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Heath Lodge Care Services Limited Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 23 February 2017

This inspection took place on 21 December 2016 and was announced.

Heath Lodge Care Services Limited is a domiciliary care agency providing personal care for people in their own homes. This includes people that may be living with dementia, some that are old and frail, (that may have disabilities) and younger people with disabilities. There were 135 people using the service at the time of the inspection.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People were not being protected against all risks and action had not always been taken to prevent the potential of harm. The provider did not always follow safe recruitment practices, so they did not know that all staff were suitable for the job. The provider was not able to demonstrate that all staff were interviewed for their role.

Staff were available to meet the needs of people however the provider was actively recruiting additional staff to cover for absences. Because of staff pressures and travel time some people did not always receive the full time they were contracted to receive.

Medicines were managed safely and people received their medicines when they needed.

People's rights were not protected because the staff did not act in accordance with the Mental Capacity Act 2005 (MCA). There was no evidence of anyone's capacity being assessed in relation to any decision and staff lacked knowledge of the MCA.

Staff did not always have the updated training they needed to meet people’s needs or have their competency checked to ensure their practice was to the expected standards. However people were positive about the care staff gave them. New staff were supported to complete an induction programme before working on their own, and people were supported by staff that had supervisions (one to one meetings) with their line manager.

Staff did not always have access to a fully personalised care plan including people’s history, needs and communication needs to use to guide their work.

The provider did not have effective systems in place to monitor the quality of care and support that people received. Field spot checks were not always carried out to ensure people received quality care and results of a customer satisfaction survey were not actioned. Staff reported because of lack of travel time they were sometimes late providing support to people.

Staff were aware of people's dietary needs and preferences, and people’s care records showed people's health care needs were met effectively.

People and their relatives told us that staff were caring and they were happy with the care they received.

People were actively involved in making decisions about their care, treatment and support, were supported to remain independent and were treated with dignity and respect.

People's concerns and complaints were encouraged, investigated and responded to in a timely manner. They were used as an opportunity for learning or improvement.

Staff were aware of the aims of the service and received a regular newsletter from the provider.#

During the inspection we found four breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We also made three recommendations to the registered provider. You can see what action we told the provider to take at the back of the full version of the report.

Inspection areas

Safe

Requires improvement

Updated 23 February 2017

The service was not safe

People were not being protected against risks and action had not always been taken to prevent the potential of harm.

The provider did not always follow safe recruitment practices, so they did not know that all staff were suitable for the job.

There were not sufficient staff to always meet the needs of people and to always stay for the full visit time.

Peoples' medicines were managed and administered safely.

People were protected against the risks of potential abuse.

Effective

Requires improvement

Updated 23 February 2017

The service was not always effective.

People's rights were not protected because the staff did not act in accordance with the Mental Capacity Act 2005.

Inductions for staff were undertaken however staff did not always have the updated training needed.

People were supported by staff that had supervisions (one to one meetings) with their line manager.

Care plans contained details on people's food preferences and people's dietary requirements.

People's care records showed people's health care needs were met effectively.

Caring

Good

Updated 23 February 2017

The service was caring

Staff were caring

Staff treated with kindness and compassion.

People felt that staff always treated them with dignity and respect.

People were actively involved in making decisions about their care, treatment and support.

Responsive

Requires improvement

Updated 23 February 2017

The service was not always responsive

Peoples care plans lacked the detail required for their personalised care needs to be met.

People's concerns and complaints were encouraged, investigated and responded to and were used as an opportunity for learning or improvement.

Well-led

Requires improvement

Updated 23 February 2017

The service was not always well led

Effective systems were not in place to monitor the quality of care and support that people received.

Staff reported that not having travel time meant they were late providing support to people.

Staff were aware of the aims of the service and felt valued.