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Inspection carried out on 19 December 2017

During a routine inspection

We carried out an unannounced inspection of the service on 19 December 2017.

Chater Lodge is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The care home can accommodate 45 people in one adapted building. There were 39 people receiving care and support at the home at the time of our visit.

The service was last inspected 10 November 2016 and the rating for that inspection was Good. Since the last inspection there has been a new registered manager recruited.

There was a manager registered with the Care Quality Commission (CQC). 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 continued to receive safe care. Staff were aware of their responsibility to keep people safe. Risks were assessed and managed to reflect people’s current needs. Staffing levels were adequate. Safe recruitment was followed to ensure suitable staff were employed.

Medicines were managed and stored safely. Arrangements were in place to make sure the premises were clean. Staff had completed relevant hygiene training. Incidents and accidents were reported and managed.

People continued to have their needs assessed. Staff received training to ensure they had appropriate skills to carry out their roles. People were supported to have sufficient amounts to eat and drink. People were supported to receive care across different services. People were involved in regular monitoring of their health and wellbeing. People were consulted about decisions about their environment. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice.

People were supported by staff who were kind and compassionate. People were treated with respect and dignity at all times. They had a good relationship with the staff, who had a strong emphasis on supporting people’s diverse needs. People experienced positive compassionate care to ensure people felt at home. Relatives were positive about the care people received.

People received personalised care that met their needs. Concerns and complaints were dealt with and responded to. People were encouraged to share their views about the home, but they were not always informed of any actions taken if they had identified concerns. We made a recommendation to the provider about the management of feedback from surveys. Discussions took place to support people at their end of life.

Systems and procedures were in place to monitor and improve the quality and safety of the service provided. There was a registered manager in post. Staff were supported to raise concerns and use the whistleblowing policy. Information systems were used effectively to monitor the quality of care.

The service worked in partnership with other organisations including the local authority, safeguarding and CQC.

Inspection carried out on 10 November 2016

During a routine inspection

The inspection took place on 10 November 2016 and was unannounced.

Chater Lodge provides accommodation for up to 45 people who require personal care and support. There were 41people using the service at the time of our inspection including people living with dementia.

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.

People told us they felt safe living at Chater Lodge. Relatives we spoke with agreed with this. The staff team knew their responsibilities relating to keeping people safe from avoidable harm and knew the procedures to follow if they felt people were at any risk of abuse or harm.

People's personal choices had been clearly expressed in plans of care and individual needs had been identified. All members of staff had received appropriate training that enabled them to meet the needs of people who used the service.

People received their medicines as prescribed by their GP. There were systems in place to regularly audit the medicines that were stored at the service. All associated records were correctly completed and checked.

Recruitment checks had been carried out before any new members of staff had started work. This was to check that they were suitable to work at Chater Lodge.

Most people using the service felt that there were sufficient members of staff on duty each day to complete most tasks. Some people did express the feeling that an extra member of staff at busy periods, such as meals and early morning, would be good. We saw that there were sufficient staff on the day of our inspection in one dining room but in a second dining room staff were rushed at times.

The registered manager had a monitoring system in place to assess the correct levels of staffing needed and additional action plans were in place for busy periods of the day.

People told us that their meals were good. People’s nutritional and dietary needs had were regularly assessed and a balanced diet was being provided. Those at risk of not eating sufficient amounts were closely monitored and supported.

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People had access to healthcare services such as opticians, chiropodist and GP when necessary. This supported the continued health and well-being of people using the service.

People had been regularly involved in making decisions about their care and support and how this was provided. Where people did not have the capacity to make their own decisions, these had been made for them in their best interest and in consultation with other appropriately appointed persons.

People told us that the registered manager and the staff team were kind and caring. They felt that all support and care was provided in a way that respected their dignity. The relatives we spoke with expressed the same feelings and positive comments about the quality of the care provided at Chater Lodge. Throughout our visit we saw and heard staff treating people with consideration and respect, always asking and discussing things before supporting people.

Staff meetings and meetings for people who used the service and their relatives were regularly held. These meetings provided people with the opportunity to be involved in the development of the service and the registered manager kept people informed of any changes or future plans for the service.

The staff team felt supported by the registered manager and felt able to speak with them about any concerns or worries. They felt that they had the right to speak out about any issues and developments within the service. People using the service and their relatives knew what to do if they had any concerns and they felt confident that any issues would be dealt with appropriately by the registered manager or an

Inspection carried out on 23 December 2014

During a routine inspection

This inspection took place on 23 December 2014 and was unannounced. When we last inspected the service on 22 August 2013 we found the provider was compliant with the standards we assessed.

Chater Lodge is a care home without nursing. The service provides care and support for a maximum of 45 older people. At the time of our inspection there were 36 people using the service. Part of the first floor accommodation (known as Memory Lane) is specifically for people with dementia.

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.

People told us they felt safe. People were protected from the risk of abuse because staff had received training and knew what to do and who to report to should they suspect abuse. Accidents and incidents were recorded but the action taken to reduce any further risk was not. Some people, relatives and staff said they sometimes had to wait for staff to attend to them and staff were very busy in the mornings. People said they got their medicines as prescribed by their doctor.

People told us they liked the staff. Staff had received all the training they required and were due to receive updated training about dementia care. People were asked for their consent before receiving care and treatment but the principles of the Mental Capacity Act 2005 were not always followed. People had their needs assessed and a plan of care was developed for each assessed need. Some plans of care were not as focused on the person or specific in their detail as they should have been to ensure that staff were fully aware of people’s individual needs and how to meet them.

People told us about the things they liked to do and we observed people engaged in activities which they enjoyed. Information about people’s life history and preferences were recorded for most but not all people. Social and recreational activities on offer did not fully reflect everyone’s individual interests and hobbies People were supported to eat and drink and maintain a balanced diet. They said they liked the meals provided. People had access to healthcare professionals when required but there was one incident where a person had not attended a doctor’s because staff had failed to arrange it.

People said the management team were open and approachable. There were quality monitoring process in place and these included seeking the views of people who used the service and their relatives.

Inspection carried out on 22 August 2013

During a routine inspection

We spoke with four people who used the service. People told us they were happy with the care they received. They told us they liked the staff. one person said " It couldn't be better". Another person said " They are excellent". We also observed interaction between staff and people who used the service. Staff were friendly, kind and respectful. Staff spent time sitting with people and engaging them in conversation and activity.

During the course of the inspection, we were informed of a safeguarding matter, in that a concern had been raised. This is where one or more person's health, wellbeing or human rights may not have been properly protected and they may have suffered harm, abuse or neglect. There was evidence that the provider had taken action to address these issues. The overall review of this matter was not yet concluded.

The provider followed robust recruitment procedures and pre employment checks to ensure that only people who were suitable, were employed.

There was an ongoing programme in place to assess and monitor the quality of service provision.

Inspection carried out on 27 September 2012

During a routine inspection

Some people living at Chater Lodge had cognitive and communication difficulties. We used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us. We also spoke with two people who used the service and a visiting relative.

People spoken with told us they liked the staff and were happy with the service provided.

One person told us their health was 'infinitely better' since moving into Chater Lodge and that they were perfectly content and happy.

A relative spoken with told us that staff always respected people's privacy and dignity.

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