Haydon’s Lodge is a residential care home providing personal care and support to up to six people. The service provides support to people with mental health care needs and/or learning disabilities. At the time of our inspection six men aged 40 and over who all had mental health care needs were living at the care home.The care home can accommodate six people in two adjacent terrace houses, which have their own separate entrances, but where facilities are shared. This includes a communal rear garden, two kitchens, two dining areas/conservatory’s and two main lounges.
People’s experience of using this service
Feedback we received from people living in the care home and their relatives was positive about the standard of care and support they or their loved ones were provided at Haydon’s Lodge.
However, we found evidence during our inspection that the provider needed to take action to make improvements.
The service was not always safe. This was because the provider did not always ensure all the risks people might face were properly assessed and manged and not all fire safety equipment was always appropriately maintained. We also signposted the provider to resources to develop their approach to obtaining evidence to show all visitors to the care home did not have COVID-19 or related symptoms.
The service was not always well-managed. This was because the provider did not always operate governance systems effectively and ensure they identified and/or took appropriate action to address all the issues described above in a timely way. The provider also failed to notify the Care Quality Commission (CQC) without delay about the occurrence of a number of incidents that had adversely affected the health and well-being of people living in the care home.
People continued to be supported to stay safe and be protected against the risk of avoidable harm and abuse. People were supported by enough competent staff who knew them well and had been safely recruited. The environment was kept clean. People received their prescribed medicines as and when they should.
Staff had the right levels of training and support they needed to deliver effective care and support to people living at the care home. People had access food and drink that met their dietary needs and wishes. People were helped to stay emotionally and physically healthy and well. 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. People lived in a suitably adapted and comfortable care home.
People were treated equally and with compassion, and had their human rights and diversity respected. Staff treated people with respect and dignity and upheld their right to privacy. People were encouraged and supported to maintain and develop their independent living skills. People were encouraged to make decisions about the care and support they received and had their choices respected.
People had up to date person-centred care plans in place, which enabled staff to understand and meet their people's personal, social, emotional and health care needs and wishes. Staff ensured they communicated and shared information with people in a way people could easily understand. People were supported to participate in meaningful recreational activities that reflected their social and cultural interests. People's concerns and complaints were well-managed, and the provider recognised the importance of learning lessons when things went wrong. People were supported to maintain relationships with family and friends. Plans were in place to help people nearing the end of their life receive compassionate palliative care in accordance with their needs and expressed wishes.
People living at the care at home, their relatives and staff working there were all complimentary about the way the registered manager ran the service, and how approachable they were. The provider promoted an open and inclusive culture which sought the views of people, their relatives, community-based professionals and staff. The provider worked in close partnership with various community-based mental health, health and social care professionals and agencies to plan and deliver people's packages of care and support.
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 13 April 2018).
At our last inspection we discussed with the provider concerns we had about chemicals and other substances hazardous to health (COSHH) not being safely stored and faulty window restrictors in people’s bedrooms. The provider responded immediately during and after that inspection and confirmed appropriate action had been taken to improve how they stored COSHH and maintained window restrictions.
At this inspection we found the provider continued to take appropriate action to ensure COSHH were always securely stored away in locked cupboards when they were not in use and window restrictors were in place and well-maintained throughout the care home.
Why we inspected
We undertook this planned inspection based on the previous rating and as part of a random selection of services rated good.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.
We have identified two breaches at this inspection in relation to the provider’s failure to always properly assess and manage risks people living in the care home might face and to operate their oversight and scrutiny systems effectively.
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.