Byron Lodge Care Home

Updated 11 May 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection, we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by 2 inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Byron Lodge is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Byron Lodge is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post. A new manager had been recruited and was in the process of registering with CQC. The manager had been in post about 4 weeks.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 5 people who used the service and 2 relatives about their experience of the care provided. We spoke with 7 members of staff including the registered manager, nurses, senior care workers, care workers and ancillary staff. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We reviewed a range of records. This included 5 people’s care records, multiple medication records, staff files in relation to recruitment and staff supervision and quality monitoring records.

Updated 11 May 2023

About the service

Byron Lodge is a residential care home providing personal and nursing care for up to 61 people. At the time of our inspection there were 43 people living at the home. Some people using the service were living with dementia.

People’s experience of using this service and what we found

Systems in place to monitor the service were not always effective. Audits identified areas of some improvement but some issues were not actioned in a timely way. For example, the sluice bin had been identified for replacing on 6 March audit, but this was still not replaced when we carried out our inspection. This audit also identified that equipment should not be stored in bathrooms, but this was still evident on inspection and storerooms required attention, especially the decommissioned bathrooms.

People did not always receive person centred care. We observed the meal service on 2 units and found the meal time experience poor.

We found some concerns regarding medicine management. The provider could not always evidence people were given their medicines as prescribed. Following our inspection, the manager took appropriate actions to ensure systems improved.

We carried out a tour of the home with the manager and the home generally, was visibly clean, but deep cleaning was required to ensure equipment, furniture and storerooms were clean. Storerooms required organising and sorting out. The manager confirmed action had been taken following our inspection.

Risks in relation to people's care and support were in place. However, some people had lost weight and there were limited evidence to show how this was being addressed.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Staff were aware of what actions to take to safeguard people from the risk of abuse. The manager kept a record of safeguarding concerns and monitored the outcome.

Accidents and incidents were analysed but there was lack of evidence to show what actions had been taken to mitigate future risks. Following our inspection, the manager introduced a system to improve this analysis.

People, relatives, and staff spoke highly of the new manager and felt she was approachable and taking action to improve the service.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 25 December 2020).

Why we inspected

The inspection was prompted in part due to concerns received about medicines management, infection control, and leadership. A decision was made for us to inspect and examine those risks. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Byron Lodge on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to medicine management and governance and leadership.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.