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Heath Lodge Care Services Limited Inadequate

Inspection Summary


Overall summary & rating

Inadequate

Updated 9 May 2018

Heath Lodge Care Services Limited is a domiciliary care agency which provides care and support to people in their own homes. It provides a service to older adults and younger disabled adults. The agency had a total of 91 clients, 80 of whom received the regulated activity of personal care.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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. The registered manager registered with CQC on 8 February 2018.

We last carried out a comprehensive inspection of this service in December 2016 when we rated the service as Requires Improvement overall. We found breaches of regulation in relation to a lack of risk assessments, recruitment processes, person-centred care and quality assurance. Following that inspection the registered provider submitted an action plan to us telling us how they planned to address our concerns. We carried out this inspection to see if the registered provider had taken action in line with their action plan. We found that despite being told all concerns would have been addressed by May 2017, this was not the case.

Risks to people’s safety were not always identified or staff were not provided with sufficient information in order to help keep people safe. Where incidents that had occurred which were potential safeguarding concerns, these had not been acted upon. Staff did not take appropriate action or learn from accidents and incidents. Staff did not always use the appropriate personal protective equipment when carrying out personal care to people and there was a lack of staff to meet people’s needs. Staff did not always stay the time they were allocated to do so.

Where people lacked capacity to make decisions we found that staff had not followed the legal requirements in relation to consent. There was a lack of person-centred information in people’s care plans to help ensure people received responsive care. Care plans were not always reviewed as often as they should be and staff did not always know about people’s individual needs.

People had been given information on how to make a complaint, however not all complaints had been logged as such and it was unclear from the records whether or not complaints had always been resolved.

Although the registered manager had a clear vision for the service we found there was still a lack of robust quality assurance monitoring processes in place. This meant the registered provider could not guarantee people were receiving a good standard of care. Staff did not always feel supported or valued by the registered provider.

People were cared for by staff who showed kindness, care and attention. People told us they communicated well with staff and they encouraged them to make their own decisions and remain independent.

People received the medicines they required as well as sufficient food and drink. People were cared for by staff who had appropriate training and had been recruited through robust recruitment processes. Staff had access to the training they required to undertake their role. In addition, they had the opportunity to meet with their line manager on a regular basis.

People were supported to access healthcare professionals when they needed them. Before the agency started to provide care an assessment was carried out to ensure they could meet a person’s needs. People were asked for their feedback about the agency and they told us that on the whole they felt the agency was well-managed.

As a result of our findings we have made one recommendation to the registered provider and found six breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report. Full information about CQC's regulatory response to any concerns found during inspections is added to reports after any representations and appeals have been concluded.

The overall rating for this service is ‘Inadequate’ and the service has therefore been placed in ‘Special measures’. Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, will be inspected again within six months.

The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.

If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration.

For adult social care services the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

Inspection areas

Safe

Inadequate

Updated 9 May 2018

The service was not safe.

Risks to people were not always identified or guidance in place for staff to keep people safe from risk.

Potential safeguarding concerns were not escalated and as such people may be unsafe.

There was a lack of sufficient numbers of staff to ensure people received their full allocated time.

Staff did not always use the appropriate personal protective equipment when carrying out care.

Staff did not learn from accidents and incidents to help ensure they did not reoccur.

People received the medicines they had been prescribed.

Staff recruitment processes helped to ensure only suitable staff worked at the agency.

Effective

Requires improvement

Updated 9 May 2018

The service was not consistently effective.

Mental Capacity Act assessments and best interests decisions had not been made for people in line with the legal requirements.

Staff had access to appropriate training for their role.

People were provided with the food and drink of their choice.

People’s needs were assessed before the agency started to provide care.

People were supported to access the healthcare services they required.

Caring

Good

Updated 9 May 2018

The service was caring.

People had good relationships with the staff who supported them.

Staff treated people with dignity and respect and we received positive feedback from people and relatives about staff.

People were encouraged to be independent and involved in making decisions about their care.

Responsive

Requires improvement

Updated 9 May 2018

The service was not consistently responsive.

People’s care plans were not always person-centred or contained sufficient information to help ensure people received responsive care.

Complaints information was made available to people, however records in relation to complaints was not always up to date.

Well-led

Inadequate

Updated 9 May 2018

The service was not well-led.

Internal auditing and monitoring was still not robust enough to ensure people received a good level of service.

Staff were involved in the agency, but did not always feel supported or valued by the registered provider.

The registered manager had a clear vision for the service.

On the whole people felt the office was well-managed. However, some people told us communication needed to improve.

People were invited to give their views and feedback about the service.