Archived: Hale Place Garden Lodge

Updated 12 May 2015

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014. This inspection was carried out by one inspector over two days, took place on 2 December 2014 and 4 December 2014 and was unannounced.

The registered manager had not received a Provider Information Return (PIR) at the time of our visit. The PIR is a form that asks the provider to give some key information about the service, what the service does well and what improvements they plan to make. However the registered manager had pre-empted our request for information and had sent to us relevant information which we looked at before our inspection.

We looked at records that were sent to us by the registered manager or social services to inform us of significant changes and events. We reviewed our previous inspection reports. We consulted a local authority case manager who oversaw people’s care in the service, a GP, and a district nurse who visited people regularly to provide treatment. We obtained their feedback about their experience of the service. We looked at records; these included those relating to staff management and the quality of the service. We looked at people’s assessments of needs and care plans and observed to check that their care and treatment was delivered accordingly. We looked at satisfaction surveys that had been carried out.

We spoke with two relatives of people who lived in the service to gather their feedback, the registered managers, the additional manager, six members of staff and two people. Not all the people who lived at Hale Place Garden Lodge were able to communicate verbally with us. Therefore, we used the Short Observational Framework for Inspection (SOFI), to capture the experiences of people who may not be able to express this for themselves. SOFI is a way to observing care to help us understand people’s experience.

At our last inspection on 28 November 2013 no concerns were found.

Updated 12 May 2015

The inspection was unannounced and carried out by one inspector on 02 December 2014 and 04 December 2014. Hale Place Garden Lodge is modern property registered to provide care and accommodation for three older people living with dementia and assistance with personal care for people in the local community. Three people were living there at the time of our inspection. The home is situated on the same site as a second home which is also owned and managed by the same provider. The two homes that share the same grounds also share other facilities including an office outbuilding, garden and laundry room. Staff work as one team in both locations during the day.

People had varied communication needs and abilities. Some people were able to express themselves verbally; others used body language to communicate their needs. Some of the people’s behaviour presented challenges and was responded to with one to one support from staff.

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. Two registered managers shared this responsibility and were supported by an additional manager. Each manager specialised in specific areas relevant to the management of the service. One of the registered managers was the director and oversaw the quality assurance of the service. The second registered manager oversaw care and treatment and relevant documentation that were specific to people’s individual needs. The additional manager oversaw the recruitment, training and management of staff.

Staff were trained in how to protect people from abuse and harm. They knew how to recognise signs of abuse and how to raise an alert if they had any concerns. Risk assessments were centred on the needs of the individual and included risks posed when people were out in the community. Staff followed the clear guidance to reduce identified risks and protect people from harm.

There were sufficient staff on duty to meet people’s needs. Staff had time to spend supporting people in a meaningful way that respected individual needs. Staffing levels were regularly calculated and adjusted according to people’s changing needs.

There were safe recruitment procedures in place. All staff were subject to a probation period and to disciplinary procedures if they did not meet the required standards of practice.

Medicines were stored, administered and recorded safely and correctly. Staff were trained in the safe administration of medicines and kept relevant records that were accurate.

People lived in a clean and well maintained environment that was suited to meeting their needs. People’s own rooms were personalised to reflect their individual tastes and personalities. There were clear signs displayed to help people find their way around. Staff had a thorough understanding of infection control practice that followed the Department of Health guidelines which helped minimise risk from infection.

Staff knew each person well and understood how to meet their support needs. Each person’s needs and personal preferences had been assessed before they moved into the service and were continually reviewed. This ensured that the staff knew how to meet people’s particular needs and wishes when they moved in and during their stay.

Staff used their training and skills to communicate with people in ways they could understand. Interaction between people and the staff showed that staff promoted people’s independence and protected their rights.

Staff’s training was renewed annually and staff received further training specific to the needs of the people they supported. Staff received regular one to one supervision sessions and an annual appraisal to ensure they were supported to carry out their role. Staff were supported to study and gain qualifications in health and social care

The Care Quality Commission (CQC) is required by law to monitor the operation of Deprivation of Liberty Safeguards (DoLS). All care staff and management were trained in the principles of the MCA and the DoLS and were knowledgeable about the requirements of the legislation.

We observed that staff sought and obtained people’s consent before they helped them. When people declined, their wishes were respected and staff checked again a short while later to make sure people had not changed their mind.

The staff provided meals that were in sufficient quantity met people’s preferences and needs. People were able to have wine, beer, water or fruit juice with their meals. A person told us, “The meals are superb”. One relative told us, “The food is as good as in any best restaurants”. Staff knew about and provided for people’s dietary preferences and restrictions. People were supported by staff with eating and drinking whenever they needed this help.

Staff communicated effectively with people, responded to their needs promptly and treated them with kindness and respect. People told us they were satisfied with the way staff cared for them. One person told us, “Everyone is so kind and caring”. Two relatives said, “The care is excellent, we cannot fault a thing”.

People were able to spend private time in quiet areas when they chose to. People’s privacy and dignity were respected and maintained at all times.

Clear information about the service, the management, the facilities, and how to complain was provided to people and visitors. Menus and the activities programme were displayed in communal areas. Two relatives told us, “Everything is clear and we are notified about any changes” and, “The communication between staff and the residents is excellent”.

People’s care had been planned and this was regularly reviewed with their or their relatives’ involvement. A relative told us, “We feel involved, they listen to us”. One of the managers told us, “It is vital to know the whole person who may no longer know themselves, to talk with all the people who know them, their likes and dislikes, so we can connect with them”. People were referred to health care professionals in a timely way. A GP told us, “Hale Place provide excellent care in all categories”.

People were at the heart of the service. The staff promoted people’s involvement with their community and took groups or individuals on outings and ensured they took part in attending special events to minimise social isolation.

A wide range of activities and outings that included innovative ideas was available. This had a positive impact on people’s wellbeing. People were kept occupied, entertained and their interest in what was going on outside of their routine was stimulated. A relative told us how their family member’s wellbeing had “flourished” since she had moved into the service due to the activities programme. The registered manager told us, “Our goal is to keep people as active as possible and prevent social isolation to enhance their wellbeing”.

People’s views were sought and acted on. People’s relatives were asked about their views at each review of people’s care plan, when they visited the home and via an internet website. The service sent annual questionnaires to people’s relatives or representatives, analysed the results and acted on them.

Staff told us they felt valued and inspired under the registered manager’s leadership. The provider, the registered manager and staff had won several Great British Care Awards which are a series of regional and national awards throughout the UK.

The service notified the Care Quality Commission of any significant events that affected people or the service and promoted a good relationship with stakeholders.

The registered manager kept up to date with any changes in legislation that may affect the service, and participated in monthly forums with other managers from other services where good practice was discussed. They pro-actively researched specialised publications and websites to identify innovative ways to enhance people’s quality of life and introduced these to the service.

The registered manager and one other manager carried out comprehensive audits to identify how the service could improve. They acted on the results of these audits and made necessary changes to improve the quality of the service and care.