The provider sent us a report on 19 November 2103 to tell us they had taken the necessary actions to address the shortfalls.
At our inspection on 11 December 2013, the provider demonstrated that they had taken steps to address the identified shortfalls.
We looked at the care records for four people who used the service. We found that people's care needs were assessed and planned for and they received care that met their needs.
People told us they felt well cared for at Howard Lodge. One person told us, 'It is very nice here, we are well looked after.' A relative told us, 'My [relative] is cared for superbly here. There is a good atmosphere between staff and residents. Its genuine, the carers really do care. They do try to include her in activities.'
We saw that people lived in a clean, hygienic environment. They were cared for by staff who had undergone a robust recruitment procedure.
People were not protected against the risks associated with medicines because procedures for storing, recording and disposing of medicines safely were not always followed.
The provider had systems in place to monitor the safety of the service and to seek the views of people who used it.
how they were treated by staff and their involvement in making choices about their care. They also told us about the quality and choice of food and drink available. This was because this inspection was part of a themed inspection programme to assess whether older people living in care homes are treated with dignity and respect and whether their nutritional needs are met. The inspection team was led by a CQC inspector and an "expert by experience" (people who have experience of using services and who can provide that perspective).
We spoke with five people who were using the service and one visitor. Everyone we spoke with confirmed that the staff treated them with respect and provided them with choices wherever possible. People spoken with were complimentary about the care and attention that they received.
For example one person told us that, 'The staff are very kind and pleasant people to do business with. They are very caring.' and another person reported that, "The staff treat me very kindly and are friendly, they always use my first name. I feel safe here".
One person told us that, "I like it here, the staff are very professional.' Someone else said, 'The staff treat me very well, they are knowledgeable, helpful, kind and always respectful.'
All the people we spoke with were were complimentary about the meals provided. One person commented, 'The food is very good. If I don't like something they will always prepare something else for me. We get two choices of main course with plenty of fresh fruit and vegetables available'. One person told us that, "We have a varied choice of food with plenty of fresh vegetables and it's always hot when served. People we spoke with told us that hot and cold drinks were readily available in between meals and overnight. They confirmed that finger foods were available if required.
Everyone that we spoke with told us that they felt safe in the service and were confident that the manager would resolve any concerns they might have. For example one person confirmed that, "Staff never hurry me, they always explain what they are going to do and why and this makes me feel safe'. Another person commented, 'If I had any concerns I would speak to the manager and I know it would be resolved very quickly".
People told us that the care they received was unhurried and that they did not have to wait for staff assistance if required. Everyone we spoke with told us that they were aware their care records were kept in the main office.
People told us that they felt well cared for at Howard Lodge and that they had opportunities for positive social interactions and to make choices. One person using the service said, 'The staff are very pleasant and will get or do anything they can for you within reason'. A visitor with whom we spoke said, 'The carers are first class, and always caring, I am satisfied with the care provided, otherwise I would have moved (person).'
People spoke positively about the staff and said they felt safe and secure at Howard Lodge. Comments received included, 'The staff are very gentle and I feel safe with them' and 'The care staff here are really excellent.'