21 April 2016
During a routine inspection
Brittany Lodge provides accommodation for fifteen older people, some of whom are living with dementia, who may need support with their personal care needs. On the day of our inspection there were thirteen people living at the home. The home is a large property situated in Hove, it has a large communal lounge and dining room and well maintained gardens.
The home did not have 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. Part of the registered person’s registration under the Care Quality Commission is to ensure that certain conditions of their registration are met. One condition imposed on the person’s registration states that they must ensure that the regulated activity is managed by an individual who is registered as a manager. However, the registered manager had left the home eleven months previously and the provider had taken over the day to day management since then. The provider had notified us of this, however the de-registering of the previous registered manager had not taken place. This was an area of practice in need of improvement.
There were sufficient numbers of staff to ensure people’s needs were met and their safety maintained. Staff had received induction training and had access to ongoing training to ensure their knowledge was current and that they had the relevant skills to meet people’s needs. People were safeguarded from harm. Staff that had received training in safeguarding adults at risk, they were aware of the policies and procedures in place in relation to safeguarding and knew how to raise concerns. People felt safe, one person told us “There is always someone to help me. I feel very safe, as safe as houses”.
Risk assessments had been undertaken and were regularly reviewed. They considered people’s physical needs as well as hazards in the environment and provided guidance to staff in relation to the equipment that they needed to use and the support the person required. People were encouraged and enabled to take positive risks. People’s independence was not restricted through risk assessments. Observations of people assessed as being at risk of falls showed them to be independently walking around the home. There were low incidences of accidents and incidents, those that had occurred had been recorded and were used to inform practice. For example, accident records for two people showed that they had experienced falls. The provider had taken the appropriate action to ensure people’s immediate safety. They had also made appropriate referrals to the falls prevention team to ensure that people were appropriately assessed and supported to minimise the chances of falls reoccurring.
People received their medicines on time and told us that if they were unwell and needed medicines that staff provided these. People were asked for their consent before being offered medicines and were supported according to their preferences. Medicines were administered by staff that had received appropriate training and there were safe systems in place for the storage, administration and disposal of medicines.
People were asked their consent before being supported with anything. People had access to relevant health professionals to maintain good health. People told us that if they were unwell that staff would call the Doctor. Records confirmed that external healthcare professionals had been consulted in relation to people’s care to ensure that they were being provided with safe and effective care. People received good health care to maintain their health and well-being. One healthcare professional who frequently visited people at the home, told us “Many patients are cared for in Brittany Lodge well past the stage in their physical and mental decline than any other residential homes, of my experience, provide. Those wishing to focus on avoidable hospital admissions would do well to visit and learn about the care provided here which provides care in a safe and appropriate setting, long after others would have passed the buck”.
People felt that they had enough food and drink and observations confirmed that drinks and snacks were offered throughout the day. People could choose what they had to eat and drink and told us that the food was good. Records of a resident meeting showed that people had been consulted about the food provided and confirmed that they were happy with the choice of food and the portion sizes. One person told us “Food is very good, I’ve no complaints”.
People were cared for by staff who knew them well and understood their needs and preferences. Observations showed people being cared for by staff that demonstrated genuine warmth and a friendly and caring nature. People told us that they felt well cared for. One person told us “They’re absolute angels, kind and caring, absolutely wonderful”.
People were involved in their care and decisions that related to this. People were asked their preferences when they first moved into the home. Regular reviews and residents meetings provided an opportunity for people to share their concerns and make comments about the care they received. Relatives confirmed that they were involved in their loved ones care and felt welcomed when they visited the home and knew who to go to if they had any concerns. The provider welcomed feedback and was continually acting on feedback to drive improvements within the home.
People were treated with dignity, their rights and choices respected. Observations showed people being treated in a respectful and kind manner. People’s privacy was maintained, when staff offered assistance to people they did this in a discreet and sensitive way. People confirmed that they were treated with dignity and their privacy maintained. One person told us “They respect your privacy, yes they do, absolutely. All staff from the newest upwards treat you with respect”.
Staff knew people’s preferences and support was provided to meet people’s needs, preferences and interests. There was a large variety of activities that were tailored to meet people’s needs and people were supported to spend time outside of the home. People were able to make suggestions as to how they wanted to spend their time and these were listened to and acted upon.
There was a homely, friendly and relaxed atmosphere within the home. People were complimentary about the leadership and management of the home and observations confirmed that the provider’s philosophy was embedded in staff’s practice. Staff felt supported by the provider and were able to develop in their roles. There were rigorous quality assurance processes in place to ensure that the quality of care provided as well as the environment itself, was meeting the needs of people and delivered a service they had the right to expect.