Berkeley Lodge

We found the following examples of good practice.

The service had introduced an online booking system to facilitate safe visiting. We were told this had been positively received by people and their relatives. The provider ensured people were still able to telephone the home to book a visiting time if they preferred.

The provider’s website included their updated policies in relation to the management of risks associated with COVID-19. This included clear information about visiting, the requirement to wear personal protective equipment (PPE), testing and when isolation would be required. All visitors were asked to read and sign a concise, large print summary on entry to confirm they understood the relevant requirements.

The provider recognised the pressures staff and the management team at the service experienced during the COVID-19 pandemic. They had resources in place to support staff wellbeing across the provider’s group of homes and were in the process of arranging reflective sessions for the managers.

Berkeley Lodge is a residential home providing personal and nursing care to 65 people with physical disabilities and long term conditions. They provide support to adults, older people and people living with dementia. The service can support up to 65 people.

Care was provided in one adapted building across three floors. People accessed different floors using lifts and there was one area of the home designed for people living with dementia.

People’s experience of using this service and what we found

Staff routinely found ways to improve people's health and wellbeing and there was an integrated approach to meeting people's healthcare needs. People spoke positively about the support they had to maintain their health and wellbeing and this matched our observations. Staff were knowledgeable in areas such as hydration and oral health care and there were robust systems to monitor and check these areas of care to ensure these needs were being met. Staff training was linked to checks of people’s needs and the outcomes of clinical governance audits regularly led to meaningful and targeted staff training.

People were supported to achieve personalised goals and we saw examples of people being supported to improve their mobility and overall wellbeing. The service worked very closely with local community health services and this had achieved positive outcomes for people, particularly for people living with dementia. People’s home environment had been tailored to their needs and designed in line with best practice for dementia care.

Care was delivered in a personalised way and there was a focus on encouraging people to maintain relationships and reduce isolation. We saw examples of people being made to feel good by staff with personalised activities and events. There was an ongoing schedule of activities and people benefited from ongoing activities and engagement with care staff. Care plans contained a high level of detail about people’s needs and backgrounds and care delivery was regularly reviewed. Care plans were in place to ensure people received personalised and dignified end of life care.

People told us staff were caring and we made observations that showed staff were committed to the people they supported. People were involved in their care and people were supported with dignity, ensuring their privacy was respected. People received their medicines from trained staff and medicines were managed safely.

People received assessments of their needs before receiving support. There were clear plans to manage risks whilst enabling them to be independent. 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.

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 27 April 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.

Berkeley Lodge is registered to provide accommodation, nursing care and support for up to 65 people. The home provides end of life care and care for people living with dementia. The home is registered to provide care for 65 people. At the time of our visit there were 62 people at the home, none of whom were receiving end of life care. The home has a wide range of communal areas and well maintained accessible gardens.

The home had a registered manager in place. 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 were protected from risks to their health and wellbeing. Up to date plans were in place to manage risks, without unduly restricting people’s independence.

People said they felt safe at the service and knew who they would speak to if they had concerns. The service followed the West Sussex safeguarding procedure, which was available to staff. Staff knew what their responsibilities were in reporting any suspicion of abuse.

People were treated with respect and their privacy was promoted. Staff were caring and responsive to the needs of the people they supported. People's health and well-being was assessed and measures put in place to ensure people's needs were met in an individualised way.

People’s medicines were managed safely. People had enough to eat and drink throughout the day and night. The mealtime was an inclusive experience.

There was an open and friendly culture combined with a dedication to providing the best possible care to people. Staff at all levels were approachable, knowledgeable, professional, keen to talk about their work and committed to the on-going development of the home. The atmosphere in the home was happy and calm. People were engaged and occupied; they interacted and chatted with each other. Every person we spoke to, without exception was extremely complimentary about the caring nature of the management and staff.

Staff received training to enable them to do their jobs safely and to a good standard. They felt the support received helped them to do their jobs well.

There were enough staff on duty to support people with their assessed needs. The registered manager considered people’s support needs when completing the staffing rota and staffing levels were calculated appropriately. The registered manager followed safe recruitment procedures to ensure that staff working with people were suitable for their roles.

People benefited from receiving a service from staff who worked well together as a team. The registered manager and the staff team took an obvious pride in their work, but were not complacent, and were looking for ways to improve the service. Staff were confident they could take any concerns to the management and these would be taken seriously. People were aware of how to raise a concern and were confident appropriate action would be taken.

The premises and gardens were well maintained. All maintenance and servicing checks were carried out, keeping people safe. People were empowered to contribute to improve the service. People had opportunities to feedback their views about the home and quality of the care they received.

We read through personal care files and found that people were thoroughly assessed before admission and people or their next of kin were involved in their care planning. We found evidence that people's consent was sought prior to care being delivered. There were risks assessments in place and we found that they were reviewed regularly. We found that people were receiving care appropriate to their needs in a safe and comfortable environment.

We looked at the rota and found that there was the right amount of staff on duty on each shift with a good skill mix. We also found that thorough recruitment procedures were in place and staff were receiving a good level of training and support from the management. We found that accurate and appropriate records were kept in about the management and delivery of the service. Records were fit for purpose, securely stored and accessible to only designated members of staff.

People told us they were aware of their plans of care and support and had been involved in developing these.

We observed staff interacting with service users and we also looked at records of care and support for three people in detail. We found that people's privacy, dignity and independence were respected. People told us they were happy with the quality of service provided at Berkeley Lodge.

People said they were supported to take their medicines safely and at the times prescribed.

People said they felt safe and were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

Checks were undertaken before staff began work. There were effective staff recruitment and selection processes in place.

People and/or their representatives were asked for their views about their care and treatment and they were acted on. There were systems in place to monitor the service. There was a complaints process that was available to people.