Horfield Lodge

People and their relatives agreed the service was safe. The registered manager and staff understood their role and responsibilities to keep people safe from harm. Risks were assessed and plans put in place to keep people safe. There was enough staff to safely provide care and support to people. Checks were carried out on staff before they started work to assess their suitability to support vulnerable people. Medicines were well managed and people received their medicines as prescribed. People were protected by the home's infection control policy and procedures.

The service provided an effective service. Training and development was based on research and best practice guidelines to enhance quality and safety of the service provision. Staff felt constantly supported, valued and praised. They told us, "There is no shortage of praise and we get thanked for all we do", "I feel valued by everyone I work with" and "Teamwork is essential and we have no problems there". People continued to receive a nutritious, healthy diet that met individual preferences. The home was decorated and maintained to a very high standard whilst maintaining a homely feel. People were consulted about the adaptation and design of their home and choice and preferences were respected. There were various areas to enjoy activities, events and personal private time. The service had been creative in developing areas of the home that would enhance people's wellbeing.

The service was exceptionally caring and put people at the heart of everything they did. One lady told us, "Nothing is too much trouble for the staff, it's down to them that my wellbeing has improved both physically and emotionally, every day I wake up with a purpose". We were introduced to people throughout our visit and they welcomed us. They were relaxed, comfortable and confident in their home. Staff had an excellent awareness of individuals' needs and treated people in a warm and respectful manner. They were

knowledgeable about people's lives before they started using the service. Every effort was made to enhance this knowledge so that people's life experiences remained meaningful. The commitment of the staff was excellent. They told us, "This is my second home", "We are all so proud when we go home at the end of our shift, they all mean the world to us" and "I always feel happy coming back to work".

The service was exceptionally responsive to people's health and social needs. People received person centred care and support. One relative told us, "They know mum inside out, they have made every effort to get to know her, care is personalised, the staff know my mum as well as I do!". Regular monitoring and reviews meant that referrals had been made to appropriate health and social care professionals. Where necessary care and support had been changed to accurately reflect people's needs and improve their health and wellbeing. People were offered a vast array of activities both at the service and in the local community. The whole team were proud and privileged to support people with end of life care. One relative wrote to the registered manager recently and stated, "I have seen a quote in your home, 'You matter because you are you and you matter to the last moment of your life'. The staff of Horfield Lodge certainly lived up to that statement in their treatment of my mother".

People benefitted from a service that was very well led. The provider, registered manager, deputy and staff team maintained a clear focus on continually seeking to improve the service people received. Staff told us the registered manager led by example and they had tremendous respect for her. Comments included, "She is extremely supportive and approachable", "I look up to her and she inspires me" and "I cannot fault the manager, we are where we are because of her". Everyone demonstrated strong values and, a desire to learn about and implement best practice throughout the service. Good quality assurance systems were in place and based upon regular, scheduled audits, which identified any action required to make improvements. This meant the quality of service people received was monitored on a regular basis and, where shortfalls were identified they were acted upon.