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Inspection Summary


Overall summary & rating

Good

Updated 9 January 2019

The inspection took place on the 14 and 17 December 2018 and was unannounced.

Broughton Lodge is a ‘care home’ operated by Cygnet Care Services Limited (the registered provider). 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.

The care home is set within its own extensive grounds in a rural location in Macclesfield. The care home accommodates up to 20 people across three separate units, each of which have separate adapted facilities. At the time of our inspection, the service was accommodating 12 people with a diverse range of needs.

The care home was registered in July 2015 and had therefore not been developed and designed in line with the values that underpin ‘Registering the Right Support’ and other best practice guidance. Consequently, the service does not currently conform to some aspects of Building the Right Support and Registering the Right Support guidance. For example, the number of registered places and the location of the building.

At the time of our inspection, the care home did not have 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.

A new manager had been appointed to manage the service who had been in post since October 2018. We saw evidence during the inspection that the manager was in the process of applying to CQC to become the registered manager of Broughton Lodge.

The manager was present during the two days of our inspection and was supported by their operations director and deputy manager. The management team were clear about their roles and responsibilities and keen to share developments within the service since the last inspection.

During our site visit, we spoke with staff, people living in the care home, their relatives and representatives. We also undertook direct observations of the standard of care provided. Overall, we noted that staff were sensitive and responsive in their approach to people’s needs and that people were encouraged to follow their preferred daily routines and treated with dignity and respect.

Holistic assessments, care planning processes and risk management systems were in place that confirmed the complex and diverse needs of people using the service were identified, planned for and kept under review. This helped staff to be aware of the support needs of people living in the care home and to understand how best to support them.

People were offered a choice of nutritious and wholesome meals and staff were observed to offer appropriate support and supervision to people who required prompt and support during mealtimes.

Staff had access to induction, mandatory and service specific training to help them understand their roles and responsibilities. This programme of training was in the process of being rolled out to new staff to ensure staff were equipped with the necessary knowledge, skills and understanding for their roles.

Systems had been established to ensure that staff working in the care home had been correctly recruited and to safeguard people from abuse. A complaints policy and process was also in place to ensure concerns and complaints were listened to and acted upon.

Personalised weekly timetables and activity schedules were in place that had been developed for people using signs and symbols. People were supported to access local leisure, recreational and social facilities and to participate in their preferred activities.

People had access to an in-house multi-disciplinary team that consisted of speech and language therapists, occupational therapists and psychologists. People w

Inspection areas

Safe

Good

Updated 9 January 2019

The service was safe.

Sufficient numbers of staff were deployed to respond to the needs of people.

Policies and procedures were in place to provide guidance to staff about safeguarding adults and staff understood how to recognise and respond to allegations or suspicion of abuse.

Recruitment procedures provided appropriate safeguards for people using the service. This helped to reduce the risk of unsuitable people being employed in the care home.

Systems had been established to protect people from the risks associated with unsafe medicines management.

Effective

Requires improvement

Updated 9 January 2019

The service was not always effective.

People’s needs had been assessed however we observed occasions when people did not always receive appropriate supervision that was tailored towards their individual needs.

A programme of staff training and development was in place that was in the process of being rolled out to staff to ensure they had were equipped with the necessary knowledge and skills.

People had access to a choice of nutritious meals and systems were in place to liaise with GPs and other health and social care professionals when necessary to maintain people’s health and wellbeing.

Caring

Good

Updated 9 January 2019

The service was caring.

People were treated with dignity and respect and their privacy and human rights were safeguarded.

People had access to an independent advocate to help them express their views and opinions on the service.

Responsive

Good

Updated 9 January 2019

The service was responsive.

Care and support plans had been developed that were subject to ongoing review to ensure people’s changing needs were identified and planned for.

People were encouraged to engage in a range of person-centred activities and were supported to follow their preferred routines.

There was a complaints procedure in place and any concerns were responded to appropriately.

Well-led

Good

Updated 9 January 2019

The service was well led.

A new manager had been appointed to provide leadership and direction at Broughton Lodge who was in the process of registering with CQC.

Governance and quality assurance systems had been developed to ensure oversight and scrutiny of the service. This included processes to enable people who lived in the care home and their relatives to be consulted about their views and opinions of the service.

The service continued to work in partnership with other agencies and health and social care professionals.