Burgh Heath Lodge

We found the following examples of good practice.

The service had appropriate procedures in place for visiting, including checking of COVID-19 passports for visiting professionals.

The registered manager has facilitated visits for people safely and regularly during the pandemic.

The service was clean and tidy throughout. There were robust cleaning schedules inclusive of high touch point areas, to promote safe infection control practices.

Staff had received all appropriate infection prevention and control training. This included the correct use of personal protective equipment (PPE), and donning and doffing safely. Staff were observed to be wearing PPE correctly.

The registered manager had managed risks to people from outbreaks through appropriate isolation and separation of areas within the service.

Burgh Heath Lodge is a residential care home for up to nine people with mental health needs. At the time of the inspection there were eight people living at the home.

People in residential care homes receive accommodation and personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

At our last inspection we rated the service as good. At this inspection we found the evidence continued to support the rating of good. There was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The provider was a small family owned organisation who displayed a positive and compassionate culture of care. People benefitted from receiving person centred care in a supportive environment.

People were kept safe at Burgh Heath Lodge. There was a consistent staff team that was sufficient to meet the needs and preferences of the people that lived there.

Risks to people were identified and clear guidance was in place to minimise risk, whilst not restricting people’s choices and freedom. Staff understood what action they should take if they suspected abuse, including the agencies that needed to be notified. Each person had a plan which detailed the support they needed to get safely out of the building in an emergency.

People’s medicines were stored and administered safely. External checks were in place to ensure standards were maintained. Staff understood how to protect people from the spread of infections and the home was kept clean.

The provider had carried out appropriate recruitment checks to ensure staff were suitable to support people in the home. Staff received a comprehensive induction and ongoing training so that they could meet the needs of people who lived at the home.

People were supported to maintain good health and they had access to relevant healthcare professionals when they needed them. People benefitted from the way the staff worked with other services to ensure effective care and support. People had a varied and balanced diet to support their nutrition and health.

The home was adapted to meet the needs of the people who lived there. Improvements had been made and were planned to cater for some additional needs as people aged.

People’s consent was sought in line with the legal requirements of the Mental Capacity Act. Where people's liberty was restricted to keep them safe, the provider had followed the requirements of the Act, and the Deprivation of Liberty Safeguards (DoLS), to ensure the person's rights were protected.

People were treated compassionately by kind and caring staff. Individual support needs were accommodated by staff in a calm and sensitive way. People’s privacy and independence was promoted at all times. Contact with families and friends was encouraged and enabled to happen.

People received an individualised service. They were given choices and had a say over their day to day care, including any activities and their meals. People’s background and their need for communication and social interaction was understood. They were given opportunities to go on outings and to the shops.

People living at the home benefitted from the relationships the service had formed with local community organisations and with professionals.

The service was well managed. Staff were supported and involved. People felt they were part of a family and they were enabled to share their views. There was good governance in place and record keeping was organised and clear. Standards were maintained through a series of quality assurance checks.

Feedback was welcomed and a complaints policy was in place. Families and professionals spoke highly of the care and support provided.

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.

The home was adapted to meet people’s needs. A large ramp had been installed at the front of the house to support people who required help with their mobility. Flooring was smooth and uncluttered to aid with people’s mobility needs. Mobility equipment such as stair lifts, and a walk-in bath were in place. With the adaptations the home still retained a homely feel and reflected the interests and lives of the people who lived there.

The inspection took place on 03 February 2016 and was unannounced. At our previous inspection in September 2013 we had identified no concerns at the home.

There was positive feedback about the home and caring nature of staff from people and relatives. One told us, “The staff are very caring.” Another told us that Burgh Heath Lodge was much better than the previous home they were at, and, “Staff are very nice here.” A relative said, “The provider and manager are very caring, and staff are also very friendly.”

People were safe at Burgh Heath Lodge. Although there was a small staff team there were sufficient staff deployed to meet the needs and preferences of the people that lived there. A relative said, “I have no worries around the numbers of staff.”

Risks of harm to people had been identified and clear plans and guidelines were in place to minimise these risks, without restricting people’s freedom. One person said, “If I did not feel safe or staff were unkind to me I would tell the manager and/or the owner. Staff understood their duty should they suspect abuse was taking place, including the agencies that needed to be notified, such as the local authority safeguarding team or the police.

In the event of an emergency people would be protected because there were clear procedures in place to evacuate the building. Each person had a plan which detailed the support they needed to get safely out of the building in an emergency.

