015, the service was rated Good. At this inspection on 28 November 2017, we found the service remained Good.

There was 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.

Staff had a good understanding of abuse and the safeguarding procedures that should be followed to report abuse and incidents of concern. Risk assessments were in place to manage potential risks within people’s lives, whilst also promoting their independence.

The staff recruitment procedures ensured that appropriate pre-employment checks were carried out so only suitable staff worked at the service. Adequate staffing levels were in place. We saw that staffing support matched the level of assessed needs within the service during our inspection.

Staff induction training and on-going training was provided to ensure they had the skills, knowledge and support they needed to perform their roles. Specialist training was provided to make sure that people’s needs were met and they were supported effectively.

Staff were well supported by the registered manager and senior team, and had regular one to one

supervisions. The staff we spoke with were all positive about the senior staff and management in place, and were happy with the support they received.

People's consent was gained before any care was provided. People told us that staff always checked with them before providing care.

Staff treated people with kindness, dignity and respect and spent time getting to know them and their specific needs and wishes. Care plans reflected people’s likes and dislikes, and we saw that staff spoke with people in a friendly manner.

People were involved in their own care planning and were able to contribute to the way in which they were supported. People and their family were involved in reviewing their care and making any necessary changes.

The provider had systems in place to monitor the quality of the service as and when it developed and had a process in place which ensured people could raise any complaints or concerns. Concerns were acted upon promptly and lessons were learned through positive communication.

The service notified the Care Quality Commission of certain events and incidents, as required.

The inspection took place on 1 December 2015 and was unannounced.

Woburn Sands Lodge provides accommodation and personal care for up to ten people with mental health needs and learning disabilities. At the time of our inspection the service was providing support to eight people.

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.

Staff had an understanding of abuse and the safeguarding procedures that should be followed to report abuse and people had risk assessments in place to enable them to be as independent as possible.

Effective recruitment processes were in place and followed by the service and there were sufficient numbers of staff available to meet people’s care and support needs

Medicines were stored, handled and administered safely within the service.

Staff members had induction training when joining the service, as well as regular on-going training.

Staff were well supported by the registered manager and had regular one to one supervisions.

People’s consent was gained before any care was provided and the requirements of the Mental Capacity Act 2005 were met.

People were able to choose the food and drink they wanted and staff supported people with this.

People were supported to access health appointments when necessary.

Staff supported people in a caring manner. They knew the people they were supporting well and understood their requirements for care.

People were involved in their own care planning and were able to contribute to the way in which they were supported.

People’s privacy and dignity was maintained at all times.

People were encouraged to take part in a range of activities and social interests of their choice.

The service had a complaints procedure in place and people knew how to use it.

Quality monitoring systems and processes were used effectively to drive future improvement and identify where action was needed

During this inspection, we gathered evidence against the outcomes we inspected to help answer our five key questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. The detailed evidence supporting our summary can be read in our full report.

Is the service safe?

We found that risk assessments identified individual risks, to people's health, safety or welfare. People’s care records and risk assessments were regularly reviewed and updated as and when their needs changed. The staff received appropriate training to ensure they had the skills and knowledge to meet people’s needs.

We saw there were effective medicines management systems in place. This meant that people using the service were protected against the risks associated with the unsafe use and management of medicines.

Is the service effective?

Effective systems were in place to monitor the management of the service.

People’s care plans and risk assessments were regularly reviewed and updated as and when people’s needs changed.

Is the service caring?

We observed friendly and positive interactions between staff and people using the service. We saw the staff were patient, kind and genuinely warm towards the people they were supporting.

We noted over the lunchtime the staff provided assistance for one person who required help with eating and drinking. The assistance was provided sensitively and with attention to preserving the person’s dignity.

Comments we received from people using the service were positive. For example, “the staff are lovely, they know me very well”, “the staff are always there to help me and I can’t fault the care I receive, the staff have really helped me”.

Is the service responsive?

It was clear from our observations that staff knew the people who used the service well, and they were attentive to their needs throughout. For example, one person started coughing when eating their meal and the staff responded promptly to ensure their welfare.

We saw that people's physical and mental health was closely monitored and appropriate action was taken in seeking the advice and guidance of health and social care professionals.

When we visited in October 2013 we found the provider had not maintained accurate and appropriate records. At this inspection we found that improvements had been made to recording keeping. Records that were no longer required had been appropriately archived and improvements had taken place to the recording of the monthly quality audits. The audits clearly identified areas for further action and recorded the actions that had been taken. This meant that records were accurate and fit for purpose.

Is the service well-led?

At the time of our inspection the previous registered manager was going through the process of de-registering with the Care Quality Commission. The new registered manager and the staff we spoke with were clear about their roles and responsibilities. We found that regular quality audits were carried out by the manager, other senior staff and a senior representative from within the company. We saw that the quality audits included checks of people's care records; risk assessments, accidents and incidents, medication records and health and safety checks to the home environment. We found that action plans with timescales were produced and completed for areas that needed attention. This meant there were effective systems in place to regularly assess and monitor the quality of service that people received.

We spoke with four people who used the service. One person told us that the staff were compassionate and helpful. They told us that if they required any support to arrange appointments with external professionals, for example, dentists or chiropodists, they were given the support they required. Another person told us that the staff were kind and another said that they could not fault the staff.

We found that people were treated with dignity and respect and their care was planned to meet their needs. We found that the provider had suitable arrangements in place to deal with any suspected abuse and appropriate checks were completed on staff before they commenced employment. We found that the provider sought feedback about the service and they acted on the information they received. However we also found that unclear and unnecessary documentation was maintained that made clear plans and audits difficult to understand.