Bryony Lodge

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

We found one breach of the regulations. We expect health and social care providers to give the right support: people were not always supported to have maximum choice and control over their lives. People lacked the opportunity to pursue their hobbies and interests, to go out into their local community and to go to bed at a time of their choosing. The provider was responsive to the concerns we raised during our assessment. They increased their staffing levels, and this enabled people to take part in activities and choose what time they wanted to go to bed. Right Care: the care people received was not always person centred, we saw some people’s care plans lacked detail and were generic, this meant that staff did not always know people’s needs and how they liked to be supported. Risk assessments were not always in place or did not provide enough detail to effectively mitigate the risk. People were sometimes at risk of harm because staff did not always have the information they needed to support people safely. The provider was responsive to our concerns and made improvements, but these were not yet embedded. Right Culture: Some of the time staff seemed rushed and did not always interact or engage with people. For example, we observed staff failing to interact or talk with a person whilst supporting them to move. This increased the risk of people feeling disempowered, isolated, and less likely to engage with staff. The provider was responsive to our concerns following our initial visits and took appropriate action. The provider increased staffing levels and this gave staff time to engage more with people and created opportunities for people to develop their skills. The ethos, values, attitudes, and behaviour of staff was positive. Staff were kind and caring and we observed positive interactions and mutual respect for each other.

This service scored 65 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Kindness, compassion and dignity during this assessment. The score for this quality statement is based on the previous rating for Caring.

People told us they were not involved in their care planning. However, they said staff gave them advice and were encouraging them to be involved. Relatives told us there was lack of management support, communication was poor and there were not enough staff on shift to support people. The provider was responsive to our concerns and took appropriate action. On our final visit improvements had been made and were being embedded into the service. The new manager had held meetings with relatives and where appropriate involved them in developing care plans.

Staff told us they could not take people out regularly or for more then an hour at a time, due to staffing levels. Staff were able to describe people’s likes and dislikes and their hobbies and interests. Staff encouraged people to participate in activities that they enjoy and encouraged them to participate in day-to-day household tasks. The operations manager had contacted people’s funding authorities to complete reassessments for individuals. They had identified a lack of access to the community and opportunities for people to pursue their hobbies and interests away from the service. The provider was responsive to our concerns, they took appropriate action and made improvements. For example, they provided an additional 12 hours support a day and this enabled people to complete meaningful activities with staff.

Staff were very busy, and this led to task focused interactions frequently taking place. This increased the risk of people receiving support that was not personalised. Staff remained calm, kind and caring. The provider was responsive to our concerns and took appropriate action and made improvements. At our final visit, more staff were available, and staff were relaxed and had taken the time to interact with people on a 1 to 1 or group basis. We observed interactions that were positive and staff were able to enhance people’s emotional wellbeing.

The provider had a robust policy and procedure in place to assess people’s needs prior to admission. People’s risk assessments and support plans did not always provide staff with sufficient information to provide efficient and good quality support. Risks to people were not consistently identified and processes were not always in place to reduce risk and monitor people’s medical conditions, Some people’s risk assessments and support plans were generic and therefore did not promote individualised support. The provider was responsive to the concerns we found during the inspection and at our follow up visit improvements had been made. People had individualised support plans detailing their likes, hobbies and interests as well as their goals for the future.

People and relatives told us people’s choices were sometimes restricted. People who were unable to leave the service unaccompanied by staff were allocated an activity time to go to the beach, café or shop. However, the frequency of these outings were limited and mostly took place on a weekly basis. People that could go out independently needed to return to the service by 7.30pm. This was so staff could support them to go to bed. The provider was already aware of the concerns we identified during the assessment and has made improvements.

Staff told us they were not always able to offer people choices due to the availability of staff. Staff told us that some people were supported to get ready for bed and get into bed by 7.30pm and people were not able to choose when to go out and what to do because of staffing levels. The provider was responsive to our concerns and additional staff were employed. This has had a positive impact on people.

People were not offered the choice of when they could go out and they had very limited opportunities to pursue hobbies and interests and be an active part of their local community. People were not always offered a choice of when they went to bed. For example, people that had mobility needs and needed hoisting were all in bed by 7.45pm. This was because after this time there is only one member of staff available. At our final visit we observed staff interacting and positively engaging with people. They were given the opportunity to go out and participate in activities they were known to enjoy. For example, the service had set up a sensory area in the lounge and we observed people engaged in this area. This appeared to have a positive impact on their emotional wellbeing. We also observed people having the opportunity to decide when they went to bed.

Staff shift planning did not always enable staff to provide personalised support. This was because there were not enough staff to enable people to make choices and maintain or develop their skills. People had clear care plans that detailed people’s likes and dislikes, communication preferences and how they preferred to make choices. Staff had completed learning disability, autism and person-centred care training. This provided staff with the knowledge and skills to provide effective support. The provider was responsive to our concerns and made improvements. At our final visit, there were more staff scheduled to work. This had a positive impact and people had more autonomy. They were able to participate in activities, pursue hobbies and interests and had opportunities for to develop their skills.

People’s relatives told us there were not enough staff and there was a lack of management oversight. People told us that staff were there when they needed them. For example, one person told us; “They are good, they help”. People’s relatives told us that staff were helpful. The provider was responsive to our concerns about staffing levels and made improvements. Relatives told us that the new manager was very supportive and responded to any concerns and provided regular updates.

Initially staff told us that they were often very busy, and it was difficult to respond immediately, but they tried their best. The provider responded to our concerns and increased staffing levels. The new manager was working with staff and coaching them as required. Additional training has been provided to increase staff awareness of people’s needs.

Staff did not always provide people with the support and supervision they required. This increased the risk of deteriorating health conditions not being recognised and appropriate medical treatment being delayed. The provider was responsive to our concerns and made improvements. At our final visit we observed staff being responsive to people’s needs; they were able to recognise subtle changes in people and took the appropriate action straight away.

Initially staff told us that they were very busy at times and because there was not a manager in post, this made them feel stressed. Staff told us, they felt supported by the operations manager and the director. They felt well trained and were confident supporting people. At the second inspection visit the new manager told us they felt supported throughout their induction and the operations manager was very approachable.

Initially there was not a manager or deputy manager in post, the operations manager and director visited the service once a week. Staff were able to contact the operations manager via telephone or email for support or to escalate concerns. There was an employee assist programme in place for staff this was a service that staff could use to obtain free independent and confidential advice and counselling. The company has robust policies and procedures in place and staff were being supported by the operations manager. Staff had regular meetings through their probationary period. The new manager worked Monday to Friday and this was usually working at the service. She had started coaching staff and providing them with additional support.