About the service:

Braemar Lodge is a care home with nursing. 52 people were living in the home at the time of the inspection.

What life is like for people using this service:

People continued to receive an exceptionally person-centred service. Services were tailored to meet the needs of individuals and delivered to ensure flexibility, choice and continuity of care. People were supported make choices and have as much control and independence as possible. People had organised meaningful activities and occupations that were important to them.

People had been supported to develop clear care plans that were specific to them. These plans were regularly reviewed with people to keep them up to date.

People received caring and compassionate support from kind and committed staff. The registered manager led by example and had successfully created a caring and reliable team.

People were complimentary about the care they received and about the quality of staff.

Staff respected people’s privacy and dignity. People were supported to be as independent as possible.

The registered manager had made improvements since the last inspection to ensure people always received safe care and treatment. People felt safe and received support to take their medicines safely. People said staff responded promptly to requests for assistance.

Risks to people’s well-being and safety were assessed, recorded and kept up to date. Staff supported people to manage these risks effectively.

People’s rights to make their own decisions were respected. People were supported to maintain good diet and access health services if needed.

The service was well-led. The provider’s quality assurance processes were effective and there was a focus on continuous improvement. The registered manager provided good support for staff to be able to do their job effectively.

More information is in Detailed Findings below.

Rating at last inspection:

Good. Report published 9 August 2016.

Why we inspected:

This was a planned inspection based on the rating at the last inspection.

Follow up:

We will monitor all intelligence received about the service to inform when the next inspection should take place.

Braemar lodge is a home providing care and nursing for up to 55 people. The home is part of the Colten Care Group. At the time of our visit, 52 people were living in the home. The inspection took place on 13 and 14 June 2016. This was an unannounced inspection and the home’s first rated inspection.

A registered manager was in post when we inspected the service. 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. The registered manager was present and approachable throughout our inspection. Staff, relatives and people who used the service told us the registered manager was always available if they needed to speak with her and had confidence in her abilities to manage the service.

The registered manager and staff we spoke with were passionate about providing a service that placed people and their families at the very heart of the service. This was confirmed with us by four health care professionals we spoke with and through speaking with relatives and visitors.

A wide range of activities were available which people’s family and friends were invited to. Staff spent quality time with people to give them emotional support and comfort. Staff were seen reminiscing with people about their life, singing, or discussing the events of the day. We saw people regularly choosing how to spend their time and the home enabled and encouraged this sense of freedom. People had taken on roles within the home such as in the salon, or on reception and were able to actively participate in the daily running of the home.

People were encouraged and supported to develop and maintain relationships with people that mattered to them and with the community. The home actively sought ways to encourage people to feel part of the homely environment and prevent social isolation.

There was good open communication between staff which allowed knowledge to be shared and people's care needs to be met effectively. Staff were seen actively thinking of solutions and ideas to enable people to retain their independence and provide individually tailored care.

The management culture of the home was open, and dedicated to providing good care to people. Standards were high, and staff responded to this well. Comments from relatives and staff included “The whole place is extremely well run”, “It’s the management that’s good about this home, she’s so clued up about everything, it’s dealt with, nothing is ever left” and “It’s like one big family, they care about everything”.

People told us they felt safe when receiving care and were involved in developing and reviewing their care plans. Systems were in place to protect people from abuse and harm and staff knew how to use them.

Sufficient levels of staff were in place, however people told us call bells could take a while to be answered. Audits showed there were large number of calls that took 11 minutes and over to be answered. This had been picked up by the registered manager and the call bell system was being investigated. During our inspection we did not hear prolonged ringing of call bells.

People’s medicine records were left on view during medicine administration rounds allowing the potential for access to people’s private information during these times. All other medicine management was appropriately maintained.

Staff were appropriately trained and skilled. They received a thorough induction when they started working for the service. They demonstrated a good understanding of their roles and responsibilities, as well as the values and philosophy of the service.

The provider regularly assessed and monitored the quality of care provided at Braemar Lodge. The service encouraged feedback from people and their relatives, which they used to ma

People told us staff listened to their views and respected the decisions they made. One person told us “I get the care I want. I’m always asked for my permission before any care is provided.” We observed staff took time to explain the care they were going to assist with. Staff explained the importance of knowing the person and how they communicated to ensure people's consent was given.

People were satisfied with their care. One person said "it's very good." Another person told us ”everything’s good about it. The care is good. The food is good.” We observed staff were patient and caring. They communicated with people in a friendly yet professional way. People's plans of care were detailed and provided sufficient detail to assist staff to provide appropriate care.

People's records were regularly reviewed and were up to date. Staff and people's records were stored securely.

People were satisfied with the cleanliness of the home. We found the home to be clean and tidy. There were adequate handwashing facilities for people, staff and visitors. Staff were knowledgeable about the principles of infection prevention and control. We observed they applied the principles in practice.

Staff told us they were well supported. We found there was a regular training programme. Staff received regular supervision and an annual appraisal.

One person living at the home said “staff are very good, friendly, they know everyone’s names and are kind and welcoming”.

People had enough food and drink. One person living at the home said “the food is adequate”. Another person said “the food is very nice, very good, you get good choice”.

The provider had taken steps to provide care in an environment that was suitably designed and adequately maintained.

The provider had taken steps to ensure that equipment was adequately maintained.

People living at the home felt able to discuss areas for improvement with staff. One person said “I could bring any issues up with staff. If I’ve told nurses anything it’s fixed”. Another person said “you could tell the manager anything”.