The inspection took place on 8 March 2017 and was an unannounced inspection. The home is registered to provide accommodation with personal care and nursing to 60 people. At the time of our inspection there were 36 people living in the home.

There was a newly appointed manager in post. The manager had recently submitted their application to the Care Quality Commission to become the registered manager. 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 home is run.

People and their relatives told us that they felt safe at the home. Staff were trained in adult safeguarding procedures and knew what to do if they considered someone was at risk of harm, or if they needed to report concerns.

There were systems in place to identify risks and protect people from harm. Risk assessments were in place and gave sufficient information as to what action staff should take. Staff were competent and provided support in accordance with people’s care plans. Referrals were made to appropriate health care professionals to minimise risks and meet people’s health needs.

There were sufficient staff to keep people safe and meet their needs. The manager had followed safe recruitment procedures. Medicines were given to people on time and as prescribed.

Policies and procedures were in place to guide staff in relation to the Mental Capacity Act 2005. Staff understood the processes in place for ensuring decisions were made in people’s best interests. Staff and the manager ensured these steps were taken for people living at the home. Staff sought people’s consent and recorded this.

Staff were caring, they knew people well, and they supported people in a dignified and respectful way. Staff acknowledged and promoted people’s privacy. People felt that staff understood of their needs and they had positive working relationships with them.

People and their relatives were involved in the assessment and review of their needs. Staff had knowledge of people’s changing needs and they supported people to make decisions or changes to the way their planned care was delivered. Staff offered choices to people regarding all aspects of their care and support, and upheld these choices. People told us that they had access to activities and hobbies.

People and staff knew how to raise concerns and these were dealt with appropriately. There were processes in place to obtain the views and feedback of people and their relatives. The views of people, relatives, health and social care professionals were sought as part of the service’s quality assurance process. Effective quality assurance systems were in place to regularly review the quality of the service that was provided.

Braeburn Lodge is registered to provide accommodation for up to 60 people requiring nursing or personal care, including people living with dementia. The home opened in January 2015 and is purpose built over two floors. The ground floor provides accommodation for people with general nursing and care needs and the first floor is reserved for people living with dementia. There were 28 people living in the home at the time of our inspection.

We inspected the home on 25 November and 3 December 2015. The first day of our inspection was unannounced.

The service did not have a registered manager. The service was being managed on a temporary basis by an operations manager (the ‘interim manager’) employed by the registered provider, pending the recruitment of a permanent manager. At the time of our inspection an application to register the interim manager had been submitted to CQC. A registered manager is a person who has registered with the CQC to manage the service. Like registered providers (‘the provider’), 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.

CQC is required by law to monitor the operation of the Mental Capacity Act, 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are in place to protect people where they do not have capacity to make decisions and where it is considered necessary to restrict their freedom in some way, usually to protect themselves. At the time of our inspection the provider had submitted DoLs applications for six people living in the home and was waiting for these to be assessed by the local authority.

Staff understood the issues involved in supporting people who had lost capacity to make some decisions. However, management supervision of front line care staff was inconsistent and some staff lacked the knowledge and skills required to meet the needs of people in the specialist unit for people living with dementia.

Staff knew how to recognise signs of potential abuse and how to report any concerns. However, despite detailed systems for assessing and monitoring people’s care and support needs, some people were not consistently protected from the risk of falling.

Staff worked closely with local healthcare services to ensure people had access to any specialist support required. Medicines were well-managed in a person-centred and discreet way.

There was a warm and friendly atmosphere in the home. Staff knew and respected people as individuals and provided kind, person-centred care. There were sufficient staff to meet people’s needs without rushing.

A specialist activities team organised a varied programme of activities and staff and volunteers supported people to maintain their personal interests. Food and drink were provided to a high standard.

Although the interim manager had clearly made a positive impact during his time at the home, cover arrangements in his absence were not completely effective.

The provider met regularly with people and their relatives and sought their suggestions for service improvement. However, the provider’s response to issues identified through quality monitoring and auditing was not consistently effective.

People and their relatives knew how to raise concerns or make a complaint.