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Archived: Heath Lodge Care Services Limited Surrey Requires improvement

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Inspection Summary

Overall summary & rating

Requires improvement

Updated 30 November 2018

Heath Lodge Care Services is a domiciliary care agency which provides personal care to people who live in their own homes. It provides a service to people living with dementia, learning disability of autistic spectrum disorder, mental health condition, physical disability or sensory impairment and younger adults. At the time of our inspection the service was providing care to 69 people.

This announced inspection took place on 1 November 2018.

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. There was a registered in post who assisted us with our inspection.

We last carried out a comprehensive inspection of this service on 13 and 14 February 2018 when we rated the service as Inadequate overall. We also took some enforcement action, in the form of warning notices, against the registered provider as we had found continued breaches of regulations from the previous inspection. Following this inspection, the registered provider submitted an action plan telling us how they planned to address our concerns. We carried out this inspection to see if the registered provider had acted in line with their action plan. As such we checked to see if there were sufficient staff, people were receiving safe care and kept free from abuse, people received person-centred care, their consent was sought and good governance was in place. We found overall the service people received had improved, however the registered manager and provider needed to ensure sustainability of those improvements.

Staffing levels at the agency were sufficient, however we found that staff were leaving people early to get to the next person. This was because no travel time was allowed in between calls. People confirmed with us that staff did not stay the full time. The registered manager and senior management took immediate action to address this.

The registered manager was aware of their statutory requirements to notify us any safeguarding concerns or serious injury. Care records for people were very detailed and demonstrated a person-centred approach. People’s consent was sought in line with the Mental Capacity Act 2005.

Risks to people were identified and managed and people received the medicines they required. Accidents and incidents were recorded and lessons learnt. Pre-assessments were completed to ensure the agency could provide appropriate care. Where people required food provided to them or input from health care professionals this was done.

People told us staff were kind and caring. They said they had seen staff following good infection control processes. People were cared for by staff who had been recruited through appropriate channels. Staff were sufficiently trained and supported to manage people’s needs. Staff had regular supervisions with their line manager.

The registered manager worked with other professionals to ensure people’s needs were met. Complaints and comments received by the registered manager were responded to in an appropriate manner.

The provider’s senior management and the registered manager were open and transparent about the shortfalls within the service and committed to continuing to take action to improve. Feedback at our inspection resulted in them taking prompt action to address the lack of travelling time for staff. Quality assurance processes were more robust and despite the short time the registered manager had been in post improvements had already taken place. People, relatives and staff felt the service had improved since the registered manager had taken up post. Staff felt supported and told us the culture within the team had got better.

This service has been in Special Measures. Services that are i

Inspection areas


Requires improvement

Updated 30 November 2018

The service was not consistently safe.

Staffing levels were sufficient, but staff did not always stay the full time with people.

People�s medicines were managed safely.

Appropriate recruitment checks were carried out to ensure suitable new staff were employed.

Risks to people were assessed and managed by staff. Accidents and incidents were recorded.

Staff understood their roles and responsibilities in safeguarding people.

Infection control processes were followed.



Updated 30 November 2018

The service was effective.

Mental Capacity Act assessments had been carried out for people in line with the legal requirements.

Staff were sufficiently trained and supported by the provider and senior staff so as to ensure they followed best practice.

People had choice over their meals and were supported to access healthcare services.

Assessments were carried out prior to people receiving care from the agency.



Updated 30 November 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 about staff.

People were involved in making decisions about their care.



Updated 30 November 2018

The service was responsive.

Staff followed guidance in people�s care plans to help ensure they received appropriate and responsive care. People�s care plans were person-centred and detailed.

Complaints and feedback was listened to by the registered manager and acted upon.


Requires improvement

Updated 30 November 2018

The service was not consistently well-led.

One shortfall identified at our previous inspection had not been addressed, although prompt action was taken following this inspection. This related to staff travelling time.

Internal auditing and monitoring had started to identify shortfalls and the registered manager was taking action to improve the service that people received.

People, relatives and staff were involved in the running of the service.

The registered manager worked with external agencies.