Hesketh Park Lodge

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.

People’s experience of using this service:

Some people told us they felt they sometimes needed more support than was offered. There was limited information completed with regards to people’s likes, dislikes, hobbies and interests. The registered manager explained to us that this was something they were working towards. We also saw that information in people’s care plans, which tracked how much food and fluid they were consuming was not always completed on the electronic system. When we queried this, we saw it was recorded in paper records. We raised this with the registered manager at the time of our inspection who assured us this was being addressed.

Everyone we spoke with said that they felt safe living at Hesketh Park Lodge. Medication was stored and managed well and people told us they received their medications on time and by staff who were trained to give them. There was enough staff in post to be able to support people effectively. We did raise that one area of the home was observed by us to be understaffed at one point during the day. There was a process in place to log, track and monitor any incidents and accidents. These were then analysed for patterns and trends. Contractual checks were up to date on the premises and lifting equipment and there was a good standard of infection control through the building. Staff were recruited and selected safely to work with vulnerable people.

The registered manager and staff team were complying with the principles of the Mental Capacity Act 2005. Where people lacked the mental capacity to make certain decisions these were made on their behalf following a best interest process. The home was decorated and furnished to a high standard. Staff attended all training deemed as mandatory by the registered provider and new staff were required to complete an induction before commencing work. Staff told us they were supported by the registered manager and had attended supervisions. The food was well presented and we received positive comments regarding the food. People were supported to access health care services when they needed to.

The staff were kind and caring and people told us that the staff respected their privacy, dignity and right to choose what they wanted to do with their time. Staff were able to describe how they provided dignified care.

Complaints were recorded and responded to in line with the registered providers complaints process.

The staff were in the process of completing further training in end of life.

There were audits in place which looked at service provision and the registered manager had used these auditing tools to identify some of the improvements which were being made to people’s person centred information.

The registered manager had acted within the remit of their role and had notified the Care Quality Commission of any reportable incidents.

Rating at last inspection: This is the first inspection at this location.

Why we inspected: This was a planned inspection in line with our methodology.

Follow up: Ongoing monitoring