CQC report explained · a residential care home
What the CQC found at Brighton & Hove City Council - Ireland Lodge
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and avoidable harm. Inspectors found suitable risk assessments, enough staff, safe recruitment, safe medicines practice and effective infection control.
- Effective?
- Good
- People's health, nutrition and fluid needs were monitored and supported. Inspectors found that food and fluid recording had improved since the previous inspection, although some staff were overdue refresher training.
- Caring?
- Good
- Staff treated people with kindness, dignity and respect. People and relatives gave positive feedback, and staff supported people to make choices and maintain independence.
- Responsive?
- Good
- Care plans were personalised and included people's preferences, backgrounds, relationships and health needs. Relatives were involved, and people were supported with activities, communication and relationships.
- Well-led?
- Requires improvement
- The manager was well regarded and the culture was positive, but governance systems were not consistently robust. Some training was overdue and some policies had not been reviewed for several years.
What inspectors found, July 2022
Rated Good overall, with safe, kind and personalised care, but the home was Requires Improvement for leadership and governance.
Inspectors visited without warning on 25 and 26 April 2022. They spoke with 13 people, seven relatives, the manager and seven staff. They reviewed care, medicines, recruitment, training, accidents, complaints, safety checks and management records.
The home was rated Good for Safe, Effective, Caring and Responsive. Inspectors found people were safe, treated with kindness and respect, involved in their care, and supported according to their needs and preferences. Food and fluid monitoring had improved since the previous inspection.
The Well-led rating remained Requires Improvement. Some staff and managers had missed refresher training deadlines, and some policies had not been reviewed for several years. The manager had started taking action, but the systems were not yet robust or consistent.
The previous overall rating was Requires Improvement in April 2020. The earlier breach about failing to send statutory notifications had been resolved, and the provider was no longer in breach at this inspection.
Kind and respectful care
People were supported by staff who understood their needs and preferences. Relatives and professionals consistently described the care as positive.
“People experienced safe care from kind and respectful staff who understood their needs and preferences.” from the report
Personalised support
Care plans were written around each person's life, choices, relationships, beliefs and health needs. People and relatives were involved in planning and reviewing care.
“Care plans were individualised, person centred records.” from the report
Improved nutrition records
The home had improved its monitoring of food and fluid intake since the previous inspection. Staff used care plans and handover records to identify who needed extra support.
“At this inspection we found this had improved.” from the report
Good partnership working
The home worked with relatives, GPs, district nurses and other professionals to support people's health and moves into and out of the service.
“The service worked closely with the local GP practice and when facilitating hospital discharge arrangements.” from the report
Overdue staff training
needs fixingSome staff were overdue online refresher training because they had difficulty accessing laptops. The manager had put more equipment and protected training time in place, but the system had not ensured training was completed on time.
“Some staff were overdue online refresher training due to lack of access to laptops.” from the report
Policies not up to date
needs fixingSome provider policies and processes had not been reviewed for several years. A manager had been recruited to take responsibility, but the review had not yet started.
“We found some of the provider's policies and processes had not been reviewed for several years.” from the report
Governance was inconsistent
needs fixingThe home had improved its statutory notifications and was no longer in breach of the previous regulation. However, inspectors still found that some governance processes were not followed robustly and consistently.
“However, we found improvements were required to ensure processes were followed robustly and consistently.” from the report
- 01Which staff are still overdue refresher training, and when will all required training be completed?
- 02Which policies had not been reviewed at the inspection, and have they now been updated?
- 03How does the manager check that governance processes are followed consistently?
- 04How will you keep my relative's care plan and risk assessments updated if their needs change?
- 05How will you involve me in food, fluid, health and care reviews if my relative needs support with these?
This inspection considered all five CQC questions and included infection prevention and control, as well as care, premises and management systems. This explanation was written from the published report of 9 July 2022 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, April 2020
Rated Requires Improvement; inspectors found safe, kind and responsive care, but hydration records and management oversight needed improvement.
This was an unannounced inspection on 16 July 2019. Inspectors spoke with people, relatives, staff and health professionals. They reviewed care, medicines, staff records, incidents, audits and other documents.
People and relatives generally described the care positively. Inspectors found good standards for safety, kindness, dignity, independence and personalised support. Medicines, staffing, recruitment and safeguarding arrangements were also found to be safe.
The home was rated Requires Improvement overall. Effective care and leadership were both rated Requires Improvement. Fluid records were not being added up and analysed, which could make it harder to identify people's hydration risks. The home's checks also failed to identify that some legal notifications had not been sent to CQC.
The previous overall rating was Good in February 2017. Effective remained Requires Improvement, although staff supervision had improved. Well-led fell from Good to Requires Improvement. The provider was required to submit an action plan, and CQC said it would monitor progress.
People felt safe
People and relatives were confident that staff would keep them safe. Staff understood abuse indicators and how to report concerns.
“I know we can go home, and the people here will do their job and she is safe.” from the report
Safe medicines support
Staff were trained and assessed as competent to give medicines. Audits were carried out, and medicines were tailored to people's routines where possible.
“The service had implemented safe systems and processes which meant people received their medicines in line with best practice.” from the report
Kind and respectful care
Inspectors saw staff treating people with kindness and respect. People were supported to make everyday choices and remain as independent as possible.
“People and their relatives spoke highly of the kind and caring nature of staff.” from the report
Personalised support
Staff took time to understand people's backgrounds, interests and communication needs. Activities and daily support were adapted to individual preferences.
“Person centred care was at the forefront of the delivery of care.” from the report
Hydration records were incomplete
needs fixingFluid charts recorded drinks but were not added up or analysed at the end of the day. This could make it harder to recognise when someone needed further action to prevent dehydration.
“There was a lack of analysis and fluid intake remained uncalculated at the end of each day.” from the report
Legal notifications were missed
seriousThe home had not notified CQC about DoLS authorisations and some other reportable events, including a serious fall and a safeguarding enquiry. This was a breach of Regulation 18.
“Audits and internal reviews failed to identify that statutory notifications were not consistently submitted to the Commission.” from the report
End of life plan was missing
needs fixingOne person receiving end of life care did not have a specific plan setting out their wishes and preferences. The manager agreed this was needed and took action during the inspection.
“An end of life care plan was not in place detailing the person's wishes and preferences.” from the report
- 01How are fluid charts now totalled and reviewed each day for people at risk of dehydration?
- 02What checks now ensure DoLS authorisations, safeguarding enquiries and serious injuries are reported to CQC on time?
- 03What has changed since the inspection when the service was rated Requires Improvement for Effective and Well-led?
- 04How will the building works and additional bedrooms affect the person during a respite or transitional stay?
- 05How are people's wishes recorded if they need end of life care?
This inspection assessed all five CQC questions and looked at both the care and the premises; the report also records that building works were taking place. This explanation was written from the published report of 24 April 2020 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Brighton & Hove City Council - Ireland Lodge
4 rated inspections over 7 years: the service has held its Good rating throughout.
- July 2022Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
Read what inspectors found at Brighton & Hove City Council - Ireland Lodge →
- April 2020Requires improvementdown from GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
Read what inspectors found at Brighton & Hove City Council - Ireland Lodge →
- March 2017Goodstayed GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- February 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- January 2014
Report published without a new overall rating.
- April 2013
Report published without a new overall rating.
- April 2012
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 23 December 2010.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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Most charge £1,020 to £1,280 a week. 37 can care for a couple. 10 years' experience on average.
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