Oak Lodge

Oak Lodge is a residential care home providing personal care for up to 28 people. The service provides support to people with dementia, mental health, older people and younger adults. At the time of our inspection there were 16 people using the service in one adapted building.

People’s experience of using this service and what we found

Care plans and risk assessments were person centred and reflective of people's current needs. Medicines were stored safely and were managed well. The environment was much improved, and work was still ongoing to improve the home. Quality audits clearly identified areas for improvement and ensured that people were safe and involved in their care and support.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

There were enough staff. Staff were recruited safely and received an induction to ensure they had the skills and knowledge to undertake their role. The staff team told us they were well supported and that they delivered person-centred care. We observed all the staff team working together well and the culture at the service was professional, warm and welcoming.

Regular activities were carried out to promote social inclusion and the servcie had improved links with the local community. People instead of using the hairdressing room in the home, visited a neighbourhood salon with the support of the staff.

Systems were in place to protect people from abuse. Staff demonstrated a good level of understanding in relation to safeguarding. Appropriate referrals to the local safeguarding team had been made. People and staff spoke positively about the registered manager and felt able to raise concerns and were confident that these would be addressed.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was requires improvement (published 10 February 2021). At our last inspection we recommended that the provider made improvements in relation to quality audits, staff recruitment and medicines. At this inspection we found the provider had made improvements in these areas.

At our last inspection we recommended that the provider made improvements in relation to quality audits, staff recruitment and medicines. At this inspection we found the provider had made improvements in these areas.

Why we inspected

We carried out an unannounced inspection in January 2021 and found improvements were needed. We undertook this focused inspection to check the service had followed their action plan and to confirm improvements were made. This report only covers our findings in relation to the Key Questions safe, effective and well-led which contain those improvements.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Oak Lodge is a residential care home providing personal care for up to 28 people aged 65 and over. Eleven people were living at the home at the time of the inspection.

People’s experience of using this service and what we found

The provider had systems in place for monitoring the quality and safety of the service through the use of routine checks and audits. However, there were multiple types and methods of audits that did not always identify issues and put forward one clear improvement plan.

We recommend audits are reviewed to ensure they are effective in supporting and evaluating learning from current performance.

Medicines were managed safely at the home but some improvements were still needed. Some records were not correctly completed. Staff had now been trained and assessed as competent to administer medicines.

We recommend the service consider reviewing the guidance for staff and records for topical medicines.

We saw the provider had not followed their own recruitment policy when recruiting staff since our last inspection. The provider told us they had employed staff safely and they had already completed an action plan to ensure they followed their policy going forward.

Works were still ongoing to improve the environment in both communal areas and people's personal space. We saw new furniture, beds and mattresses had been purchased and areas such as the laundry and bathrooms were significantly improved.

There was a new management team at the service and people, relatives and staff we spoke with told us they felt supported by them.

We saw significant improvements had been made to the environment to ensure it was safe and clean. Staff were clear on the use of personal protective equipment and had been trained in infection control procedures. Measures to reduce the risk of COVID-19 were now in place.

People were happy with the care they received at Oak Lodge. Relatives we spoke with said here had been significant improvement in the communication from the service.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was inadequate (published 24 August 2020) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This inspection was carried out to follow up on the action we told the provider to take at the last inspection.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to coronavirus and other infection outbreaks effectively.

As the provider has demonstrated improvements and the service is no longer rated as inadequate for any of the five key questions, it is no longer in special measures.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Oak Lodge is a residential care home providing accommodation with personal care to older people, some of whom were living with dementia. The service can support up to 28 people in one building over two floors. At the time of this inspection, 15 people lived at the service

People’s experience of using this service and what we found

Risks which affected people's health, safety and wellbeing were not always documented. This meant that staff did not always have adequate information to manage and mitigate risks to people. Accidents and incidents had not been thoroughly recorded and action had not been taken to reduce risks.

Staff had not been trained or assessed to carry out key tasks for people such as medicine administration or supporting them with catheter care.

Staff did not have access to adequate supplies of personal protective equipment (PPE). The service did not have sufficient infection prevention and control measures in place. Government guidance in relation to COVID 19 was not followed.

