Brampton Lodge

Updated 1 September 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

The inspection team consisted of 1 inspector an Expert by Experience and a specialist advisor. 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

Brampton Lodge 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. Brampton 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 Brampton Lodge were going through a change in management. CQC had not received notification the previous manager was not in post. However, during the inspection there was a turnaround manager in position to support the home with changes and improvements they had identified. A new manager had been appointed and was waiting to start their induction prior to registering with CQC.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.

We reviewed the information we had received about the service since the last inspection. We sought feedback from the Local Authority. We used this information to plan out inspection.

During the inspection

During the inspection we spoke to 6 people who used the service, 4 family members, and 11 staff members including, care workers from both day and night shifts, senior care workers, activity co-coordinator, auxiliary staff, administration staff and the manager. This was to gain their views and experience of the service.

We spoke to external professionals. We reviewed 10 care records, multiple medication administration records, and 3 staff personnel files in relation to recruitment. We also viewed various records, policies, and procedures in relation to the governance of the service and management.

Updated 1 September 2023

About the service

Brampton Lodge is a residential care home providing accommodation and nursing, personal and intermediate care for up to 59 older people, some of whom are living with dementia. The home is split into 3 wings providing care for, 30 people living with dementia, 15 general nursing places and 14 intermediate care places. At the time of our inspection the service was providing accommodation to 57 people.

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

Brampton Lodge is in the process of a change of management, as a result we found inconsistency in the recording of information and care planning due to systems being reviewed and updated. The governance systems were in the process of being implemented and existing systems being updated.

Some care plans had been updated and contained personalised information however, others were task based and lacked person-centred details.

Good practice regarding the safe administration of medicine was not always being followed. The oversight of medicine was not robust enough to ensure people were safely given their medicines.

The deployment of staff within the home was not always appropriate, we observed people being left for long periods of time without their assessed level of support.

The gaps in recruitment resulted in the use of agency staff this presented difficulties to some people being supported and additional pressures on permanent staff. People raised concerns regarding the staff turnover.

People were not always provided with a choice, some people had to get up in the morning when was convenient for the staff rather than when they wanted too.

People were not always supported at mealtimes which resulted in people eating cold food, no encouragement was provided for those that required this level of support and food choices were limited.

Restrictions were in place for some people without the legal authority to do so.

Not all people were given the opportunity to participate in activities within the home, this is something we have recommended the provider reviews.

Health and safety checks were in place and were being monitored as required.

Policies and procedures were in place to safeguard people from abuse and staff were aware of their own roles and responsibilities. People told us they felt safe.

The provider needs to continue to make the changes identified within this inspection report and their own internal audits.

People were not supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests. This system was being reviewed at the time of the inspection.

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

Ratings at the last inspection.

The last rating for the service under the previous provider care concept, was good (published on 13 November 2020).

Why we inspected

The inspection was prompted in part due to concerns received about poor care and staffing levels. A decision was made for us to inspect and examine those risks.

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 have found evidence the provider needs to make improvements, please see the Safe, Effective, Caring, Responsive and Well led sections of this report.

Enforcement and Recommendations

We have identified breaches in relation to the administration of medication, lack of person-centred care, processes relating to the Mental Capacity Act and governance systems in managing and monitoring the service.

Recommendations have been made in relation to residents participating in activities.

You can see what action we have asked the provider to take at the end of this full report.

Follow up

We will request an action plan from the provider to understand what that they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.