This inspection was unannounced and took place on 10 January 2019.

Broughton Lodge is a ‘care home’. 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.

The care home is registered to provide personal care and accommodation up to 18 people. The home specialises in the care of older people including people living with dementia. At the time of the inspection there were 17 people at the home which included people receiving respite care.

At the last inspection in November 2017 the home was rated requires improvement.

Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions, safe, effective and well led to at least good. An action plan was received by CQC and at this inspection we saw that actions planned had been put into practice.

At this inspection we found improvements were needed to make sure people received care which was person centred and provided social stimulation. People were not always supported to take part in age appropriate activities. One person said, “There’s nothing wrong with the place. Staff are lovely but I do nothing all day. I do feel lonely but I make the best of it.” One visiting relative said about the activity programme, “This is an area which needs improving.”

There was 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. At the time of this inspection the registered manager was not available but the provider was available throughout the day.

People told us the registered manager was open and approachable and they felt able to raise concerns or complaints. People felt safe and staff knew how to recognise and report any suspicions of abuse. Staff were confident the registered manager would take action to make sure people were protected if they reported any concerns.

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 supported this practice. Staff worked in accordance with up to date guidance to make sure people’s legal rights were protected.

People told us staff were kind and patient and our observations during the inspection confirmed this. Staff spoke respectfully to people and provided care in an unhurried manner.

People were happy with the food provided and told us there was always a choice of meal. One person said, “We get nice food.” Another person told us, “No complaints about the food.”

People’s health was monitored by staff and people had access to healthcare professionals according to their individual needs. People’s medicines were safely administered and clear records were kept of medicines administered or refused.

The provider was committed to making on-going improvements to the service and facilities offered at Broughton Lodge. There were ways for people to express their views and make suggestions about the home.

Further information is in the detailed findings below

This inspection took place on 28 and 29 November 2017 and was unannounced. This was the first inspection since the provider changed in November 2016. This was a comprehensive inspection.

Broughton Lodge provides accommodation and personal care for up to 18 people. At the time of the inspection there were 17 people living in the home and one person staying for a period of respite. The service specialises in caring for older people including those living with dementia. Broughton Lodge is a detached property situated in the town of Burnham on Sea.

There was 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.

Some information relating to staff’s pre-employment checks was not available in staff personnel files.

There was not a crisis contingency plan in place in the event of an emergency and people not able to be accommodated in the home. The director confirmed this was in place following our inspection. Risks to people were assessed, however some of the assessments required additional information.

There were some gaps in staff training and staff required updates in some subjects. Where there were gaps in staff training, these had been identified and future training dates had been arranged for them.

People’s rights were not fully protected because the home had not consistently acted in accordance with the Mental Capacity Act 2005 (MCA).

Medicines were stored safely and securely, the process for administering medicines was not in line with good practice, the director and registered manager amended this during our inspection.

Quality assurance systems were not always fully effective at identifying and addressing shortfalls in the service provided.

People felt safe at the home and with the staff who supported them. Staff were aware of the correct action to take if they suspected someone was being abused. There were adequate numbers of staff available to meet people’s needs in a timely manner.

Systems were in place to reduce the risk of infections and we saw staff had access to personal protective equipment. Incidents and accidents did not occur often in the home, when they did they were recorded by staff. Accidents and incidents did not happen very often however when an incident had occurred, learning from it was shared with the staff team.

Staff monitored people’s health and well-being and made sure they had access to other healthcare professionals according to their individual needs.

People commented positively about the food, people had access to a choice of food and received adequate nutrition and hydration.

Staff received regular one to one supervision and they commented positively about the support they received from the registered manager.

People were supported by staff who were kind and caring. Where people found it difficult to express themselves, staff showed patience and understanding. Staff treated people with respect and dignity.

The home was responsive to people’s needs and people were able to make choices about their day to day routines. People had access to a range of organised and informal activities, people told us they would like to do more art and craft activities and cooking. The director told us they would look into arranging this.

People were able to follow their religious and spiritual beliefs because religious services were held at the home. People and their relatives contributed to the planning of their care. The registered manager was in the process of transferring all of the care plans over to a new format which was person centred.

People and their relatives were aware of the complaints procedure and felt confident to raise any concerns with the registered manager