Background to this inspection
Updated
25 October 2016
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This inspection took place on 22 and 24 August 2016 and the first day was unannounced. The inspection team consisted of an adult social care inspector.
Before the inspection we reviewed the information we held about the service, including notifications. Notifications are changes, events or incidents the provider is legally obliged to send us within required timescales. Before the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.
During the inspection, we used a number of different methods to help us understand the experiences of people who lived in the home, including observations, speaking with people, interviewing staff and reviewing records. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We spoke with six people who used the service and three visiting relatives. We spoke with the deputy manager and seven other members of staff, including two nurses and four care workers and an ancillary worker.
We looked at a sample of records including four people’s care plans and other associated documentation, medicine records, five staff files, which included staff training and supervision records, four staff member’s recruitment records, complaint, accident and incident records, policies and procedures, risk assessments and audit documents.
Updated
25 October 2016
We carried out an inspection of Brierton Lodge Care Home on 22 and 24 August 2016. The first day of the inspection was unannounced. We last inspected Brierton Lodge Care Home in October 2013 and found the service was meeting the relevant regulations in force at that time.
Brierton Lodge Care Home provides accommodation, nursing and personal care for up to 58 people, including people living with dementia. There were 58 people accommodated there on the day of our inspection.
The service had a registered manager in post. A registered manager is a person who has registered with the CQC 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 registered manager was on extended leave and a deputy manager was in day to day charge.
People told us they felt safe and were well cared for. Staff took steps to safeguard vulnerable adults and promoted their human rights. Incidents were dealt with appropriately, which helped to keep people safe.
The building was safe and well maintained. The property was purpose built and adaptations had been made and additional signage provided to improve safety and highlight potential hazards. Other risks associated with the building and working practices were assessed and steps taken to reduce the likelihood of harm occurring. The home was clean throughout.
We observed staff acted in a courteous, professional and safe manner when supporting people. Staffing levels were sufficient to safely meet people’s needs. The provider had a robust system to ensure new staff were subject to thorough recruitment checks.
Most medicines were safely managed. The administration of topical medicines (creams applied to the skin) was inconsistently recorded.
As Brierton Lodge Care Home is registered as a care home, CQC is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS) and to report on what we find. We found appropriate policies and procedures were in place and the deputy manager was familiar with the processes involved in the application for a DoLS. Arrangements were in place to assess people’s mental capacity and to identify if decisions needed to be taken on behalf of a person in their best interests. People’s mental capacity was a common thread considered through all care plans and risk assessments. Where necessary, DoLS had been applied for. Staff obtained people’s consent before providing care.
Staff had completed safety and care related training relevant to their role and the needs of people using the service. Further training was planned to ensure their skills and knowledge were up to date. Staff were well supported by their managers and other senior staff. Staff performance was assessed annually and objectives set for the year ahead.
People’s nutritional status was assessed and plans of care put in place. The recording of people's fluid intake and associated guidance for staff to follow was not always clear. This was being addressed by the provider. People’s health needs were identified and external professionals involved if necessary. This ensured people’s general medical needs were met promptly. People were provided with assistance to access healthcare services.
Staff displayed an attentive, caring and supportive attitude. We observed staff interacted positively with people. We saw that staff treated people with respect and explained clearly to us how people’s privacy, dignity and confidentiality were maintained.
Activities were offered within the home on a group and one to one basis. Adaptations had been made to the home to provide a calm and comfortable environment for people living with dementia. Staff understood the needs of people and we saw care plans and associated documentation were clear and person centred.
People using the service and staff spoke well of the home’s managers and they felt the service had good leadership. We found there were effective systems to assess and monitor the quality of the service, which included feedback from people receiving care and oversight from external managers.