Background to this inspection
Updated
25 February 2020
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 Care Act 2014.
Inspection team
The inspection was carried out by one inspector 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
Heath Lodge is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
We reviewed the information we already held about the service in the form of notifications that had been submitted to us. Notifications are information about events or incidents which providers are required by law to inform us about. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.
During the inspection
We spoke with six people who lived in the home and four relatives. We spoke with seven members of staff including the registered manager, the deputy manager, two senior healthcare assistants, two healthcare assistants and a domestic assistant. We also spoke with a visiting healthcare professional and visiting activities facilitator. We reviewed three people’s care files, including assessments, care plans and records of care. We reviewed medicines records and storage within the home. We reviewed three staff files including recruitment and supervision records. We reviewed health and safety records, meeting records, surveys, audits and other records relevant to the management of the service.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We reviewed updated information and action plans submitted by the registered manager.
Updated
25 February 2020
About the service
Heath Lodge accommodates up to 23 older people in one adapted building. The building was originally an ordinary home which has been extended and adapted to become a care home. At the time of our inspection 19 people were living at Heath Lodge. Many of the people living at Heath Lodge were living with dementia.
People’s experience of using this service
People were supported to have choice in their day to day lives and staff supported them in the least restrictive way possible and in their best interests. However, the provider had not always followed best practice guidance in terms of seeking consent. The systems around ensuring deprivation of liberty safeguards were followed were not always robust.
People and relatives told us they were involved in their assessments and in reviews of their care needs. Records showed care plans were reviewed and updated regularly. Further work is needed to ensure records are clear about what people’s current needs and preferences are.
Feedback from people, relatives and professionals was collected regularly. Most people had a positive experience, however, relatives and professionals had noted the décor required updating. There was a plan in place to redecorate the home.
There were quality assurance and audit systems in place. These had not identified the issues with consent or the content of the care files. The registered manager was very responsive to our feedback and has a plan in place to improve the quality of record keeping within the service.
People and relatives told us they had a positive experience of care and support at Heath Lodge. They told us there was a family atmosphere and they were supported by kind, compassionate staff who knew them and their needs well. We saw staff interacted with people positively and engaged them in activities that were suitable for their needs.
People were kept safe by staff who knew how to support them safely. The registered manager had a plan in place to update risk assessment to ensure they reflect the knowledge of staff. Staff knew how to identify and respond to allegations of abuse.
There were enough staff working to ensure people’s needs were met. People and relatives commented that the staff team was stable, and this helped ensure people’s needs were met. Staff were recruited in a way that ensured they were suitable to work in a care setting.
People’s healthcare needs were met, and they were supported to follow the advice of healthcare professionals.
People told us they liked the food and we saw people were supported to eat in a kind way by staff who respected their choices and promoted their independence in eating.
Relatives confirmed they were able to visit when they wished, which supported people to maintain their relationships and links with their community.
People and relatives knew how to make complaints. Complaints had been investigated and responded to appropriately.
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 July 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Enforcement
We have identified breaches in relation to consent and good governance at this inspection.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.