Briggs Lodge Residential and Nursing Home

Updated 28 April 2023

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 Health and Social Care Act 2008.

As part of this inspection, we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

This inspection was carried out by 2 inspectors and 2 Experts 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

Briggs Lodge Residential and Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Briggs Lodge is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced and the first day of the inspection started at 7.45pm.

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 we used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 12 people and 4 relatives about their experiences of care received. 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 spoke with 16 members of staff, the registered manager and the regional support manager. Following our site visit we also spoke with a further 9 relatives on the telephone.

We reviewed care records for 14 people, multiple medicines records, health and safety records, 4 staff recruitment files, cleaning schedules, accidents and incidents, complaints, compliments, safeguarding records, personal emergency evacuation records, staff training data, service improvement plans, dependency levels, staff rotas for 4 weeks, quality monitoring audits, meeting minutes, analysis for falls, accidents and safeguarding and various policies and procedures.

Updated 28 April 2023

About the service

Briggs Lodge Residential and Nursing Home is a care home providing accommodation with personal and nursing care for up to 66 people. The service provides support to people over 65 years and people living with dementia. At the time of the inspection there were 52 people using the service.

Accommodation is provided on 3 floors accessed by stairs and a lift. People have their own room with en-suite facilities. There are also communal toilets, bathrooms, lounges and dining areas. There is a cinema room, café, bar and a hairdressing salon. People can access the garden from the ground floor. Some rooms on the ground floor also have access to the garden.

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

Prior to our inspection we received concerns about staffing numbers being too low. During this inspection, we found there were not always enough staff to support people in a timely way. People and relatives told us weekends were times when they noticed lower levels of staff. Whilst there was no impact seen to people’s safety, people noticed their call bells took longer to be answered. Relatives noticed the front door took longer to be answered at a weekend.

The registered manager told us recruitment had been successful, but staffing had been a challenge. They used agency staff to fill gaps in rotas but had not needed to use them as often in the month prior to the inspection. Staff calling in with short notice sickness had been a concern, but the registered manager was addressing this with support from the provider.

Staff had been recruited safely and received training when they started employment. Training covered a range of topics including safeguarding, infection prevention and control and manual handling. Staff we spoke with understood their role in safeguarding and how to report any concerns. The service reported any concerns to local authority safeguarding teams and notified CQC when needed.

People had a personalised care plan which was regularly reviewed. All records were held electronically and only accessed by staff with the required log in passwords. Information about people’s life history and guidance on how they wanted their care delivered was recorded.

Overall risks to people’s safety were assessed with risk management plans in place for staff to follow. We found behaviour support guidance for 2 people was not in place. This was addressed during our inspection. Additional monitoring to mitigate risks had taken place and was recorded. We found conflicting records for 1 person; their notes were not consistent with a record on an accident form. The registered manager took immediate action to address this shortfall.

People’s medicines were safely managed. Staff had training on how to safely administer medicines and their competence was regularly checked. There had been issues with obtaining medicines stock from the pharmacy, but the registered manager was reviewing suppliers to make improvements.

The service was clean throughout, and staff had cleaning schedules in place to cover all areas of the home. Staff wore personal protective equipment (PPE) when needed and there were specific areas identified to store, put on and take off PPE. People had COVID-19 risk assessments in place which helped to identify people more at risk of catching COVID-19.

People were able to have visitors when they wished. We observed family members visiting all times of the day and in the evenings. Activities were taking place which anyone was welcome to join. Special events were planned for national celebratory days such as Easter and the new King’s coronation. Information about activities people enjoyed was recorded in their care plans.

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 at the end of their life had their wishes recorded. Staff worked with local healthcare professionals to make sure people had medicines they needed to be comfortable at this time in their lives. Local GPs visited weekly and other healthcare professionals could be called if needed.

There was a registered manager in post. Staff told us they were approachable and visible in the service. Staff told us there was good teamwork amongst staff and good communication. Systems were in place to manage complaints and information about how to complain was available. Quality monitoring was regularly carried out by the management team and the provider. This meant the provider had a good oversight of how the service was performing. Any actions identified were added to an overall service improvement plan.

Meetings were held regularly. People could attend weekly ‘residents meetings’ and staff had opportunity to also meet to discuss changes and ideas. Systems such as keyworker, named nurses and resident of the day were in place. These helped people to discuss their care and make sure their preferences and wishes were known.

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 requires improvement (published 12 August 2021).

Why we inspected

We received concerns in relation to low staffing numbers and the impact on people’s care and the approach of the registered manager. As a result, we undertook a focused inspection to review the key questions of safe, caring, responsive and well-led only.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

We found some evidence that improvement was required for staffing but found no evidence during this inspection that people were at risk of harm from these concerns. Please see the safe, caring, responsive and well-led sections of this full report.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from requires improvement to good based on the findings of this inspection.

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

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.