Archived: Brighton Lodge

Brighton Lodge provides care and support for adults who are living with a learning disability. The home has a maximum occupancy of 10 people, on the day of our inspection nine people were resident at the home.

The service 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.

We found that not all aspect s of the premises and equipment had been serviced and checked in line with current regulations and good practice. On the day of the inspection we were unable to evidence a ceiling tracking hoist had been in serviced line with the Lifting Operations and Lifting Equipment Regulations 1998 (LOLER). However, after the inspection the registered manager provided us with evidence of the most recent safety check, completed during December 2016. Due to a delay in the completion of work to the gas cooker, the gas safety certificate for the home had expired, and although water temperatures in the two baths at the home were routinely checked, the temperatures of other water outlets were not monitored. This demonstrated a breach of Regulation 15 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Relatives told us they felt their family member was safe and staff were knowledgeable about the types of abuse and the actions to take in the event a person was at risk of harm or abuse.

Each of the care records we reviewed contained risk assessments, individual to each person and relevant to their care and support needs.

There were enough staff on duty to meet people’s needs and there was a procedure in place to reduce the risk of staff being employed who may be unsuitable to work with vulnerable people.

Staff were assessed as competent to administer people’s medicines. Systems to record the stock levels of medicines kept at the home and the administration of variable dose medicines needed to improve.

New staff completed a programme of training and induction, however there was a lack of records to evidence the training staff had completed. Supervision for staff had not been completed on a regular basis but this had been identified by the registered manager and they had taken action to address this.

Our discussions with the manager and staff showed they had a good understanding of the Mental Capacity issues relating to consent and decision making.

Care records detailed peoples preferences in regard to their meals and staff were knowledgeable about the support people needed to eat and drink sufficient amounts safely. Peoples care records also evidenced the support they received from external professionals, such as their GP.

Relatives were very positive about the good care their family member received. Staff spoke to us about the people they supported in a professional, caring and knowledgeable manner. Staff knew people well including their likes and dislikes. When we observed the interactions between staff and people who lived at the home it was friendly and inclusive, people looked relaxed in the company of staff. Staff respected people’s right to privacy and dignity, for example bathroom and toilet doors could be locked and people were able to spend time alone in their rooms if they chose to do so.

People were supported to engage in a wide range of activities and were enabled to maintain contact with family and friends.

Care plans were person centred and detailed people’s care and support needs, as well as their likes and dislikes. Care plans were reviewed and updated on a regular basis to ensure they were reflective of people’s current requirements.

Staff understood their duties and the standard expected of them whilst they were on duty. Staff were proud to work at the home and felt supported by the registered manager. There were systems in place to monitor the service provided to people, for example regular checks of peoples medicines, reviews of peoples care needs and regular staff meetings. However, these were not robust and had not identified the concerns we had noted. We have made a recommendation that the registered manager seek advice and guidance from a reputable source, regarding effective auditing systems.

You can see what action we told the provider to take at the back of the full version of the report.

Below is a summary of what we found. The summary describes what people using the service, their relatives and staff told us, what we observed and the records we looked at.

Is the service safe?

There were enough staff on duty with the relevant skills and experience needed to support people living in the home. People's relatives told us that they were satisfied with the staffing levels in the home and one relative said "there is always enough staff and I have never had any concerns, they are marvellous". Systems were in place to ensure that people were protected against risks associated with their medicines and people's medicines were safely and appropriately managed by the home.

The home has policy and procedures in place in relation to the Mental Capacity Act. CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. At the time of our inspection applications were being submitted to review whether the arrangements for people's care and treatment in the home amount to a deprivation of their liberty. This was in response to a recent Supreme Court judgment and the provider was taking appropriate action to ensure the human rights of people using the service were protected.

Is the service effective?

People told us they were happy with the care and support they received. People's care plans were person centred and reflected their individual needs and preferences in a format to meet their communication needs. It was clear from what we saw and from speaking with staff that they understood people's care, support and communication needs and they knew them well.

People's relatives told us that the service had helped people make improvements in their health, social skills and quality of life. A relative said 'I can't thank them enough, my relative interacts better with other people, their health is well managed and they have helped the person to express their emotions'.

Is the service caring?

People were supported by kind and attentive staff. We saw that staff treated people with dignity and respect and showed patience and encouragement when supporting people. People we spoke with confirmed that staff were kind. A relative said, 'there is a consistency of approach with people, staff sit and listen and know how to encourage people'. Another relative said, 'staff are all very kind and treat people as individuals'.

Is the service responsive?

Records confirmed that people's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people's wishes.

People completed a range of activities within the home and community and people were supported to maintain relationships with their friends and relatives.

Is the service well led?

Staff had a good understanding of the ethos of the home and quality assurance processes were in place. This helped to ensure that people received a good quality service at all times. A staff member said, 'there is a flexible, supportive culture in the home, managers check on practice and are very helpful".

Records showed that people and their relatives were asked for their feedback on the service and their comments were acted on. The service worked well with other agencies and services to make sure people received their care in a joined up way.

Care plans provided clear details about the care and support each person needed which included their individual choices. There were clear details about how people demonstrated their decision making.

People living at Brighton Lodge were protected from the risks of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. Relatives that we spoke with believed their family members were safe living at Brighton Lodge.

There was a training plan that was followed to ensure people who lived at Brighton Lodge were cared and supported by staff that had the relevant skills and knowledge. Relatives told us that 'The staff are well trained.'

There was a system in place for assessing the quality of the service provided. This included seeking the views of people who used the service and their relatives and learning from incidents that occurred and complaints that were received.