Archived: Britannia Lodge

We found the following examples of good practice.

¿ The registered manager was following the government's guidance on whole home testing for people and staff. This included using rapid testing and weekly testing for staff.

¿ Staff had received training on working during the pandemic in relation to COVID-19 and had received training in the correct use of PPE.

¿ People were supported to isolate when required and the environment had been set up to encourage social distancing when people were able to meet in communal areas.

¿ Staff completed regular health screening on people to help identify any symptoms early.

¿ New admissions were assessed prior to admission and tested for COVID-19. On admission people were supported to isolate.

¿ The registered manager had spent funds available to support good infection prevention control practices. They had changed flooring to support easier cleaning and chairs had wipeable surfaces. They had purchased additional equipment to aid with cleaning such as a fogging machine which they used regularly to sterilise areas.

¿ At the time of the inspection, visits to the service had been halted due to the outbreak. However, the registered manager had provided a closed of area adjacent to the service which could be used by visitors when visiting recommences and they had processes in place for this to be facilitated safely.

¿ People’s wellbeing was supported by video and telephone calls to relatives and staff continued to engage with people in activities of their choice.

At our last inspection on 10 June 2016 we rated the service good. At this inspection we found the evidence continued to support the rating of good but there had been a deterioration in ‘effective’ which was rated as ‘requires improvement’. There was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

People continued to receive a safe service where they were protected from avoidable harm, discrimination and abuse. Risks associated with people’s needs including the environment, had been assessed and planned for and these were monitored for any changes. There were sufficient staff to meet people’s needs and safe staff recruitment procedures were in place and used. People received their prescribed medicines safely and these were managed in line with best practice guidance. Staff knew what to do in the event of an accident but there had not been any accidents in the last 12 months.

The service had deteriorated to ‘requires improvement for ‘effective’. People did not have access to the first-floor bathroom and the ground floor bathroom was in need of some refurbishment or repair to the floor covering. The registered manager had identified these shortfalls and was planning the work required. Staff received the training and support they required to meet people’s needs. People were supported with their nutritional needs. The staff worked well with external health care professionals, people were supported with their needs and accessed health services when required. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. The principles of the Mental Capacity Act (MCA) were followed.

People continued to receive care from staff who were kind, compassionate and treated them with dignity and respected their privacy. Staff had developed positive relationships with the people they supported, they understood people’s needs, preferences, and what was important to them. Staff knew how to comfort people when they were distressed and made sure that emotional support was provided.

People continued to receive a responsive service. People’s needs were assessed and planned for with the involvement of the person. Care plans were in place for each identified need. People received opportunities to pursue their interests and hobbies, and social activities were offered. There was a complaint procedure and action had been taken to learn and improve where this was possible.

The service continued to be ‘well led’. People and staff felt supported by and had confidence in the registered manager. There were systems in place to monitor the quality of service provision and these included seeking the views of people and staff. There was an open and transparent and person centred culture at the service.

Further information is in the detailed findings below

Britannia Lodge is registered to provide accommodation and personal care with nursing for up to 15 persons who may be living with mental health problem. There were 11 people living in the service at the time of the inspection.

There was a manager in post who was in the process of registering. 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.

At the last inspection in June 2015 we had concerns about the risks to people’s health and safety, the condition of the premises, medication practice, the food supply, people’s healthcare and staff support. We were also concerned about people’s assessments, care plans and the quality of the service. At this inspection we found that many improvements had been made in all areas and the new manager had put in place a system for monitoring the quality of the service on a regular basis.

People now received safe care and support in a way that ensured their happiness and well-being. There were enough staff who had been safely recruited, were well trained and supported to meet people’s assessed needs. People received their medication as prescribed and there were safe systems in place for receiving, administering and disposing of medicines. Staff knew how to protect people from the risk of harm. They had been trained and had access to guidance and information to support them with the process. Risks to people’s health and safety had been assessed and the service had care plans and risk assessments in place to ensure people were cared for safely.

The manager and staff had an understanding of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS) and had made appropriate applications when needed.

People had a sufficient choice of food and drink to meet their individual needs and to keep them healthy. People’s care needs had been assessed and their care plans provided staff with the information they needed to meet people’s needs and preferences and to care for them safely. People’s healthcare needs were monitored and staff sought advice and guidance from healthcare professionals when needed. Staff were kind and caring and knew the people they cared for well. They ensured that people’s privacy and dignity was maintained at all times. People expressed their views and opinions and they participated in activities of their choosing. People were able to receive their visitors at any time and their families and friends were made to feel welcome. Where people did not have friends or family to support them advocacy services were available. An advocate supports a person to have an independent voice and enables them to express their views when they are unable to do so for themselves.

People’s concerns or complaints were listened to and acted upon. There was an effective system in place to assess and monitor the quality of the service and to drive improvements.

We looked at three care plan files and found that people's individual needs had been considered and plans detailed the support required. We found that people's capacity to consent to care and treatment was assessed and recorded.

We found there were systems in place to ensure that the premises were safe and suitable for people using the service.

We found that people were cared for, or supported by, suitably qualified, skilled and experienced staff.

There were systems for people using the service and others to raise any concerns, complaints or compliments they had and staff took appropriate action as required.