Brighton Lodge

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• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

During our assessment of this key question, we found the systems and processes in place to safeguard people from abuse were not always comprehensive. Some staff had not completed all of the required training relevant to their role and staff development was not supported by a process of supervision or appraisal. Recruitment practices needed to be improved to keep people safe. These concerns resulted in breaches of regulation 18 and regulation 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can find more details of our concerns in the evidence category findings below.

This service scored 72 (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 Learning culture during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

People felt safe living at the service. One person told us, “l feel safe because I like the staff.” Another person said, “I do feel safe.” We spoke with 3 people and they all told us they could talk to staff if they had any concerns and felt listened to. Relatives felt their loved ones were safe. One relative told us, “I don’t worry about [person’s name]. [Person’s name] can’t wait to go back when they come home to visit. Another relative said, “[Person’s name] is definitely safe.”

Staff were able to identify safeguarding concerns. The registered manager told us, “Staff are all trained in safeguarding. They do this as part of their induction it is also contained yearly as part of our PBS approach training with staff. We have team meeting quizzes, and some are around safeguarding which we go through with staff. We take learning from any safeguarding incidents and ensure staff have additional training if needed. We follow the Hampshire safeguarding policy.” The registered manager was able to tell us how people were supported to raise concerns about their safety. They told us about different stakeholders they worked with in relation to safeguarding concerns. They said, “In the event of a safeguarding incident, or an increase in behaviours we will contact the placing authority and share the concerns. We hold 6 monthly reviews which family members come to and 12 monthly ones the local authority can attend, and they do attend. We discuss safeguarding matters as and when they arise.”

We were unable to obtain detailed feedback from people about how their care and support helped them stay safe. However, we observed people were well-dressed, clean and well cared for. The atmosphere throughout the inspection was calm, relaxed and welcoming. We noted people who wanted to be were engaged in activities and those who did not were given space to do what they wished to do.

The registered manager told us safeguarding concerns had been raised with the local authority’s safeguarding team and action was taken to ensure people remained safe. However, there were no records to support this. There were no training records in place to demonstrate staff had received safeguarding training. In the absence of appropriate records the provider could not be assured that staff would identify and report safeguarding concerns appropriately. There was a detailed Safeguarding policy in place which had been reviewed in November 2023.

People and their relatives were happy with the support provided. Relatives we spoke with told us, they were kept up to date and asked for their views in relation to their relatives’ risks, health and emotional support requirements. One relative told us, “I get a report from the home now and again telling me about [person name] behaviour and things and asking me what I think. I’m quite happy with it all. I have no problems or concerns with it. I have never had any concerns. But I would be the first to speak up if I did.” Another relative told us, “We don’t have any concerns but if we did we would go to [Registered manager], the manager, [registered manager] is very approachable. If [registered manager] is on duty, they are the one who answers the phone and are always ready to chat.”

Staff told us there were detailed risk assessments in place for people which were accessible to them. Staff told us any updates to risk assessments would be communicated to them during team meetings. Staff were able to describe how to mitigate risks to the individuals they were supporting. One person was at risk of choking, however, only 3 out of the 8 staff correctly identified the person required support to eat and drink safely. We spoke to the deputy manager about this. When asked how they assured themselves people were being supported safely during mealtimes, the deputy manager told us, “There are always experienced staff available at mealtimes.” The registered manager was able to confidently tell us how they ensured people were involved in making decisions about how they wanted to be supported to keep safe. The registered manager told us where people lacked capacity to make decisions about their care independently, they involved family, advocates and other appropriate professionals in agreeing decisions about how to manage risks. They told us they ensured staff were aware of risks, staff signed to confirm they had read company policies and risk assessments and we saw evidence of this.

We observed how a person at risk of choking was supported during lunchtime. We saw their food had been pureed to reduce their risk of choking and staff supported them at mealtimes appropriately. We did not observe anyone experiencing distress during the inspection.

Care plans needed to be more detailed about people’s needs and risks and how these should be managed. This included in relation to people’s care and health needs. Following the inspection the registered manager emailed us a copy of one person’s updated eating and drinking support plan. The deputy manager assured us there were systems in place for new staff to complete shadow shifts and undergo moving and handling competency assessments to know how to support people safely. We reviewed people’s emergency evacuation plans (PEEPs). These were detailed although the registered manager told us there were plans to improve these by adding information about the emotional support each person would require to evacuate following advice from a fire officer who conducted a recent audit.

We did not look at Safe environments during this assessment. The score for this quality statement is based on the previous rating for Safe.

People reported that overall, there were usually enough staff. When asked if they were supported by well trained and knowledgeable staff, 1 person told us, “Yes, the staff know what I like.” Relatives felt there were enough staff. One relative told us, “We think there is enough staff. There is when we visit and [person’s name] goes out quite a lot, always with staff.” Another relative said, “I think there is enough staff but then I don’t go very often. But I would know if [person’s name] wasn’t happy and [person’s name] has never said they couldn’t do something because staff were not there.”

Staff felt there were enough staff to support people in the home. Some staff raised concerns about the lack of supervision with 1 saying, “I haven't had a supervision for some time this was due to the impact of Covid. Management have recently asked me to come forward and ask for a supervision. Previously supervisions were monthly. Even though I haven't had a supervision I still discuss my job role with both senior staff and management”. Another staff member told us, “Supervision at Brighton Lodge has been difficult to achieve regularly but [the registered manager] is available at all times.” When we spoke with the registered manager, they told us they had not carried out any supervisions or appraisals within the last 12 months, however, said they had had verbal catch ups with staff, but these were not recorded. The registered manager told us, “I know I must get better at recording.” The registered manager told us how they planned the rota to ensure there were sufficient staff to meet people’s needs. They described how they inducted new staff, saying, “We have shadow shifts. I have a brand new employee, we put new staff on 5 shadow shifts, we give them a shift for each support. He will have 2 shadow shifts supporting with moving and handling. We then shadow them. We have sign off sheets for moving and handling and medication, so staff are deemed competent and are confident before they support people on their own.”

During the onsite visit there were enough staff on duty to support people with their needs. People appeared to be in receipt of their 1:1 support and we observed positive interactions between people and staff.

Safe staff recruitment processes were not in place. We reviewed recruitment files for the 3 most recently recruited staff members. The provider had failed to always undertake checks to assure themselves of staff’s satisfactory conduct in previous employment or obtained a full employment history prior to offering employment. This was the case for 2 of the 3 files we looked at. The systems and processes in place were ineffective in ensuring staff received appropriate training, supervision or appraisal. There were shortfalls in the completion of training records in safeguarding, moving and handling, health and safety, infection control, supporting people with autism and Makaton training. This meant the registered manager could not be assured staff had acquired the knowledge and skills required for their role.

We did not look at Infection prevention and control during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Medicines optimisation during this assessment. The score for this quality statement is based on the previous rating for Safe.