Buckingham Lodge Care Home

Updated 25 January 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

Two inspectors carried out an unannounced inspection on 12 October 2022. The inspector then returned for a second day of inspection on 13 October 2022, alongside a medicine’s inspector. The second day was announced. An Expert by Experience carried out phone calls to relatives of people using the service. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Buckingham lodge is a care homes where people receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced on the first day.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We carried out the inspection over two days. We looked at medicines in depth, carried out observations on each of the units. We spoke with the registered manager, the clinical lead, the deputy manager, the cook, the administrator, the director of compliance, a member of the activity team, two nurses and an additional six members of the care team. We spoke with a visiting professional and spoke with eight people using the service. We looked at four care plans and other records relating to the management of the service.

Our Expert by Experience telephoned and spoke with ten relatives of people receiving support.

Updated 25 January 2023

About the service

Buckingham lodge is a residential care home providing personal and nursing care to up to 73 people. The property had a ground middle and top floor and can accommodate people who need residential accommodation, nursing or those living with dementia. At the time of our inspection there were 52 people using the service.

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

People were mostly 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. We did find however one person’s needs could not continue to be met safely in line with their preferences and felt the service could have established this earlier and clarified the risks.

The service had undergone a management of change with new providers taking over the running and management of the home in 2021. There has been an established registered manager who has now been in post for a year and has managed to significantly reduce agency staff and achieve full recruitment. This has created a more stable service which was more responsive to people's needs. Although we found the provider had the numbers of staff, they said they needed, we observed people were not always being supported by staff in line with their needs. The manager told us no one had been identified as requiring one to one support. They stated staff checked on people at regular intervals across the day to help promote their safety.

The manager and deputy manager had tried to impress on each member of staff about the importance of person-centred care and although the culture was changing it was not firmly embedded. Though our observation we found some staffs practice was task focused

Activity staff were working hard but had limited support from care staff to ensure regular interactions and meaningful activity was part of everyday life for people.

People told us staff were kind and caring and upheld their dignity. The environment was safe, clean and well maintained. Whilst the service offered lots of space and different areas for people to use, we did not observe staff encouraging people making use of the facilities other than accessing the dining room and lounge area.

Medicines were managed safely but we have made a number of recommendations.

Improvement in record keeping would help to evidence how staff are delivering care in line with people’s needs.

Governance and oversight were strong, and engagement was improving with opportunities for people, staff and relatives to feedback their experiences to help improve the care provided.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

This service was registered with us on 25 February 2021 and this is the first inspection.

The last rating for the service under the previous provider was requires improvement, published on 07 April 2020.

Why we inspected

We inspected this service to give it a rating as a first inspection under a new provider.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.