Archived: Brook Lodge

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well led?

Is the service safe?

At the time of the inspection there were 9 people living at the home. People told us they felt able to raise their worries with staff. One person told us, 'When you're not happy you've got to talk to staff - they help'. We observed staff working with people in a way that respected people's rights and dignity.

Systems were in place to make sure that managers and staff learnt from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduced the risks to people and helped the service to continually improve.

Systems were in place to ensure medicines were prescribed and administered to people appropriately and safely. We observed staff administering medicines on the day of the inspection and found them to be skilled, competent and aware of the risks associated with administering medicines.

Staff knew about risk management plans and people's individual behaviour plans and showed us examples where they had followed them. People were not put at unnecessary risk but also had access to choice and remained in control of decisions about their care and lives.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While no applications had needed to be submitted, proper policies and procedures were in place. Consideration of Deprivation of Liberty principles was reflected in people's care plans. Relevant staff had been trained to understand when an application should be made and how to submit one.

Is the service effective?

People told us that they were happy with the care they received and felt their needs had been met. People told us about the various activities they were supported to do. One person told us, 'I do drawing, I go to the pub and I'm going on holiday soon'. Another person told us 'I've been on the bus. I've got my paper. I'm going out again now'.

It was clear from our observations and from speaking with staff that they understood people's care and support needs and that they knew them well. One person told us, "(Staff member) is my keyworker, she does my keyworker meetings. We meet every day. She got me clothes, a coat. She got them in Gloucester and I chose them'.

Staff had received training to meet the needs of the people living at the home. Staff told us they felt well supported and were given the training and support they required to be able to care for people to the best of their abilities.

Is the service caring?

People were supported by kind and attentive staff who knew their needs well including their emotional and behavioural needs. People told us they thought staff were 'nice' and 'I do like the staff'.

People's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people's wishes. One person told us, 'It's good food ' you get a choice'.

We observed staff working sensitively with people, particularly with those who were less able to verbally communicate their wishes.

Is the service responsive?

The service worked well with other agencies and services to make sure people received care in a coherent way.

On the day of the inspection a health specialist attended the home as part of some ongoing work with one person living at the home. They had been alerted following a number of incidents and were working with both the person and with staff in order to improve the situation for all involved.

We noted that people's care plans were reviewed and amended as people's needs changed. For example, one person's routine around their habits had been changed, in cooperation with them, when they became more independent in controlling their habit. This meant that people's care plans were amended in line with people's changing needs so that staff always had up to date information about how best to support people.

Is the service well-led?

Staff told us they were clear about their roles and responsibilities. Where issues arose these were escalated and actioned appropriately. Although staff supervisions and appraisals did not always happen in a timely manner, staff told us they felt well supported. Issues around their professional development were raised in other forums such as staff meetings.

The service had a quality assurance system in place, and records showed that identified problems and opportunities to change things for the better were addressed promptly. As a result the quality of the service was continuously improving.

We observed staff managing challenging behaviour effectively and working flexibly as a team to respond to the changing needs of the people living in the home.

A range of activities were on offer for people, including horse riding, visits to the local park, shopping and meals out. Activity plans were individualised for each person, although if people felt they didn't want to take part in their regular planned activity other choices were offered.

Appropriate arrangements were in place in relation to obtaining and the recording of medicine. There were enough qualified, skilled and experienced staff to meet people's needs. The provider sought the views of people who used the service and used these comments to improve and develop the service.