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Inspection Summary


Overall summary & rating

Good

Updated 18 December 2018

This inspection took place on 9 and 16 November 2018 and was unannounced.

Heathfield Lodge is a residential ‘care home’ which provides accommodation and personal care for up to 26 older people, including people living with dementia. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

Heathfield Lodge is large Victorian property with accommodation located over three floors. The upper floors are accessible via a passenger lift. There are two dining areas on the ground floor and a large lounge. A garden area is located at the rear of the building and parking at the front. At the time of the inspection 21 people were living at the service.

There was a registered manager in post. A registered manager is a person who has registered with 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. During the inspection we found the registered manager to be open, transparent and receptive to the feedback provided.

At the last inspection which took place in October 2017 we identified breaches of Regulations 12, 17 and 20A of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Heathfield Lodge was awarded an overall rating of ‘Requires Improvement’. Following the inspection, we asked the registered provider to complete an action plan to tell us what changes they would make and by when. During this inspection, we looked to see if the registered provider had made the necessary improvements.

At the last inspection, we found the registered provider was in breach of regulation in relation to ‘Safe Care and Treatment’. Medication management processes were not safely in place and the health and safety of people living at Heathfield Lodge was being compromised. During this inspection we found that the registered provider was no longer in breach of this regulation in relation to ‘Safe Care and treatment’. However, this area of care could be further developed.

We have recommended that the registered provider reviews the medication processes to maintain the level of safe care people receive.

At the last inspection, we found the registered provider was in breach of regulation in relation to ‘Good Governance’. The systems which were in place did not effectively monitor and assess the quality and safety of care people received. During this inspection we looked at the governance systems, audits and checks which were in place and found that improvements had been made. Although the registered provider was no longer in breach of regulation in relation to ‘Good governance’ further developments could be made in relation to this area of care.

We have recommended that the registered provider reviews some of the quality assurance systems to further improve the quality and safety of care being provided.

At the last inspection, we found that the registered provider was in breach of regulation in relation to the ‘display of performance assessments’. The registered provider was not clearly displaying the previous inspection ratings which must be displayed for people, visitors and staff to see. During this inspection we found that the registered provider was clearly displaying the ratings from the last inspection and therefore was no longer in breach of this regulation.

Risk assessments were in place for people who lived at Heathfield Lodge. People’s level of risk was identified from the outset and measures were put in place to keep people safe. Staff were familiar with people’s risks, they told us they received regular updates in relation to people’s health and well-being.

People told us they felt safe living at Heathfield Lodge.

Inspection areas

Safe

Good

Updated 18 December 2018

The service was safe.

We recommend that medication procedures are further reviewed to maintain the quality of care people receive.

People received their medication from staff who were sufficiently trained and had their competency assessed.

People�s level of risk was safely managed and support measures were in place to mitigate risk.

Staff were safely recruited and appropriate pre-employment checks were completed.

Effective

Good

Updated 18 December 2018

The service was effective.

The registered provider was complying with the principles of the Mental Capacity Act, 2005.

Staff were supported on a daily basis; they received regular supervision as well as training, learning and development opportunities.

People�s nutrition and hydration needs were assessed and supported from the outset.

Caring

Good

Updated 18 December 2018

The service was caring.

Staff were observed providing kind, compassionate and sincere care.

People were treated with dignity and respect.

For people that did not have any friends or family to represent them, details of local advocacy services were available.

Responsive

Good

Updated 18 December 2018

The service was responsive.

Staff were familiar with the likes, preferences and wishes of the people they supported. Care records demonstrated a person-centred approach to care.

The registered provider had a complaints policy and process in place.

A range of activities were scheduled for people to participate in on a weekly basis.

People received support around their end of life care, preferences and wishes.

Well-led

Requires improvement

Updated 18 December 2018

The service was not always well-led.

We have recommended that the registered provider reviews their quality assurance systems to ensure the quality and safety of care people receive is well-maintained.

Feedback regarding the management of the service was positive. Actions had been taken to improve areas of concern identified at the last inspection.

The registered provider had a range of different policies and procedures in place. Staff were familiar with the importance of complying with such policies.