Safeguarding concerns had not been reported by staff and management. The registered manager was not clear of their role and responsibility in relation to safeguarding.

Regular deep cleaning regimes were not in place and areas of the home such as the laundry and sluice were dirty and cluttered.

Medicines had not been managed safely. Staff had not received appropriate training and competency assessments. Guidance from other professionals had not been followed.

Quality assurance processes were in place to monitor the quality and safety of the service, but these did not identify serious concerns we found and contradicted practice we observed. There was a clear lack of provider oversight and they had not ensured effective and competent management was in place.

Some staff members we spoke with raised concerns about the management of the service.

We did observe people appeared comfortable and happy with staff interaction with them.

For more details, please see the full report which is on the Care Quality Commission website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (report published 19 October 2019.)

Why we inspected

Serious whistleblowing concerns were received by the local authority safeguarding team in relation to management of the service and the quality of care and support that was being provided. There had been a number of safeguarding concerns raised by other professionals. As a result, we carried out a focused inspection to review the key questions of safe and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from good to inadequate. This is based on the findings at this inspection.

We have found evidence that the provider needs to make substantial improvements. Please see the safe and well-led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Oak Lodge on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to the safety of people and the risk of harm. We also identified breaches in relation to the management and monitoring of the service, premises and equipment and staffing at this inspection.

Please see the action we have told the provider to take at the end of this report.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will continue to monitor information we receive about the service and we will continue to work with partner agencies. We will also request a specific action plan to understand what the provider will do immediately to ensure the service is safe. We will work alongside the provider and the local authority to closely monitor the service. We will return to visit in line with our re-inspection programme. If we receive any concerning information we may inspect sooner.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe. And there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it. And it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

Oak Lodge is a residential care home which provides older people with personal care. The home can accommodate up to 28 people. On the day of our inspection visit, 13 people were using the service.

People’s experience of using this service and what we found

People and their relatives told us they were very happy with the care and support provided at Oak Lodge. People were consulted about ongoing environmental changes at the service such as new décor in the lounge, dining room and ground floor communal areas.

Medicines were managed safely, there were enough staff on duty and staff were recruited safely. People were protected from abuse by staff who understood how to identify and report any concerns. The risks to people’s health, safety and welfare had been assessed, recorded and plans put in place to reduce these.

People were supported to access healthcare services if needed. People were supported to have enough to eat and drink and staff were trained to support people who had different dietary needs.

Interactions we saw between people and the staff team were very positive and relatives also said they were made very welcome at the home. People were treated with kindness, dignity and respect.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Person-centred care planning was still not fully embedded into the service. Care plans were inconsistently completed. Some records lacked detail around supporting people when they became distressed whilst others contained in-depth personal details to ensure care workers could look after a person in line with their needs, preferences, wishes and choices.

People were supported to engage in activities they enjoyed. Although the service did not have a current activity co-ordinator in place, they were actively recruiting to this role. People and their relatives told us they knew how to make a complaint.

There was a clear management structure and staff were supported by the registered manager. Quality assurance systems were completed.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update: The last rating for this service was requires improvement (published 22 January 2019) and there was a breach of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulation.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

We last inspected the service in February 2018 and found the provider had breached two regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulation 2014. This related to the systems and processes used to assess, monitor and improve the safety of the service, which had not identified the concerns we found. The provider had failed to submit statutory notifications. We asked the provider to complete an action plan to show what they would do to improve the service.

Oak 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.

Oak lodge can accommodate up to 28 people. At the time of our inspection 13 people were using the service.

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.

At this inspection medicine administration records did not always appropriately record the effectiveness of ‘as and when’ medicine. The provider's quality assurance process had failed to identify these shortfalls.

The provider’s quality assurance system had not identified the shortfalls. This was a breach of Regulation 17 (Good governance) of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

You can see what action we told the provider to take at the back of the full version of the report.

No new staff had been recruited since our last inspection. The provider did have a policy and procedure in place for safe recruitment.

The provider ensured staffing levels met the needs of the people living in Oak Lodge.

Staff were aware of safeguarding and knew how to raise concerns if they felt people were at risk of abuse or poor practice. Where lessons could be learnt from safeguarding concerns these were used to improve the service.

