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Berrywood Lodge Requires improvement

Reports


Inspection carried out on 8 October 2018

During a routine inspection

This inspection took place on 8 October 2018 and was unannounced.

Berrywood Lodge is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Berrywood Lodge is registered to accommodate 30 people with mental health conditions and learning disabilities. At the time of our inspection there were 24 people living in the home.

At the last inspection in June 2016 this service was rated good. At this inspection we found the service to require improvement.

The premises had not been adequately cleaned. One person’s bedroom had not been sufficiently cleaned by staff, and some furnishings within it were soiled and had been missed by the cleaning staff.

Cleaning records and audits to check that areas within the home had been cleaned appropriately, were not robust and did not contain enough detail to ensure that standards remained high for people.

There were areas throughout the service that had not been well maintained and required refurbishment. We were shown that work was due to start on the refurbishment of certain areas throughout the home, however, these improvements had not been carried out in a timely manner.

There was a registered manager in post. 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.

People felt safe. We saw that staff had been appropriately recruited in to the service and security checks had taken place. There were enough staff to provide care and support to people to meet their needs. People received their prescribed medicines safely.

The care that people received continued to be effective. Staff had access to the support, supervision, training and ongoing professional development that they required to work effectively in their roles. People were supported to maintain good health and nutrition.

People told us their relationships with staff were positive and caring. We saw that staff treated people with respect, kindness and courtesy. People had detailed personalised plans of care in place to enable staff to provide consistent care and support in line with people’s personal preferences.

People knew how to raise a concern or make a complaint and were confident that if they did, the management would respond to them appropriately. The provider had implemented effective systems to manage any complaints that they may receive.

The service had a positive ethos and an open and honest culture. The manager was present and visible within the home.

We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have told the registered provider to take at the back of the full version of the report.

Further information is in the detailed findings below.

Inspection carried out on 29 June 2016

During a routine inspection

This unannounced inspection took place on the 29 June 2016. Berrywood Lodge provides accommodation for up to 29 people who have learning disabilities or mental health needs. There were 23 people in residence during this inspection.

There was a registered manager in post. 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.

People were safeguarded from harm as the provider had systems in place to prevent, recognise and report concerns to the relevant authorities. Senior staff knew their responsibilities as defined by the Mental Capacity Act 2005 (MCA 2005) and Deprivation of Liberty Safeguards (DoLS) and had applied that knowledge appropriately.

There were sufficient numbers of experienced staff that were supported to carry out their roles to meet the assessed needs of people living at the home. Staff received training in areas that enabled them to understand and meet the care needs of each person. Recruitment procedures protected people from receiving unsafe care from care staff unsuited to the role.

People’s care and support needs were continually monitored and reviewed to ensure that care was provided in the way that they needed. People had been involved in planning and reviewing their care when they wanted to.

People were supported to have sufficient to eat and drink to maintain a balanced diet. Staff monitored people’s health and well-being and ensured people had access to healthcare professionals when required.

Staff understood the importance of obtaining people’s consent when supporting them with their daily living needs. People experienced caring relationships with the staff that provided good interaction by taking the time to listen and understand what people needed.

People’s needs were met in line with their individual care plans and assessed needs. Staff took time to get to know people and ensured that people’s care was tailored to their individual needs.

People had the information they needed to make a complaint and the service had processes in place to respond to any complaints.

People were supported by a team of staff that had the managerial guidance and support they needed to carry out their roles. The quality of the service was not always effectively monitored and timely action taken by the audits regularly carried out by the manager and by the provider.

Inspection carried out on 6 May 2014

During a routine inspection

We considered all the evidence we had gathered under the outcomes we had inspected to answer questions we always ask; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well lead?

This is a summary of what we found-

Is the service safe?

People told us that they felt safe living at Berrywood Lodge, one person said “I am comfortable living here, the staff are nice and they know how to help me”. People told us they knew how to raise any concerns with the registered manager should they need to do so.

Individual plans of care contained risk assessments to promote people’s safety, including safe access to the local community, nutritional risk, the risk of falls and the effects of pressure on the body.

We found that staff had the right checks before they started working in the home and that staff had the right training to ensure people were well cared for and were safe.

The right checks were done to ensure that environment and the equipment used were well maintained and safe to use.

Is the service effective?

Staff related well to people and knew how they liked to be supported. All of the people living at Berrywood Lodge had an individual plan of care; these had been regularly reviewed to ensure that they contained appropriate information.

We saw people were comfortable and relaxed within their environment, people looked well cared for and they were dressed according to their age, gender, culture and the weather conditions. We saw that people had access to a range of aids and adaptations to support their independence and mobility.

Records showed that people had access to a range of health professionals and other NHS services when they were required.

Is the service caring?

We saw that staff were mindful of people’s privacy and that they treated them with respect. We saw that people were involved in decisions about their care and any restrictions were made in their best interests and with their consent.

