Braeburn Lodge is registered to provide accommodation for up to 60 people requiring nursing or personal care, including people living with dementia. The home opened in January 2015 and is purpose built over two floors. The ground floor provides accommodation for people with general nursing and care needs and the first floor is reserved for people living with dementia. There were 28 people living in the home at the time of our inspection.
We inspected the home on 25 November and 3 December 2015. The first day of our inspection was unannounced.
The service did not have a registered manager. The service was being managed on a temporary basis by an operations manager (the ‘interim manager’) employed by the registered provider, pending the recruitment of a permanent manager. At the time of our inspection an application to register the interim manager had been submitted to CQC. A registered manager is a person who has registered with the CQC to manage the service. Like registered providers (‘the provider’), 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.
CQC is required by law to monitor the operation of the Mental Capacity Act, 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are in place to protect people where they do not have capacity to make decisions and where it is considered necessary to restrict their freedom in some way, usually to protect themselves. At the time of our inspection the provider had submitted DoLs applications for six people living in the home and was waiting for these to be assessed by the local authority.
Staff understood the issues involved in supporting people who had lost capacity to make some decisions. However, management supervision of front line care staff was inconsistent and some staff lacked the knowledge and skills required to meet the needs of people in the specialist unit for people living with dementia.
Staff knew how to recognise signs of potential abuse and how to report any concerns. However, despite detailed systems for assessing and monitoring people’s care and support needs, some people were not consistently protected from the risk of falling.
Staff worked closely with local healthcare services to ensure people had access to any specialist support required. Medicines were well-managed in a person-centred and discreet way.
There was a warm and friendly atmosphere in the home. Staff knew and respected people as individuals and provided kind, person-centred care. There were sufficient staff to meet people’s needs without rushing.
A specialist activities team organised a varied programme of activities and staff and volunteers supported people to maintain their personal interests. Food and drink were provided to a high standard.
Although the interim manager had clearly made a positive impact during his time at the home, cover arrangements in his absence were not completely effective.
The provider met regularly with people and their relatives and sought their suggestions for service improvement. However, the provider’s response to issues identified through quality monitoring and auditing was not consistently effective.
People and their relatives knew how to raise concerns or make a complaint.