Background to this inspection
Updated
27 August 2022
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
This inspection was carried out by one inspector.
Service and service type
Hesketh Park 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.
Hesketh Park 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 service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.
At the time of our inspection there was a manager in post who was in the process of applying to the CQC to become registered.
Notice of inspection
This inspection was unannounced on the first day and announced on the second day.
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 undertook a visual inspection of the home and observed the delivery of care and support at various times throughout the day. We spoke with five people and one relative. We also spoke with six members of staff, including the registered manager, deputy manager, regional lead, concierge, a senior carer and a nurse.
We looked at records in relation to people who used the service including four care plans and systems for monitoring the quality of the service provided. We also looked at staff recruitment files and people’s medication records.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at staff training and quality assurance records. We spoke with two members of care staff, including a unit leader. We also spoke with three relatives on the telephone to help us understand their experience of the care and support their loved one received.
Updated
27 August 2022
About the service
Hesketh Park Lodge is a purpose-built home offering care and support to older adults, including those living with dementia. Facilities include a cinema room and hair salon. The service can provide support for up to 79 people. At the time of our inspection there were 35 people living at the home.
People’s experience of using this service and what we found
People told us they enjoyed living at Hesketh Park Lodge and were happy with the care and support received.
People received their medicines as prescribed, but we have made a recommendation about the management of some types of medicines.
People lived in an environment that was safe and were protected from abuse and avoidable harm.
Risks to people were identified, mitigated and managed safely. The home was clean and well maintained, staff followed infection prevention and control best practices to help minimise the risks of COVID-19 and other infections.
Staff were recruited safely, and staffing levels were sufficient to support people’s needs.
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.
Training records did not evidence that staff had received all mandatory training to help them perform their roles. Accurate records were not always kept to evidence people’s care and support.
There was a lack of consistency in how the service was managed and led. The service had undergone changes in management since the last inspection. Although the current manager had only been in post a short time, they had already identified areas of improvement.
We received positive feedback about the new manager from people, their relatives and staff.
During and immediately after our inspection, both the manager and provider began to address our concerns demonstrating their responsiveness and genuine commitment to improving the standard of care delivered to people.
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 (report published 28 March 2019).
Why we inspected
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.
The inspection was prompted in part due to concerns received about staffing and staff competence. As a result, we undertook a focused inspection to review the key questions of safe, effective, responsive and well-led.
We have found evidence that the provider needs to make improvements. Please see the effective, responsive and well-led key question sections of this full report.
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 read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Hesketh Park Lodge on our website at www.cqc.org.uk.
Enforcement and Recommendations
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 breaches in relation to staffing 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 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.