Archived: De Brook Lodge

We looked at six care plans during this visit. Records had been updated to reflect people's choices for bathing or showering and the type of toiletries they preferred. We found similar improvements had been made by informing the chef about people's likes and dislikes in relation to food. We asked four people living in the home about their diets. Each person told us they enjoyed the meals provided and they said they were given food in sufficient quantities. One person told us, "Staff always ask if we want more at mealtimes." Another person commented, "You can ask staff for a sandwich or something if you are hungry between meals."

During our last visit care plans did not contain sufficient information to guide staff in how to recognise when people diagnosed with dementia needed pain relief. At this visit we saw clear guidelines added to a care plan to inform staff of the signs they needed to look out for to determine if the person was in pain.

Improvements had also been made by recording people's preferences about the way they were supported with their continence needs.

We found care records to contain more consistent recording of what people did during the day. However, the quality of the information in activity records varied across the three units.

Care records for four of the people accommodated in the home provided evidence that suitable arrangements had been made for staff to deliver their care and support safely. Improvements had been made since our last visit by adding risk assessments to the care plans belonging to people who needed to use a hoist.

The people we spoke with made positive comments about the staff who provided their care. However, one person was upset because they felt they had been spoken to in a harsh and rude way by a member of staff. Other people commented, ""Staff are very nice and they look after you", and "I find this place absolutely fabulous." A visitor told us that they were very satisfied with the care of their relative living in the home.

Suitable arrangements were in place to safeguard people from abuse and the people we spoke with told us that they felt safe.

Improvements had been made to the way night staff had been deployed. One of the night staff told us that this had improved staff morale.

Staff working in the home had good support and were provided with regular opportunities to learn new skills through training.

We found minor concerns in relation to care plans. The four that we looked at contained insufficient evidence to demonstrate that people were receiving the service according to their individual preferences.

We found that people were afforded choice in the times that they got up and went to bed. Three people living in the home told us, 'Yes I like to get up early' 'I don't sleep very well' and 'I wake up early'. Staff confirmed that they always asked people if they were ready to get up.

We saw staff interacting with people in a dignified, respectful and private manner. One person commented, 'The staff are respectful. They listen to me and answer any questions I have.' A visiting relative told us, 'I visit most days. I don't have any concerns about my X's care. The staff have a difficult job to do and they do it well. I have never heard them being disrespectful to anyone.'

During our visit we observed care staff to provide appropriate support to people in meeting their needs. A relative said, "I don't have any concerns about their personal care. Staff are very attentive and I have seen them taking the initiative when someone needs assistance." However, further development was needed to the way moving and handling risks were being assessed.

We saw that although sufficient staff had been deployed to meet people's needs, suitable arrangements were not in place to support night staff in the event of an emergency.