We saw that staff understood people’s needs including their non-verbal communication and were swift to respond when people became distressed.

Is the service responsive to people’s needs?

People we spoke with told us they felt there were enough staff to meet their needs. We saw that care plans had been updated when people’s health needs had changed and that referrals had been made to health and social care professionals when needed. We saw that staff were mindful of people’s privacy and that they treated them with respect. For example we saw that staff referred to people by their preferred name and obtained people’s consent before providing any support.

Is the service well lead?

The registered manager and the provider had conducted the appropriate checks to ensure that people who used the service were safe and well cared for.

Staff recruitment systems ensured that people were protected from abuse and unsafe care. Systems were in pace to ensure that staff had the right skills to care for people safely. Individual plans of care reflected people’s health care needs and personal preferences. Risk assessments were in place to reduce and manage the impact of identified risk factors.

Inspection carried out on 7 January 2014

During an inspection to make sure that the improvements required had been made

We conducted a follow up inspection on the 7 January 2014 to check that the provider was meeting Essential standards of quality and safety. We found that the provider had taken action to comply with the warning notice relating to Care and welfare of people who use services and the compliance action relating to Records issued as a result of our previous inspection dated 2 September 2013.

Inspection carried out on 27 August 2013

During an inspection to make sure that the improvements required had been made

We conducted a scheduled inspection on the 4 June 2013 and found that the provider was not meeting essential standards relating to outcomes 4: Care and welfare of people who use services and 5: Meeting nutritional needs. We asked the provider to make improvements in the way Care and welfare of people who use services and Meeting nutritional needs were managed at Berrywood Lodge.

The provider sent us an action plan advising us about the action they had taken to ensure improvements. We conducted a further inspection on the 27 August 2013 to review improvements to both outcomes.

We found the provider had failed to take adequate action to meet Outcome 4: Care and welfare of people who use services because people had not been adequately assessed for the risks associated with pressure on the body.

We found the provider had taken adequate action to achieve compliance with outcome 5: Meeting nutritional needs.

During this inspection we found that the provider was not meeting essential standard in relation to Outcome 21 Records.

Inspection carried out on 4 June 2013

During a routine inspection

People told us they were well looked after at Berrywood Lodge and the staff knew the care they needed and how they wished to be supported. One person commented “I am very happy here and I am well cared for”.

People told us that they had regular access to food and fluids and that they had enough to eat and drink. One person commented “we get enough to eat and drink, we have three meals a day and we can have ‘seconds’ if we want more. We also have drinks and snacks like biscuits, cake and fruit at other times during the day”.

Another person told us “the staff help me to keep my bedroom clean and tidy”. And another person said “the home is kept nice and clean.

One person said “The staff are very good; they are all nice to me and I feel safe living here”. Another person commented “The staff are nice, they know what they are doing and I would let them know if I wasn’t happy about something”.

However we found that the provider was not meeting standards in relation to care and welfare of people who use services and meeting nutritional needs.

Inspection carried out on 16 October 2012

During a routine inspection

We spoke with three people during our visit to Berrywood Lodge; they told us they were treated with respect by staff and that their privacy was respected.

Two people told us they were able to make decisions about their lives, such as their choice of food, clothing and personal routines. They told us there were activities going on in the home that they could join in with if they wanted to. They also told us that they were able to access the community and local amenities. People told us that they enjoyed the activities provided within the home such as painting and other arts and crafts sessions.

All of the people that we spoke with told us that the staff asked for consent before supporting people with their personal care and that they felt they were well looked after at Berrywood Lodge. They told us that the staff knew how they needed and wished to be supported.

All of the people that we spoke with told us the staff were nice to them and that they felt safe living at Berrywood Lodge. People told us that they knew how to raise their concerns if they needed to do so.

Two of the people we spoke with told us they thought there were enough staff on duty to meet their needs and expectations.

Inspection carried out on 19, 26 January 2011

During an inspection in response to concerns

We talked to three of the people who live at Berry wood Lodge, they told us that –

That they liked living at Berrywood Lodge.

They told us that they felt that they were well cared for.

They told us that the staff were supportive and considerate to their needs and wishes.

The told us that they had routines that were flexible.

They told us that they were able to participate in planning their care, their activities and menus.

They told us that they had meaningful activities in which to participate.

They told us that they were supported to maintain links with family and friends.

People told us that they felt safe living at Berrywood Lodge.

People told us that they got on well with other people who live at Berrywood Lodge.

People told us that the staff were nice to them.

They told us that the staff were supportive.

They told us that there were enough staff on duty to meet their needs.

They also told us that they would know who to talk to if they were concerned about anything.

They told us that they could access the local community and participate in activities of their choice.

They told us that they were able to make choices in their daily lives.

Reports under our old system of regulation (including those from before CQC was created)