The provider had carried out appropriate recruitment checks to ensure staff were suitable to support people in the home. Staff received a comprehensive induction and ongoing training, tailored to the needs of the people they supported.

People received their medicines when they needed them. One person told us, “I never go without my tablet.” Staff managed the medicines in a safe way and were trained in the safe administration of medicines.

Where people did not have the capacity to understand or consent to a decision the provider had followed the requirements of the Mental Capacity Act (2005). An appropriate assessment of people’s ability to make decisions for themselves had been completed. Staff were heard to ask people for their permission before they provided care.

Where people’s liberty may be restricted to keep them safe, the provider had followed the requirements of the Deprivation of Liberty Safeguards (DoLS) to ensure the person’s rights were protected.

People had a very good choice of food and drink available to them. People could choose the meal they wanted, when they wanted it, even if that meant the provider cooking nine different meals. All told us they had enough to eat and drink. They received support from staff where a need had been identified. Specialist diets to meet medical or religious or cultural needs were provided where necessary.

People were supported to maintain good health as they had access to relevant healthcare professionals when they needed them. People’s health was seen to improve due to the care and support staff gave.

The staff were kind and caring and treated people with dignity and respect. Good interactions were seen throughout the day of our inspection, such as staff holding people’s hands and sitting and talking with them. People looked relaxed and happy with the staff. People could have visitors from family and friends whenever they wanted.

Care plans were based around the individual preferences of people as well as their medical needs. They gave a good level of detail for staff to reference if they needed to know what support was required. People received the care and support as detailed in their care plans. Details such as favourite foods, recorded in the care plans matched with what we saw on the day of our inspection.

People had access to activities that met their needs. One person said, “I go out whenever I want to, and by myself.” A proportion of the activities were based in the community giving people access to friends and meeting new people. The staff knew the people they cared for as individuals.

People knew how to make a complaint. The policy was in an easy to read format to help people and relatives know how to make a complaint if they wished. No complaints had been received since our last inspection. Staff knew how to respond to a complaint should one be received.

Quality assurance records were kept up to date to show that the provider had checked on important aspects of the management of the home. Records for checks on health and safety, infection control, and internal medicines audits were all up to date. Accident and incident records were kept, and would be analysed and used to improve the care provided to people should they happen. The provider worked at the home which gave people and staff an opportunity to talk to them, and to ensure a good standard of care was being provided to people.

People had the opportunity to be involved in how the home was managed. Surveys were completed and the feedback was reviewed, and used to improve the service. A relative said, “My family member’s quality of life is so much better since they have moved in here.”

All the people we spoke with said they liked living there. One person said 'I like it here.' Another person said 'They do their best for me here. Anything I need they will go out and get for me.' People appeared relaxed and happy.

People who used the service and relatives had been involved in the planning of care. We saw that risks had been identified to protect the welfare and safety of people. One person told us 'I can do most things for myself, but staff help me if I need it.'

The people we spoke with told us they felt safe living at Burgh Heath Lodge. We saw procedures were in place which gave guidance to staff on safeguarding vulnerable adults. Staff were able to describe what action they would take if they suspected abuse was taking place.

We looked around the house and saw that it was clean and tidy. People who used the service told us how they helped with the cleaning, for example by sweeping the floors and vacuuming the carpets.

We saw that the manager carried out appropriate checks when they employed staff. This ensured staff were of good character and had the necessary skills and experience to do the job.

There was a system in place to record and respond to complaints. People told us they had never felt the need to make a complaint.

During our visit we spoke with five people who used the service and three members of staff (including the registered manager). We also spoke to one visitor and a relative. We spent time observing how staff interacted and supported people.

We saw staff treated people with respect, for example calling people by their preferred names and engaged them in conversations throughout the time we spent at the service. People appeared relaxed and happy.

One person told us that "I have peace of mind living here, I don't know how I would cope on my own, I have somewhere safe here.' Two other people told us that 'Staff are Wonderful.' People told us that they had been involved in the planning of their care.

A visitor told us that they were "Very impressed, staff are kind, caring and attentive to the needs of the person I visit.'

A relative told us 'I am always asked by the manager if I have any comments on my relatives care.' They went on to say that when they identified issues with the building, the manager sorted them very quickly.

We saw that there were a number of external activities on offer and people were able to regularly access the local community.

We looked around the location and saw bedrooms, communal areas, bathrooms and toilets were clean and free from unpleasant odours.