Byker Lodge

We found the following examples of good practice.

The registered manager and team worked hard to ensure staff, people and relatives were aware of the latest guidance regarding visiting and testing.

Staff responded to advice from visiting external professionals, for instance from Infection Prevention and Control (IPC) nurses.

Auditing and regular walkarounds of the service were effective in maintaining high standards of IPC practice and personal protective equipment (PPE) usage.

We carried out an unannounced comprehensive inspection of Byker Lodge on 15 and 16 March 2018. This meant that the provider and staff did not know we were coming.

At the last comprehensive inspection we rated this service overall as good. At this inspection we found the service remained good. We found no breaches of regulations and the service was meeting the legal requirements. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

There was a registered manager in post who had been registered with the Commission since 2011. The registered manager was aware of their responsibilities and had a clear vision for the service in partnership with the provider’s organisational vision. The registered manager had submitted notifications as and when required.

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 registered manager

The premises were safe. Regular checks of the premises, equipment and utilities were carried out and documented. There were infection control procedures and risk of control of substances hazardous to health (COSHH) in place. The provider had recently reassessed environmental risks and had removed a range of potential risks to people. Medicines were safely managed and there were robust medication policies in place.

People’s care plans reflected their individual needs and risks were assessed and reviewed. We found there were policies and procedures in place to help keep people safe. There was a business continuity plan in place for use in emergency situations. These were also reflected in people’s care plans with personal emergency evacuation plans (PEEPs) to support the safe evacuation of people in an emergency.

We reviewed staffing levels within the service and found these matched the assessed support requirements for people. We reviewed accidents and incidents at the service and found these to be all appropriately recorded, investigated, lessons learned shared with staff and were regularly analysed by the registered manager for themes, trends and further learning. Were applicable referrals had been made to the local safeguarding team and these were also fully investigated with outcomes and actions.

Staff were safely recruited, completed a thorough induction and they were provided with all the necessary training required for their role. There was training provided for staff in delivering end of life care and challenging behaviours in addition to key areas such as safeguarding and moving and repositioning safely. We saw evidence of regular staff supervisions, yearly appraisals and team meetings.

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 Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves, for example because of permanent or temporary problems such as mental illness, brain impairment or a learning disability. The Act requires that, as far as possible, people make their own decisions and are helped to do so when needed. When people lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and be as least restrictive as possible.

Staff treated people with dignity and respect. We observed people enjoyed positive relationships with staff and it was apparent they knew each other well. People and their relatives told us that staff knew what they liked and disliked. People received good person centred care which was clearly documented in their care plans. There were records showing assessments of people’s needs prior to entering the service and evidence of regular reviews and further assessments as people’s needs changed. There were regular reviews of people’s care plans with involvement from relatives, other professionals and partnership agencies.

We saw referrals to other agencies, for example the dietician and GP, in people’s care files. People were supported to eat and drink a healthy balanced diet.

People’s privacy and dignity was respected by staff. During the inspection we observed staff asking people discretely if they could carry out personal care and if they required support. The service promoted advocacy and there was accessible information available detailing what support people could access to help make choices about their individual lives.

There was a complaints procedure in place at the service. Any complaints received were logged electronically on the provider’s system, action plans were created and lessons learned from events and incidents were documented. We saw records of activities undertaken by people and relatives told us that people were supported to carry out their own choices for activities.

There was a robust governance framework in place to continually monitor and improve the service. We saw evidence of involvement from the provider’s senior management team and documented audits carried out during their visits to the service. All of the documents we reviewed were accurate, regularly reviewed and very organised with a clear structure.

Further information is in the detailed findings below.

Byker Lodge is a 25 bed care service that provides short stay care for people living with dementia who require emergency care in crisis situations. At the time of our inspection there were 15 people staying at the centre.

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.

We found that the service had taken appropriate steps to safeguard people from avoidable harm and abuse. Measures were in place to minimise the risks associated with people’s care and ensure that care was provided in a safe, clean environment.

New staff were subject to thorough vetting to check their suitability in working with vulnerable people. Sufficient staff were employed to provide continuity of care. Staff received the necessary training and support to develop their skills and care for people effectively.

Robust arrangements had been made for handling people’s prescribed medicines. The service worked in conjunction with health care professionals to promote people’s health and well-being. People's nutritional needs were assessed and a balanced diet with choice of meals was provided. People told us they enjoyed the food.

People’s rights under the Mental Capacity Act 2005 were understood and protected. Staff encouraged people to exercise control and, wherever possible, to be involved in decisions about their care provision. Specialist mental health care support and advocacy services were arranged when needed.

People were given information about the service and had opportunities to express their views about their care experiences. Care was provided with patience and kindness and people’s privacy and dignity were promoted. People and their relatives told us the staff were very caring and respectful and our observations confirmed this. A range of activities was offered to support people in meeting their social needs.

Assessments and personal profiles were completed to identify care needs and give staff understanding of what was important to the person. People had individualised care plans for meeting their needs which described the support they required and their preferences. Each person’s care and welfare was reviewed on a weekly basis throughout their stay.

There was an open culture in the service and staff worked inclusively with people, their representatives and external professionals. Feedback was sought and any complaints made were properly acted upon. The management team provided leadership and support to the staff team. Standards were continuously checked to assure and improve the quality of the service that people received.

We found that people's needs were thoroughly assessed to determine the care they required. Care was appropriately planned and centred on the individual's welfare and safety. Wherever possible, people and their families were supported to be involved in care planning and in decisions about their care and treatment. Care was delivered in a personalised way by skilled and experienced staff who understood the needs of people with dementia.

People and their relatives told us they had positive experiences of using the service. They told us, 'I have been extremely impressed by the care given; 'All staff have been very helpful'; 'In my opinion Byker Lodge provides first class care for people with dementia'; and, 'All the staff are lovely and kind'.

People using the service were assisted to access a range of health services to help them maintain and improve their physical and mental well-being. Staff worked closely with other professionals in co-ordinating and planning for people's current and future care needs.

There were effective systems for monitoring the quality of care provided. These included getting people's views about the service and checking the care they received met their needs.