Archived: Bramble Lodge

People’s experience of using this service:

The service met the characteristics of requires improvement.

Medicines were not always managed effectively to reduce the risks associated with them. Infection control systems were not always embedded to protect people from harm. In addition, some incidents which should have been reported to safeguarding authorities and CQC had not been. Staff were not always effectively deployed to protect people from harm. There was a particular impact at mealtimes which resulted in people’s dignity not being upheld and people not always receiving sufficient support to eat. People’s privacy was also not always protected. The systems the provider had in place to monitor and manage this were not always effective.

There were risk assessments which gave staff the necessary guidance about the help people needed. Any concerns or accidents were reviewed to learn lessons from them. Staff worked well together and with external professionals to promote people’s health and physical wellbeing. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. The environment enabled people to maximise their independence.

The provider had invested in resources to ensure people had the opportunity for stimulating and meaningful activities. When people required end of life care, there were measures in place to ensure support was compassionate and personalised. People felt able to raise concerns about their care and be confident they would be dealt with promptly.

The registered manager was approachable and there were systems in place which encouraged people to give their feedback. There were relationships with other organisations to meet people’s needs.

More information is in the full report.

Rating at last inspection: The service was last inspected on 12 April 2016 and was rated good.

Why we inspected: This was a scheduled inspection based on the date the service was registered.

Enforcement: We found two breaches in regulatory standard and you can see what action we told the provider to take at the back of the full version of the report.

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

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

This inspection took place on 12 April and 13 April 2016. The inspection was unannounced.

There was a registered manager at the service. 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 service was following the guidance in people’s risk assessments and care plans and the risk of unsafe care was reduced. People’s records were up to date and indicated that care was being provided as detailed in people’s assessments. The records had also been updated to reflect changes in people’s care needs. Medicines were managed safely.

People were safeguarded from abuse because the provider had relevant guidance in place and staff were knowledgeable about the reporting procedure.

Consent to care and support had been sought and staff acted in accordance with people’s wishes. Legal requirements had been followed consistently where people were potentially being restricted.

People told us they enjoyed their food and we saw meals were nutritious. People’s health needs were met. Referrals to external health professionals were made in a timely manner.

People told us the care staff were caring and kind and that their privacy and dignity was maintained when personal care was provided. They were involved in the planning of their care and support. There was a wide range of activities available to enable people to take part in hobbies and interests of their choice. The provider had established a ‘memory café’ that was used by the community and had separate areas for quiet space.

Complaints were well managed. The leadership of the service was praised by external professionals and relatives and communication systems were effective. Systems to monitor the quality of the service Identified issues for improvement. These were resolved in a timely manner and the provider had obtained feedback about the quality of the service from people, their relatives and staff.

People who were able to express their views told us they were happy with the care they received, and felt that their needs were being met. Comments received from people included 'I get everything I need here. It's a lovely place to be and there's always something going on; I love it here; this is my sanctuary.'

Relatives said that they were happy with the care their family member received and felt involved in decisions about their care and treatment.

People told us that they received enough to eat and drink. Most people said that they enjoyed their meals, which included a choice and variety of foods. We found that people were supported to have a well-balanced diet, and had access to regular drinks and snacks.

Arrangements were in place to ensure that people's medicines were handled safely and properly. People said that they received their medicines at the times they needed them.

People said that they liked the staff as they were friendly, helpful and caring. Staff worked well together as a team, and felt supported by senior staff. Staff received appropriate training, supervision and appraisal to carry out their work properly.

People said that they felt listened to, and able to raise concerns if they were unhappy with the care or the service.

Systems were in place for handling and responding appropriately to complaints made by people, or persons acting on their behalf.

People able to express their views said they were happy with the care and support they received, and felt that their needs were been met. One person told us ''it is a special place to live; I spend my day doing what I want to do and the staff respect that.' Another person told us 'the care and the food is very good and it's a friendly place to live. The staff are lovely and down to earth.'

People said they get the help and support they needed as there was usually enough staff on duty.

People felt that their privacy, dignity and independence was respected. People also felt safe and able to raise concerns with staff if they were unhappy.

Relatives we spoke with told us they were happy with the care and support their family member received, and felt involved in decisions about their care and treatment. One relative told us 'the staff are doing a good job and I trust them to look after my family member well.' Another relative said 'the staff provide personal care and treat people with respect. The home is run to a high standard.'