Bury Lodge Care Home

About the service

Bury Lodge is a residential care home providing personal and nursing care to 29 people aged 65 and over at the time of the inspection. The service can accommodate up to 31 people over three floors in one adapted building.

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

The provider did not manage medicines according to best practice guidance. People did not always receive their medicines as the prescriber intended. Staff did not always sign the medication administration record (MAR) when medicines had been administered. Stock was not always available for people to ensure they received their medicines.

People commented they were safe living at Bury Lodge. “Oh yes, absolutely, and It’s the best thing” (living here).”

Staff we spoke with confirmed they had received training in safeguarding and knew what to do if they felt people had been abused. Recruitment files confirmed staff had been safely recruited. However, training was not always updated, and several members of staff required further updates in their training. The registered manager had put an action plan in place to rectify this.

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.

People and relatives were positive about the caring nature of staff. They commented, it’s been the best move for [name]”, “The care is amazing” and “You don’t have to wait long” (before they answer the bell).

We observed kind caring interactions between staff and people living at the service. There was no standard formality to addressing people. Most were referred to by their first name. There was a friendly and approachable atmosphere and staff interacted with people and constantly reassured where required. There were lots of platitudes and compliments ‘your hair looks nice’, ‘are you comfortable’ and staff were often smiling.

Care plans were not always individualised and did not always reflect people’s current healthcare needs. There was lack of detailed guidance within people’s risk assessments for staff to follow.

The service did not always make referrals to healthcare professionals at the right time to make sure people’s health improved.

We have made a recommendation in relation to seeking support from other healthcare professionals.

People were able to take part in activities. We saw people attending activities during our inspection. One member of staff we spoke with told us they had started making memory boxes with people and started a ‘wish’ tree. They were looking at ways to engage staff more with the people as they had identified this was an area to improve. People had mixed views about the activities. Someone who had recently moved into the home said they liked the home more than the others that they had been to and was happy and entertained.

The governance framework did not always ensure that responsibilities were clear. Quality checks had not prevented shortfalls in the quality of service provision.

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 28/07/2017).

Why we inspected

This was a planned inspection based on the previous rating.

The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.

We found no evidence during this inspection that people were at risk of harm from this concern.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Bury Lodge on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to safe care and treatment, staffing and good governance.

Please see the action we have told the provider to take at the end of this report.

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.

Bury Lodge is registered to provide care and accommodation for up to 31 people. At the time of our inspection there were 24 people living at the service.

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 and their families told us they felt safe at Bury Lodge and had no concerns about their safety at the home. One person said “I have no concerns re safety, I can relax now”.

Staff understood their responsibilities in relation to safeguarding people. Staff received regular training to make sure they stayed up to date with recognising and reporting safety concerns. The service had systems in place to notify the authorities where concerns were identified. People received their medicine as prescribed. The manager had identified medicine administration errors and had taken action to address these.

People benefitted from caring relationships with the staff. People and their relatives were involved in their care and people’s independence was actively promoted. Relatives and staff told us people’s dignity was promoted.

Where risks to people had been identified, risk assessments were in place and action had been taken to manage these risks. Staff sought people’s consent and involved them in their care where possible.

People, relatives and staff told us at times there were not always sufficient staff to meet people’s needs. We looked at staff rotas and the hours needed to look after people. We found the home had exceeded the required care hours as identified by the dependency tool. This indicated planned staffing levels were maintained. However, the manager was in the process of reviewing the skills mix of staff on each shift. The service had safe recruitment procedures and conducted background checks to ensure staff were suitable to undertake their care role.

People and their families told us people had enough to eat and drink. People were given a choice of meals and their preferences were respected. Where people had specific nutritional needs, staff were aware of, and ensured these needs were met.

Relatives and people told us they were confident they would be listened to and action would be taken if they raised a concern. The service had systems to assess the quality of the service provided. Improvements and learning needs were identified and action was taken to make improvements which promoted people’s safety and quality of life. Systems were in place that ensured people were protected against the risks of unsafe or inappropriate care.

Staff spoke positively about the support they received from the registered manager and all of the team at the home. Staff supervision and other meetings were scheduled as were annual appraisals. People, their relatives and staff told us all of the management team were approachable and there was a good level of communication within the service.

Relatives and people told us the team at Bury Lodge was very friendly, responsive and very well managed. The service sought people’s views and opinions and acted on them.

The management teams’ ethos was echoed by staff and embedded within the culture of the service.