Accidents and incidents were recorded and monitored as part of the provider’s audit process.

Health and safety checks had been completed such as gas and electrical safety checks.

Systems and processes were in place to ensure medicines were available for people. Medicines were managed by trained staff whose competency to administer medicines was checked regularly.

Staff received regular supervision and an annual appraisal. Staff mandatory training was up to date.

People’s nutritional needs were assessed on a regular basis. People enjoyed a varied diet, with choices offered and alternatives available. Staff supported people with eating and drinking in a safe, dignified and respectful manner. People were supported with their health needs and had access to healthcare professionals when necessary.

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 supported this practice.

People and relatives felt the service was caring. Staff provided support in a respectful manner ensuring people’s privacy and dignity was promoted. Where possible people were supported to be as independent as possible.

People enjoyed a range of activities, including trips into the community and in house entertainment.

The provider had a complaints process in place which was accessible to people and relatives.

People, relatives and staff felt the registered manager and deputy manager were approachable. We observed the registered manager was visible in the service and found people interacted with them in an open and friendly manner.

The premises were suited to people’s needs, with ample dining and communal spaces. Bedrooms were personalised to people’s individual taste. Bathrooms were designed to incorporate needs of the people living at the home.

The provider worked closely with outside agencies and other stakeholders such as commissioners and social workers.

Oak 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 service accommodated up to 28 people. At the time of the inspection 12 people were using the service. 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.

We visited the home in January 2017 and found the risks we had identified at the previous inspection in August 2016 had been addressed. We found the provider had taken action in relation to the electrical and fire safety in the home. We also found the registered manager was undertaking recruitment checks to ensure the safe employment of staff and was carrying out a range of regular audits to check the health and safety of the service. People had risk assessments in place to keep them safe.

At this inspection we found that there was a breach of one of the Fundamental Standards of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This related to the governance in the home and the lack of oversight of the provider’s regulatory requirements.

A fire detector check was carried out in November 2017. The report highlighted six fire detectors in the home that were out of date and reported as obsolete. The contractor had advised the detectors may not work in the event of a fire. We checked to see if these works had been carried out and found no remedial work had been completed and the obsolete fire detectors remained in situ.

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 supported this practice.

People who were being deprived of their liberty did not always have decision specific best interests recorded in their care records regarding the use of bed rails. Despite assessments identifying these were required for personal safety. Where the provider had received authorisation to deprive people of their liberty, notifications had not been submitted to CQC as part of the provider’s regulatory requirements. We will deal with this outside of the inspection process.

The provider’s business continuity plan did not meet the needs of the service in the event of an emergency.

The provider’s quality assurance system had not identified the concerns found at the inspection.

People and relatives felt the service was safe. Policies and procedures were in place to keep people safe such as safeguarding, accident and incident policies. Staff had received training in safeguarding and knew how to report concerns.

Staff recruitment procedures were robust and included Disclosure and Barring Service checks and references. Staffing levels were appropriate to the needs of the people using the service.

Risk assessments were detailed, person-centred, and gave staff clear guidance about how to support people. People had personal emergency evacuation plans in place in case of an emergency.

People received their medicines safely and medicines were stored correctly.

Staff were trained in a range of subjects such as health and safety, first aid and fire safety. Staff also completed training in specific subjects such as dementia and end of life to meet the needs of the people using the service.

Staff received regular supervisions and an annual appraisal which covered their personal development. Staff felt they were well supported by the registered manager.

People had access to a range of healthcare, such as GPs, district nurses and dieticians. Nutritional needs were assessed and people enjoyed a health varied diet.

The premises were well suited to people’s needs, with ample dining and lounge space. Signage was available throughout the home. Some areas had been recently decorated with additional works to provide en-suite rooms.

The atmosphere at the home was warm and welcoming. Relatives were offered refreshments and the opportunity to eat with their loved one if they wished. People were encouraged to make choices in everyday decisions. Staff provided support and care in a dignified manner, ensuring privacy when necessary.

Person-centred care plans were in place and contained good levels of detailed information. Regular reviews of care plans took place to ensure staff had up to date information about people’s needs?

