We carried out a review of the data available to us about Brandon Lodge Care Home on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Brandon Lodge Care Home, you can give feedback on this service.
We found the following examples of good practice during our inspection:
• Systems were in place to prevent people, staff and visitors from catching and spreading infections.
• Although no visits were taking place at the time of inspection due to an outbreak of COVID-19, visits had been facilitated with appropriate measures in place.
• Staff supported people's emotional wellbeing. People and their relatives were supported to keep in contact using a range of technology.
• Additional cleaning of all areas and frequent touch surfaces was being carried out regularly.
• People were supported to understand the pandemic and the need for infection prevention and control (IPC) measures, such as staff wearing face masks.
• People and staff participated in a regular testing programme.
People’s experience of using this service and what we found
Assessments were not always carried out in a timely manner and changes in people’s needs was not always communicated to staff who needed the information. These issues had not formed part of the current audits and so had not been identified. The registered manager put solutions in place to address the matter immediately.
People told us they felt safe at the service. Risks to people were identified and managed. Health and safety checks were carried out regularly ensuring people had a safe environment. The provider continued to follow safe recruitment practices and ensured people were protected against the employment of unsuitable staff. Sufficient staff were deployed to meet people’s care and support needs.
Staff treated people with dignity and respect and supported people to be as independent as possible. People were supported by staff who knew them well. We observed kind and affectionate interactions between staff and people.
Staff were motivated to provide good personalised care, treating people as individuals. People and relatives spoke positively about the registered manager and care staff. Staff worked well together and were happy working at 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.
People and relatives told us they knew how to complain but had no concerns. The service regularly sought feedback from people, relatives and healthcare professionals.
The provider used information from complaints, safeguarding concerns and accidents and incidents to drive improvement and to learn when things went wrong.
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 good (Published 29 March 2017).
Why we inspected
This was a planned inspection based on the previous rating.
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.
Brandon Lodge Care Home provides care and accommodation for up to 38 people with nursing and residential care needs. On the day of our inspection there were 36 people using the service.
A registered manager is a person who has registered with the Care Quality Commission (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. At the time of our inspection, the registered manager for Brandon Lodge Care Home had recently left the service and the deputy manager was in charge. The deputy manager told us a new manager had been appointed but hadn’t started work at the home yet.
We last inspected the service in February 2015 and rated the service as ‘Good’, however the Safe domain was rated ‘Requires improvement’ due to insufficient numbers of staff on duty. At this inspection we found the service was ‘Good’ in all areas and met all the fundamental standards we inspected against.
Accidents and incidents were appropriately recorded and risk assessments were in place. The registered provider had a safeguarding adults policy in place and staff had been trained in safeguarding vulnerable adults.
Appropriate arrangements were in place for the administration and storage of medicines.
The home was clean, spacious and suitable for the people who used the service and appropriate health and safety checks had been carried out.
There were sufficient numbers of staff on duty in order to meet the needs of people who used the service. The registered provider had an effective recruitment and selection procedure in place and carried out relevant checks when they employed staff.
Staff were suitably trained and received regular supervisions and appraisals.
The registered provider was working within the principles of the Mental Capacity Act 2005 (MCA) and was following the requirements in the Deprivation of Liberty Safeguards (DoLS).
People were protected from the risk of poor nutrition and staff were aware of people’s nutritional needs. Care records contained evidence of visits to and from external health care specialists.
People who used the service and family members were complimentary about the standard of care at Brandon Lodge Care Home.
Staff treated people with dignity and respect and helped to maintain people’s independence. Care plans were in place that recorded people’s plans and wishes for their end of life care.
Care records showed that people’s needs were assessed before they started using the service and care plans were written in a person centred way.
Activities were arranged for people who used the service based on their likes and interests and to help meet their social needs.
The registered provider had an effective complaints procedure in place and people who used the service, family members and staff were regularly consulted about the quality of the service.
This inspection took place on 2 February 2015 and was unannounced. This meant the staff and the provider did not know we would be visiting. The home was last inspected by CQC on 10 September 2013 and was compliant.
The home had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (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.
Brandon Lodge Care Home is located in a quiet residential area in the village of Brandon, County Durham. It is a two storey, purpose built home which provides accommodation, nursing care, palliative care and respite care for up to 38 older people. On the day of our inspection there were 37 people using the service.
