Bury Lodge Care Home

Updated 4 April 2020

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 Care Act 2014.

Inspection team

The inspection was carried out by one inspector, one bank inspector and an Expert by Experience.

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

Bury Lodge is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

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. The provider was not asked to complete the required Provider Information Return. This is information providers are required to send us with key information about the service, what it does well and improvements they plan to make. We took this into account in making our judgements in this report.

During the inspection-

We spoke with the registered manager, the deputy manager, 10 members of staff, the chef, the engagement lead, 13 people who used the service and two relatives. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We reviewed a range of records. This included each person’s medication administration record (MAR), six care plans, four recruitment files in relation to recruitment and supervision and the training matrix. A variety of records relating to the way the service was managed. In addition, we undertook a stock check of some medicines and checked the controlled drugs.

After the inspection

We requested contact details in relation to outside professionals. We also requested further information relating to care plan audits carried out.

Updated 4 April 2020

About the service

Bury Lodge is a residential care home providing personal and nursing care to 29 people aged 65 and over at the time of the inspection. The service can accommodate up to 31 people over three floors in one adapted building.

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

The provider did not manage medicines according to best practice guidance. People did not always receive their medicines as the prescriber intended. Staff did not always sign the medication administration record (MAR) when medicines had been administered. Stock was not always available for people to ensure they received their medicines.

People commented they were safe living at Bury Lodge. “Oh yes, absolutely, and It’s the best thing” (living here).”

Staff we spoke with confirmed they had received training in safeguarding and knew what to do if they felt people had been abused. Recruitment files confirmed staff had been safely recruited. However, training was not always updated, and several members of staff required further updates in their training. The registered manager had put an action plan in place to rectify this.

People were 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.

People and relatives were positive about the caring nature of staff. They commented, it’s been the best move for [name]”, “The care is amazing” and “You don’t have to wait long” (before they answer the bell).

We observed kind caring interactions between staff and people living at the service. There was no standard formality to addressing people. Most were referred to by their first name. There was a friendly and approachable atmosphere and staff interacted with people and constantly reassured where required. There were lots of platitudes and compliments ‘your hair looks nice’, ‘are you comfortable’ and staff were often smiling.

Care plans were not always individualised and did not always reflect people’s current healthcare needs. There was lack of detailed guidance within people’s risk assessments for staff to follow.

The service did not always make referrals to healthcare professionals at the right time to make sure people’s health improved.

We have made a recommendation in relation to seeking support from other healthcare professionals.

People were able to take part in activities. We saw people attending activities during our inspection. One member of staff we spoke with told us they had started making memory boxes with people and started a ‘wish’ tree. They were looking at ways to engage staff more with the people as they had identified this was an area to improve. People had mixed views about the activities. Someone who had recently moved into the home said they liked the home more than the others that they had been to and was happy and entertained.

The governance framework did not always ensure that responsibilities were clear. Quality checks had not prevented shortfalls in the quality of service provision.

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

Rating at last inspection

The last rating for this service was good (published 28/07/2017).

Why we inspected

This was a planned inspection based on the previous rating.

The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.

We found no evidence during this inspection that people were at risk of harm from this concern.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Bury Lodge on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to safe care and treatment, staffing and good governance.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.