People enjoyed a range of activities and were supported by staff. The service had positive links in the community with regular visits from the local church.

The provider had a complaints process in place. Relatives and people knew how to make a complaint.

Staff were extremely positive about the registered manager. They confirmed they felt supported and were able to raise concerns with either the registered manager or deputy manager. We observed the registered manager was visible in the service and we saw people interacted with them in an open manner.

The provider’s quality assurance system had not identified that fire detectors were obsolete. A recent health and safety audit did not identify that any actions were required in relation to health and safety in the service. We were told that concerns relating to the fire detectors had not been escalated to higher management through the quality assurance process.

The quality assurance process was not being used to ensure that all of the Care Quality Commissions regulations were being met. The process did not identify that notifications [about DoLS authorisations being granted] were being omitted.

You can see what action we told the provider to take at the back of the full version of the report.

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. We met with the registered manager during this inspection and they showed us remedial action the service had taken.

At this visit, we were checking whether the service had met the requirements of the warning notice. At the time of our visit there were 13 people using the service at Oak Lodge.

We saw all fire doors were fitted with intumescent strips as per guidance from the Fire Officer and there were regular checks in place on fire equipment as well as regular fire drills to ensure staff were familiar with evacuation procedures. Records to support the safe evacuation of people in event of a fire were in place and up-to-date. People had risk assessments that included any health and safety risks being identified and measures taken to reduce any risk of harm.

Works in relation to fixed five year electrical wiring had been addressed.

We saw the registered manager was undertaking recruitment checks to ensure the safe employment of staff and was also carrying out a range of regular audits to check the health and safety of the service.

We last inspected the service in January 2016 and it was compliant at that time and rated as 'Good'.

Oak Lodge is situated in a residential area of Darlington close to all amenities. It provides accommodation for up to 28 people who require personal care. The service previously provided nursing care but ceased to provide this in December 2015.

There was not 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. The previous registered manager had left the service in February 2016. The manager currently working at the home commenced in March 2016 and had an application to be registered accepted by CQC.

All people we spoke with told us they felt safe at the service. Staff were aware of procedures to follow if they observed any concerns and staff also told us they would raise issues with the manager.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that as far as possible people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible.

People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. The application procedures for this in care homes and hospitals are called the Deprivation of Liberty Safeguards (DoLS).

We checked whether the service was working within the principles of the MCA and whether any conditions on authorisations to deprive a person of their liberty were being met. The provider did not have best interests decisions in place for people who required bed rails.

Established staff at the service were all given workbooks to undertake mandatory training refreshers and we saw some of these were outstanding although we saw the manager was prompting staff to complete these. The service did not provide an appropriate induction using the Care Certificate for staff new to the care sector. Some recruitment checks had not been carried out for staff recruited recently, this may mean that the service did not recruit appropriate personnel. We saw that staff had received supervision.

There were sufficient staff on duty to meet the needs of the people and the staff team were supportive of the management and of each other.

Medicines were not stored in a safe manner, although administration records showed staff were administering medicines safely.

We saw people’s care plans had been assessed and people's care needs were reviewed. We saw people were being given choices and encouraged to take part in all aspects of day to day life at the home.

Staff had a good awareness of people’s dietary needs and staff also knew people’s food preferences well. We saw everyone’s nutritional needs were monitored and mealtimes were well supported.

We observed that all staff were very caring in their interactions with people at the service. People clearly felt very comfortable with all staff members. There was a warm and caring atmosphere in the service and people were very relaxed. We saw people were treated with dignity and respect. People told us that staff were kind and professional.

We also saw a regular programme of staff meetings where issues such as fund-raising and décor were discussed. The service had a complaints procedure in place and there had not been any formal complaints since 2015.

We saw that outstanding serious maintenance issues in relation to fire doors and electrical safety at the home had not been addressed in a timely manner. The fire risk assessment was not adequate and environmental risk assessments needed review. This meant people and staff were at risk from the provider not assessing and monitoring the quality and safety of the service.

We found that audits carried out did not reflect the quality assurance policy of the provider and were not addressing issues that were outstanding. Audits were “tick box” in nature and there was not a comprehensive improvement plan for the service.

