This inspection took place on 20 and 21 November 2018 and was unannounced.Brownhill lodge is a ‘care home’ providing residential care for older people with dementia. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Brownhill lodge accommodates up to 21 people. There were 18 people using the service at the time of our inspection.
At our last inspection of this service on 21 June 2016 the service was rated Good. At this inspection we found the service remained Good. The service demonstrated they continued to meet the regulations and fundamental standards. The last inspection rating of the service was displayed correctly in the communal area of the service.
The service had a registered manager in post. 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.
Staff knew how to keep people safe. The service had clear procedures to support staff to recognise and respond to abuse. The registered manager and staff completed safeguarding training. Staff completed risk assessments for every person who used the service and they were up to date with detailed guidance for staff to reduce risks.
The service had an effective system to manage accidents and incidents, and to prevent them happening again. The provider recognised people’s need for stimulation and social interaction. People had end-of-life care plans in place to ensure their preferences at the end of their lives were met. Staff completed daily care records to show what support and care they provided to each person.
The provider carried out comprehensive background checks of staff before they started working and there were enough staff to provide support to people. Medicines were managed safely and people were receiving their medicines as prescribed. Staff received medicines management training and their competency was checked. All medicines were stored safely. The service had arrangements to deal with emergencies and staff were aware of the provider’s infection control procedures and they maintained the premises safely.
The provider trained staff to support people and meet their needs. People told us that staff were knowledgeable about their roles and that they were satisfied with the way staff looked after them. The provider supported staff through regular supervision and yearly appraisal.
The registered manager and staff understood their roles and responsibilities under the Mental Capacity Act 2005 Deprivation of Liberty Safeguards . 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 support this practice. People consented to their care before they were delivered.
Staff assessed people’s nutritional needs and supported them to maintain a balanced diet. Staff supported people to access the healthcare services they required, and monitored their healthcare appointments. The registered manager and staff liaised with external health and social care professionals to meet people’s needs.
People or their relatives, where appropriate, were involved in the assessment, planning and review of their care. Staff considered people’s choices, health and social care needs, and their general wellbeing.
Staff supported people in a way which was kind, caring, and respectful. Staff protected people’s privacy and dignity.
The service had a clear policy and procedure about managing complaints. People knew how to complain and told us they would do so if necessary. The provider sought the views of people and staff to improve the service. Staff felt supported by the registered manager. The provider had effective systems and processes to assess and monitor the quality of the care people received which helped drive service improvements. The provider worked effectively with health and social care professionals, and commissioners.