15 and 20 July 2015
During a routine inspection
We carried out this inspection on the 15 and 20 July 2015, it was unannounced. We inspected this service due to concerns we had received. It was alleged that there was not enough staff; agency staff were not skilled; people did not receive good care; a lack of activities and the food was not good.
Byron Lodge is a nursing home providing accommodation for up to 28 older people, some of whom are living with dementia, who require nursing and personal care. The accommodation is purpose built to cater for people who use wheelchairs and have difficulty moving around. Accommodation is provided over three floors. There is a passenger lift to all floors. The home is located in a residential area of Gillingham, Kent. At the time of the inspection 27 people lived at the service.
The service had 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.
The management and staff team included a registered manager, nursing staff and care staff. The ancillary staff team included two activity co-ordinators, kitchen, laundry and housekeeping staff.
There were sufficient numbers of staff to meet people’s needs. Staff had the knowledge and skills to meet people’s needs, and attended regular training courses. Staff were supported by the registered manager and felt able to raise any concerns they had or to make suggestions to improve the service to people.
People demonstrated that they were happy at the service by showing open affection to the registered manager and staff who were supporting them. Staff were available throughout the day, and responded quickly to people’s requests for help. Staff interacted well with people, and supported them when they needed it.
Staff were recruited using procedures designed to protect people from unsuitable staff. Staff were trained to meet people’s needs. They met with the supervisor and discussed their work performance at one to one meetings and during annual appraisal so they were supported to carry out their roles.
People were protected against the risk of abuse. People told us they felt safe. Staff recognised the signs of abuse or neglect and what to look out for. Both the registered manager and staff understood their role and responsibilities to report any concerns and were confident in doing so.
The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The registered manager understood when an application should be made. They were aware of the Supreme Court Judgement which widened and clarified the definition of a deprivation of liberty. The service was meeting the requirements of the Deprivation of Liberty Safeguards.
There were risk assessments in place for the environment, and for each person who received care. Assessments identified people’s specific needs, and showed how risks could be minimised. There were systems in place to review accidents and incidents and make any relevant improvements as a result.
People and their relatives were involved in planning their own care, and staff supported them in making arrangements to meet their health needs. Nursing staff carried out on-going checks of people’s health needs, and contacted other health and social care professionals for support and advice.
Nursing staff managed and administered medicines for people. Medicines were administered, stored, and disposed of safely. People received their medicines as prescribed.
People were provided with a diet that met their needs and wishes. Menus offered variety and choice. People said they liked the home cooked food. Staff respected people and we saw several instances of a kindly touch or a joke and conversation as drinks or the lunch was served.
Staff encouraged people to undertake activities and supported them to become more independent. Staff spent time engaging people in conversations, and spoke to them politely and respectfully.
The providers and the registered manager investigated and responded to people’s complaints. People knew how to raise any concerns and relatives were confident that the registered manager dealt with them appropriately and resolved them where possible.
There were systems in place to obtain people’s views about the service. These included formal and informal meetings; events; questionnaires; and daily contact with the registered manager and staff.
The providers and registered manager regularly assessed and monitored the quality of care to ensure standards were met and maintained. The providers and registered manager understood the requirements of their registration with the Commission.