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Inspection carried out on 25 August 2016

During a routine inspection

The inspection took place on 25 and 30 August 2016 and was an unannounced inspection.

Autumn Lodge - Bognor Regis provides care and support for up to 19 older residents. The home is located in a residential area of Bognor Regis, close to local amenities. At the time of our visit there were 18 people living at the home, one of whom was on a respite stay.

The service has 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.

People spoke very highly of the home. They told us that the staff were kind and that they enjoyed living there. Relatives had confidence in the care provided and said that the home was welcoming. On relative told us, “We are now recommending Autumn Lodge to other friends”.

People had developed good relationships with staff and had confidence in their skills and abilities. They told us that staff were kind and that they treated them respectfully. There was an established team of staff at the home, which offered continuity of care for people. Staff had received training and were supported by the management through supervision and appraisal. Staff were able to pursue additional training which helped them to improve the care they provided to people.

Staff responded quickly to changes in people’s needs and adapted care and support to suit them. Where appropriate, referrals were made to healthcare professionals, such as the GP or dietician, and advice followed.

People were involved in planning their care and in making suggestions on how the service was run. Staff understood how people’s capacity should be considered and had taken steps to ensure that people’s rights were protected in line with the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS).

People felt safe at the service and there were enough staff to respond to their needs. Staff understood local safeguarding procedures. They were able to speak about the action they would take if they were concerned that someone was at risk of abuse. Risks to people’s safety were assessed and reviewed. People received their medicines safely.

People enjoyed the meals at the service and were offered choice and flexibility in the menu. A variety of activities were provided, both in the form of group and individual interests. The premises provided a variety of areas for people to relax and socialise, including a well-tended garden.

There was strong leadership within the home. The registered manager and deputy monitored the delivery of care and had a system to monitor and review the quality of the service. Suggestions on improvements to the service were welcomed and people’s feedback encouraged.

Inspection carried out on 04/04/2014

During a routine inspection

Autumn Lodge - Bognor Regis provides care to older people who require support. There were 18 people living at the home on the day of our inspection. The home is registered to care for a maximum of 19 people.

People we spoke with told us they were well cared for and safe at the home. People told us that the staff were respectful and treated them with dignity. We observed staff knocking on doors, closing doors and curtains to undertake personal care and heard people being called by their preferred names. Care plans showed that people or their relatives had been involved in decisions about the care they received. Staff we spoke with were aware of their responsibilities to keep people safe. Both the registered manager and deputy manager were clear about when to report concerns to either the local authority or the Care Quality Commission. All staff received regular training in safeguarding vulnerable adults which covered the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). We found the location to be meeting the requirements of the Deprivation of Liberty Safeguards. People’s human rights were therefore properly recognised, respected and promoted. We found that the home had policies and procedures in place to support staff and ensure that medicines had been managed safely in accordance with current regulations and guidance. There were systems in place to ensure that medicines had been stored, administered, audited and reviewed appropriately. This included the administration of controlled drugs.

The home effectively met people’s health and care needs because staff communicated well with people, passed information about changes regarding people’s health or wellbeing between the team and they appropriately sought advice and treatment from health care professionals. One health care professional we spoke with following the inspection told us that the staff responded to people’s needs and provided very effective, compassionate end of life care. The home had a ‘Ten Step Dignity Challenge’, a code of conduct for staff, residents and visitors which meant that people’s dignity was respected and their human rights protected. The code included directives for staff including, “ Zero tolerance of all forms of abuse”, “Treat people with the same respect you would expect for yourself or family” and “Respect people’s right to privacy.”

We saw from care plans and speaking with people that their individual needs and preferences were regularly assessed and reviewed. Reviews were undertaken with the involvement of the individual or their relatives and this was clearly documented. All care plans seen included regularly reviewed Mental Capacity Act assessments and the home displayed information about the advocacy service in the entrance hall to ensure that people were aware of how to ensure their rights were protected. We saw from care plans that staff made appropriate referrals to other professionals and community services.

People’s needs were met because the home ensured that care reviews and care planning was carried out with the involvement of the individual and close relatives. Care plans we examined evidenced peoples involvement in their planning and reviews. This included their interests, likes and dislikes and preferences. Mental capacity assessments were completed and reviewed regularly. The registered manager showed a good understanding around MCA and DoLS, and when this may be required. The home had comprehensive risk assessments for all aspects of people’s care and their environment. People were kept safe because all staff were fully aware of these risk assessments and followed guidelines regarding minimising risks. There was a well-advertised complaints procedure which people at the home and their relatives were familiar with. People we spoke with told us, “I have no complaints but if I did I would be happy speaking to the manager.”

Accident and incident reports showed that people in the home were kept safe in a well-led home. This was because there were appropriate systems in place to record and analyse the reports and any action taken as a result. One person who had recently had a fall had been referred to a physiotherapist who had recommended the provision of a walking frame to reduce the risk of future falls. This meant the home learnt from them and ensured that adverse events were less likely to occur again. The registered manager was well established and we found from speaking with staff that their leadership encouraged a positive, empowering approach. We also observed that the registered manager had an apparent insightful understanding of the home’s residents and their changing needs. Staff underwent a thorough induction to the home and received training in areas such as moving and handling, hygiene and infection control and safeguarding. We saw from the staff training matrix that this was updated regularly. We saw that staff supported people and showed concern for people’s welfare throughout the day’s activities. People related well to staff and appeared calm and relaxed around them. The activities co-ordinator was new in post, but had recently completed dementia awareness training and this informed the range of activities organised and their personal interaction with people.

Inspection carried out on 13 May 2013

During a routine inspection

During our visit we talked with nine people living at the home. We also gathered evidence of people’s experiences of the service by indirectly observing the care they received from staff.

Everyone told us that they were happy with the care and support they received. One person told us, "I am happy here, the staff are so nice. I think I am very lucky living here".

Another person said, "If I need anything I just ring my bell, they always come quickly when I need them, although at some times of the day it can take a little longer for the staff to come. I'm not grumbling though I understand that they can't always come straight away".

All of the people that we spoke with told us that they felt that the home was clean. One person said, "They come into my room everyday and vacuum and dust around, they clean my toilet every day too, you can't ask for a better service than that."

All of the people that we spoke with told us that staff asked their permission before entering their room, and before assisting them with personal care.

People also told us that staff treated them with respect and promoted their privacy. They told us that they felt safe from harm living at the home and that they would be listened to if they raised any concerns. Our evidence gathered during this inspection supports the comments made by people who were receiving a service.

Inspection carried out on 17 July 2012

During a routine inspection

We spoke with nine people during our visit to Autumn Lodge.

All of the people that we spoke with were complimentary about the service that they received at Autumn Lodge.

People told us that they were well cared for and that the staff were kind and respectful.

People were very complimentary about the food they were given, and said that they were always offered choices of menu.

One person described the home as having a lovely atmosphere they said, “We are all friends, this is a happy circle”.

Another person said, “I am very happy to spend the rest of my days here.”

Reports under our old system of regulation (including those from before CQC was created)