Archived: Heathfield Lodge

Updated 18 December 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider was 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 took place on 9 and 16 November 2018 and was unannounced.

The inspection team consisted of one adult social care inspector, an ‘Expert by Experience’ and a ‘Specialist Advisor’. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service and a Specialist Advisor is a person who has professional experience and knowledge of the care which is being provided.

Prior to the inspection we reviewed the information we held in relation to Heathfield Lodge. This included the statutory notifications sent to us by the registered provider about incidents and events that had occurred at the service. A notification is information about important events which the service is required to send to us by law. We also contacted the Local Authority and the local Clinical Commissioning Group to get their opinions of the service.

A Provider Information Return (PIR) was also reviewed prior to the inspection. This is the form that asks the registered provider to give some key information in relation to the service, what the service does well and what improvements need to be made. We used this information to formulate a planning tool, this helped us to identify key areas we needed to focus on during the inspection.

During the inspection we spoke with the registered provider, registered manager, five members of staff, maintenance co-ordinator, nine people who lived at the home, two visiting relatives and one kitchen assistant.

We looked at the care files of five people receiving support from Heathfield Lodge, four staff recruitment files, policies and procedures, medicine administration processes, compliments and complaints and other records relevant to the quality monitoring of the service.

We undertook general observations of the home over the course of the inspection, including the general environment, décor and furnishings, bedrooms and bathrooms of some of the people who lived at Heathfield Lodge as well as lounge and dining areas.

In addition, a Short Observational Framework for Inspection (SOFI) tool was used. SOFI provides a framework to enhance observations during the inspection; it is a way of observing the care and support which is provided and helps to capture the experiences of people who live at the home who could not express their experiences for themselves.

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. Staff were familiar with safeguarding and whistleblowing procedures. The registered provider had necessary policies in place for staff to follow.

Recruitment was safely managed. People who were employed had undergone the necessary recruitment checks. Pre-employment and Disclosure Barring System checks (DBS) were carried out and appropriate references were sought prior to employment commencing.

Staffing levels were safely managed. We received positive feedback about the amount of staff employed at the home; people told us they received the support they required in a responsive and timely manner.

Accidents and incidents were monitored. There was an accident and incident reporting policy in place, staff routinely completed accident and incident documentation and risks were safely managed.

The registered provider was complying with the principles of the Mental Capacity Act, (MCA) 2005. People’s capacity was assessed from the outset and records contained the relevant information in relation to the persons capacity and Deprivation of Liberty Safeguards (DoLS).

Staff received regular supervision and were supported with training, learning and development opportunities. Staff told us they received support on a day to day basis.

People’s nutrition and hydration support needs were effectively managed. Appropriate referrals were made to external healthcare professionals and any guidance which was provided was incorporated within care plans.

We received positive feedback about the quality and standard of food people received. People shared their suggestions in relation to likes, dislikes and preferences and kitchen staff were familiar with people’s dietary support needs.

People were treated with dignity and respect. Staff provided kind, sincere and compassionate care. We received positive feedback from people and relatives about the care people received from Heathfield Lodge staff.

A person-centred approach to care was evident. Care records had improved since the last inspection; records were tailored around the needs of the person and staff demonstrated their understanding of the people they supported.

The registered provider had a complaints policy in place; people and relatives were familiar with the complaints process and how to raise any concerns.

We received positive feedback about the range of activities that were taking place. There was no dedicated activities co-ordinator in place at Heathfield however, staff ensured there was always a schedule of activities for people to participate in.

The registered manager was aware of their regulatory responsibilities. The registered manager notified CQC of events and incidents that occurred in the home in accordance with statutory requirements.