People who used the service and their relatives had conflicting views about the standard of care at Brandon Lodge Care Home. They told us, “I am happy”, “I am happy here”, “Staff are not always helpful” and “I asked for assistance for my relative and I was told you will have to wait until a care worker has time to spare”.
There were insufficient numbers of staff on duty in order to meet the needs of people using the service.
The provider had an effective recruitment and selection procedure in place and carried out relevant checks when they employed staff.
Training records were up to date and staff received supervisions and appraisals.
There were appropriate security measures in place to ensure the safety of the people who used the service.
The layout of the building provided adequate space for people with walking aids or wheelchairs to mobilise safely around the home and was suitably designed for people with dementia type conditions.
The provider had procedures in place for managing the maintenance of the premises.
CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The Deprivation of Liberty Safeguards (DoLS) are part of the Mental Capacity Act 2005. They aim to make sure that people in care homes, hospitals and supported living are looked after in a way that does not inappropriately restrict their freedom. We looked at records and discussed DoLs with the registered manager, who told us that there were DoLS in place and in the process of being applied for. We found the provider was following the requirements in the DoLS.
We saw mental capacity assessments had been completed for people and best interest decisions made for their care and treatment. We also saw staff had completed training in the Deprivation of Liberty Safeguards.
People were protected against the risks associated with the unsafe use and management of medicines.
We saw staff supporting and helping to maintain people’s independence. People were encouraged to care for themselves where possible. Staff treated people with dignity and respect.
People had access to food and drink throughout the day and we saw staff supporting people in the dining room at lunch time when required.
The home had a programme of activities in place for people who used the service.
All the care records we looked at showed people’s needs were assessed before they moved into the home. Care plans and risk assessments were in place when required and daily records were up to date. Care plans were written in a person centred way and reviewed regularly.
We saw staff used a range of assessment tools and kept clear records about how care was to be delivered.
We saw people who used the service had access to healthcare services and received ongoing healthcare support. Care records contained evidence of visits from external specialists.
The provider consulted people who used the service, their relatives, visitors and stakeholders about the quality of the service provided.
We asked people if they were asked for their consent to care and treatment. Comments included 'They always ask before they do anything' and 'They don't just tell me what they're going to do, they always ask first.'
People told us, without exception, they were happy with the care provided. Comments included 'The care is gold standard, they go the extra mile for you', 'The staff are a great lot, it couldn't be better', 'The staff are all lovely' and 'I wanted my relative to come here as it is the best for care.'
Most people were satisfied with staffing levels. One person said 'If I press the button they come straight away.' Another said 'The staff are very good here, they are as quick as they can be.'
We found the provider requested feedback from people who used its services, relatives and staff, and took action to address any concerns.
We found records were up to date and securely held.
People said they were happy with the staff and the care they provided. One person said "The staff look after me well" and another person said "It's lovely here, the staff are really attentive."
We also spoke to some relatives, they said they were involved in care planning and reviews of care. One person said 'they keep me up to date', another said 'I am very comfortable with how they make my relative feel, I know that if I can't get in to visit they will be well looked after'.
People said they were aware of the complaints system.
Another visitor said, 'If my (relative) spills any food they make sure she is changed so that she's not sitting in stained clothes.'
People commented positively on the activities at the home, especially seasonal events. People told us that they had been enjoying making calendars and other arts and craft activities.
People told us that they felt 'well cared for'. One person said, 'The care is the important thing, and I think the care is very good here.'
One relative also told us, 'The senior staff work with me to provide the right care for mum. They are so familiar with her needs that they can spot any changes and they don't hesitate to get doctors or nurses to see her.'
Another relative said, 'We have reviews about my (relative) so we can all agree how they should care for her.'
Some of the people we talked with had concerns about the cleanliness and infection control practices within the home. One visitor said, 'There was an outbreak of norovirus ('winter vomitting' bug) but they still went ahead with a social fayre so there were loads of people coming into the home.'
Another relative said, 'They've got hand gel at the front entrance but it's not easy to see and staff don't encourage people to use it.'
Another person commented, 'It's a nursing home but it's not always clean.'