Burdyke Lodge is registered with CQC to provide residential care for up to 27 older people. Three rooms are available to be used as double rooms if requested, however at the time of the inspection these were being used for single occupancy only and there were 23 people living at the home.

People’s level of care and support needs varied. People were independently mobile some using walking frames. Many were self-caring and required only guidance and prompting from staff,. A number of people went out alone or with friends and family, whilst others required more assistance with all care needs and remained in bed or in their rooms as they chose.

This was an unannounced inspection which took place on 3 and 8 November 2016.

At the last inspection undertaken July 2015 CQC did not identify any breaches of regulation. However we did make some recommendations about the safe administration of medicines, and ensuring professionalism and dignified care were maintained at all times.

There was a registered manager at the home; however the day to day running of the service was the responsibility of the home manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 also the registered provider. People spoke highly of the home and the way it was run. And staff told us that they felt supported.

Staff had an understanding about how to recognise and report safeguarding concerns. Staff were clear that any concerns would be reported to the home or registered manager.

Risk assessments were completed for identified health and environmental needs. This included specific health related risks for the individual and environmental risks for the premises. Medicines policies and procedures ensured people received their medicines safely. People who looked after their own medicines without support from staff had risk assessments to support this. These were reviewed regularly to ensure medicine procedures remained safe.

Care plans and risk assessments were regularly reviewed and updated. Documentation was personalised and included peoples choices and the involvement of family and next of kin or significant others when appropriate. There was information to inform staff of people’s backgrounds and health needs. People who moved to Burdyke Lodge for a short period of respite care had care information in place. These were updated during the inspection to ensure they contained the level of detail in permanent care folders; however staff knew people and their needs well.

People living at Burdyke Lodge told us that staff responded to them promptly when they needed assistance and they felt staffing levels were appropriate. Staff had received training and support and felt they had the knowledge and skills to provide care for people appropriately.

People had capacity to make decisions and felt involved in decisions and choices about their care. Staff told us how they supported people’s choices and preferences. Management had an understanding of mental capacity assessments (MCA) and Deprivation of Liberty Safeguards (DoLS).

We received positive feedback regarding the meals provided. Meal choices were available and people were supported to eat a healthy balanced diet. People’s weights were monitored regularly to identify any health changes, however when people declined to be weighed, this was not always clear from documentation. Referrals were made to GPs and other health professionals when required to help maintain people’s good health.

Staff were kind, caring and supportive. They knew people well and were able to tell us about peoples likes, dislikes and preferences. Staff spoke to people and we saw light hearted banter between staff and peo

We spoke with the manager, deputy manager, five members of staff, five people who used the service and three relatives. We consulted four care plans, the service's policies and three staff files. We inspected the premises, visited the kitchens and discussed catering arrangements with the chef.

We found that care plans were comprehensive, reflected people's individual needs and provided direction that enabled staff to give people the appropriate care.

We saw that nutritional and well balanced food was prepared in maintained and clean kitchens. People who used the service told us that the food was of a high quality and one person told us “The food here is really good, I like it and they always go out of their way if I want something special”.

The provider had policies and procedures in place to deal with complaints, incidents and to safeguard vulnerable adults. Staff received appropriate training and were confident about the procedures they needed to follow if they had any concerns.

We found that there were sufficient numbers of skilled staff employed and available at the home to meet people’s needs. This was complimented with a clear and robust recruitment procedure that ensured staff were skilled and qualified to carry out their roles effectively.

People told us what it was like to live at Burdyke Lodge and described how they were treated by staff and their involvement in making choices about their care. They also told us about the quality and choice of food and drink available. This was because this inspection was part of a themed inspection programme to assess whether older people living in care homes are treated with dignity and respect and whether their nutritional needs are met.

The inspection team was led by a CQC inspector joined by an Expert by Experience (people who have experience of using services and who can provide that perspective).

During the day we spoke with 12 of the 22 people present and with one visitor to the home. Overall, people spoke very positively about the home and the care provided. Everyone said that they would happily speak with the manager or deputy if they had any concerns or worries.

Comments included, “They speak to me in a kind and gentle manner and use the shortened version of my name that I like”. “Sometimes I need a drink at 3am in the morning and it’s no problem at all”. One person said, “The girls are very good on the whole, they’re chatty, happy, kind, caring and thoughtful”.

Burdyke Lodge is a residential home providing care for older people in Seaford. People living at Burdyke Lodge required varying levels of care and support. Many were highly independent and just required some assistance with washing and dressing and others required assistance with all care needs. People told us, “This is a lovely place to be.” Two visitors told us, “We have visited a number of other homes, this is by far the best.” And “When I need somewhere I will come here, it’s just so lovely here.”

This service provides care funded privately or by the local authority.

The service is registered to provide care for up to 27 people. At the time of the inspection there were 22 people living at the service.

This was an unannounced inspection which took place on 20 and 21 July 2015.

Burdyke Lodge had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 service was in a period of transition due to changes in management. Staff told us about the recent changes made to the service. In general, staff felt that it was a friendly place to work and knew that management were always available to support them. However, It was clear from talking to people that not all staff had remained professional in discussions with people using the service.

There was an acting manager who was in day to day charge of the running of the service. People told us that the registered manager and acting manager had very different management styles. This had caused some tension within the day to day running of the service for staff and people living at the service. The registered manager visited the service regularly and was in the process of overseeing the acting manager’s transition before the registration process commenced with CQC. The registered manager was on holiday at the time of the inspection.

There was no guidance in place for ‘as required’ medicines to ensure consistency in administration. We have made a recommendation about the management of some medicines.

Personal emergency evacuation plans were in place for everyone living at the service. The fire risk assessment needed to be updated.

It was unclear what hours the registered manager spent at the service as this had not been documented. The acting manager worked full time at the service, supported by the deputy manager.

Kitchen audits had not been fully completed. However auditing for other areas of the service had been completed monthly, this included falls, accidents and incidents.

People’s care needs had been regularly reviewed to ensure that any changes were identified and related risk assessments completed. People were involved in monthly reviews which were carried out with them by their keyworker.

People were asked for their consent before care was provided and had their privacy and dignity respected.

People’s nutritional needs were monitored and reviewed. People had a choice of meals provided and staff knew people’s likes and dislikes.

Referrals were made appropriately to outside agencies when required. For example GP appointments and community nursing visits.

People’s independence was encouraged and supported. Activities were provided for people who wished to attend. Many people went out alone or regularly with family and friends.

There was an on-going recruitment programme to ensure that appropriate staffing levels were maintained and to ensure staff were safe to provide care to people. Staff received a period of induction with on-going support provided. There was a clear programme of staff training, regular supervision and appraisals.

Staff had a good knowledge of how to recognise and report abuse. Staff felt their training needs were met and they had opportunity for further future development.

Feedback was gained from people this included questionnaires and meetings.

There was an on call rota to ensure management availability at all times should an emergency occur.