There were breaches of the Health and Social Care Act 2008. You can see the actions we required the provider to take at the end of this report.

We carried out this inspection to check that improvements had been made in respect of shortfalls in the consent to care and treatment identified on our previous visit on 2 September 2014.

During our inspection on 9 February 2015, we spent time speaking with the new manager, the senior nurse in charge and three care staff. We reviewed records and quality documentation that was appropriate to the focus of this inspection, including seven care plans. We spent time observing and speaking with people who lived there.

At our inspection we found that the home had recruited a new permanent manager. This individual had just received their criminal background check to be able to register with CQC.

If you want to see the evidence that supports our summary please read the full report.

The management of the home had recently changed and provider was actively recruiting for a new manager. The nurse in charge said herself and another nurse at the service were managing as an interim measure but it 'was challenging'.

We set out to answer our five 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. If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

Everyone we spoke with told us they felt safe and secure living at the home. Staff we spoke with understood the procedures which they needed to follow to ensure that people were safe. We saw that staff had not followed recent legislation changes regarding the Deprivation of Liberty Safeguards and no appropriate applications had been made to the supervisory body. People also did not have current capacity assessments in their plans of care. The nurse in charge stated she would seek advice from the supervisory body and work on assessments immediately after our visit.

Care plans and risk assessments were in place and updated on a regular basis and were based on people's individual needs and preferences.

Systems were in place to make sure that staff learnt from events such as accidents and incidents, concerns, complaints, whistleblowing and investigations. This helped to reduce the risk of harm and ensured that lessons were learnt from mistakes.

Is the service effective?

Everyone had their needs assessed and had individual care records which set out their care needs.

It was clear from our observations and from speaking with staff that they had a good understanding of the care and support needs of people living at the home and that they knew people well. Assessments included dietary, social and leisure and emotional needs.

People spoke highly of the staff and said that they were happy with the care that had been delivered and their needs had been met. On the day of our visit an entertainer dressed in war-time clothing was visiting the home and people joined in the songs and appeared to enjoy the show very much.

People had access to a range of health care professionals some of which visited the home and all was documented in the care files.

Is the service caring?

People were supported by kind and attentive staff who showed patience and gave encouragement when supporting people, whilst helping them to remain independent.

People who used the service, their relatives and friends were asked for their views on the care and service provided. Where shortfalls or concerns were raised, these were addressed.

People told us that they were happy with the care and support provided to them.

Is the service responsive?

There was clear evidence contained within people's care plans to show how they worked with other health and social care professionals.

People told us that they knew how to make a complaint if they needed to.

Is the service well-led?

There were systems in place to assure the quality of the service provided. The way the service was run was regularly reviewed. The manager had recently left the home and we saw that the home was actively recruiting for a manager and following the inspection the regional manager stated she was offering further support to the home in the interim. The nursing staff were also having to undertake administrative responsibilities and we asked the provider to ensure they had enough time away from their nursing duties to make sure these tasks this took place.

Staff were clear about their roles and responsibilities. Staff had a good understanding of the ethos of the home and were knowledgeable about people's needs. This helped to ensure that people received a good quality service at all times.

What people said:

People who were able to express their views told us they were happy with the care and support they received. People said of the staff; 'The staff are all nice' and 'The staff are lovely'. One person said; 'I play dominoes and watch tv'. Comments about food were very positive by everyone we spoke with, people told us; 'They feed us too much and there is plenty of choice'

Staff told us 'It's a nice home here, the care is good' and 'We are a good staff team'. The laundry staff told us; I get what I need, I've got some new towels on order'.

We saw from the activities file, that activities were planned in throughout the year including trips, walks, going to the pub, music and a variety of entertainers who were scheduled to visit the home.

The home was clean although fixtures and fittings were looking dated. We saw that staff had information about infection control and we observed people using personal protective equipment appropriately. The home was working on an action plan from an infection control audit carried out by the Primary Care Trust in 2012.

We saw records of regular staff and resident meetings and a monthly newsletter where issues relating to the day to day running of the home were talked about. This showed that people were kept informed about issues regarding the home.