Burnham Lodge is a nursing and care home that is registered to provide nursing care for up to 60 people. At the time of our inspection, 44 people were living at the service. Burnham Lodge is a private family owned service.

This inspection was undertaken on the 26 & 27 January 2016 and was unannounced.

Burnham Lodge had a registered manager in place. 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.

Burnham Lodge is a large period property located in Burnham, Buckinghamshire. Burnham Lodge is set over four floors and is a registered nursing home. The home provides care to people who require assistance with personal care and nursing needs. Staffing at Burnham Lodge consists of registered nurses, care assistants and domestic staff.

We found people were receiving good care at Burnham Lodge. People were protected from harm as there were appropriate risk assessments and staff training in place. Medicines were managed in a way which prevented potential harm and promoted people’s rights.

People were cared for by staff who were polite, caring and responsive to their needs. When people requested assistance, staff acted promptly. People we spoke with were complimentary about the staff team at Burnham Lodge.

People’s needs were assessed to ensure their needs were met in a way which promoted their rights, dignity and privacy. Where people required support with their nursing needs, these were done by clinical staff who had the knowledge and skills to promote people’s wellbeing.

We found there to be clear management oversight of the service. Many positive changes had occurred since the new manager came into post which appeared to have a positive impact on the people living at Burnham Lodge.

People were supported to access a range of activities and we observed these to be well received by those who participated. People had free access to the grounds of Burnham Lodge. The home was well maintained and had a homely atmosphere. People told us they were happy living at Burnham Lodge.

When we visited Burnham Lodge on 21 August 2013 we found people’s dignity and freedom of choice was not always respected and promoted. We also found the provider was not notifying the Care Quality Commission about events which were reportable under this regulation. We set a compliance action and required the provider to tell us how and when they would become compliant. Following the inspection we saw evidence the home had taken immediate action on the areas of concern. We received an action plan dated 13 November 2013 which set out what actions were to be taken, to achieve compliance. During this inspection we found the action plan had been put in place.

We spoke with five people who lived in Burnham Lodge and one relative. One person told us "I am very happy here, I choose what I like to eat and activities I want to take part in." Another person said "The food is lovely, always plenty of it and we have many options to choice from." A third person told us "All the staff here respect me and my choices and my dignity and independence is respected." A relative we spoke with told us "I come very often here, and I have always found the staff respectful and they respect people's dignity and independence."

The home had a policy in place, which clearly set out how mealtimes should be planned to ensure people’s choice, dignity and independence were promoted. The manager had introduced dining room audits, to ensure staff respected people's dignity and independence.

We found people could now be confident that important events that affected their welfare, health and safety were reported to the Care Quality Commission so that, where needed, action could be taken.

During our visit we spoke with four people and one relative. All the people we spoke with were complimentary about the home and the staff. People told us staff were polite and treated them with respect. People said they could choose how they spent their time and had opportunities to be involved in activities. Comments included “I have variety of entertainment to choose from which pleases me”, “I choose what I would like to eat and the time I get up and retire for the day.” The relative we spoke with told us told us “They always talk nicely to my (X) and treat (X) with respect…I am happy we decided to bring (X) here.”

We found people were involved in making decisions about their care and were offered choices in what they wished to eat and activities they wished to take part in. However, people's dignity was not always respected and promoted. People who use the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

We found there were enough qualified, skilled and experienced staff to meet people's needs. We found that events which affect people's welfare, health and safety were not being reported to the Care Quality Commission as required.

We spoke to five people and one visitor. People said the care was “very good.” One person said, “My wishes, privacy and dignity are respected.” Another said, “The care is excellent. I cannot fault it.” A third person said “Staff are very good with washing me as well as getting me into bed. They always make sure the door is shut.” A fourth person said “We receive a high standard of care.”

People said they received their medicines at the right time. We spoke to a person who was managing their own medicines. The person said, “I am able to take my medication by myself. Staff keep my medication in a safe place and assist me by getting what I want when I request it.”

People said their bedrooms were cleaned daily. A visitor we spoke with said, “The home is spotless.”

People said staff supported them to maintain their independence.

People described staff as “most helpful, pleasant, polite and professional.”

We found people received the appropriate care and support that met their needs. People’s medicines were safely administered. The environment was appropriately maintained to promote people’s safety and wellbeing. The service ensured there was an effective recruitment and selection procedure in place. Staff were appropriately trained, supervised and appraised.

People said that the home provided them with choices and staff respected their privacy and dignity. They said that they were registered with a GP who visited the home weekly or as and when required.

Relatives of people living in the home said that the home was recommended to them. They said that they initially visited the home on behalf of their family member. Staff were able to answer their questions and provided them with written information about the home.

People told us that they felt safe living in the home. They said that they knew how to make a complaint and whom to speak to if they were not happy with a situation.

People said that the home was well maintained and their rooms were clean and tidy.

People told us that staff were trained appropriately to meet their needs and staff spoke to them appropriately.

Relatives of people living in the home said that staff were approachable and were knowledgeable about their family member’s care needs.

People told us that their views were sought about the care they received.