You are here

We are carrying out a review of quality at Heath Lodge. We will publish a report when our review is complete. Find out more about our inspection reports.

Inspection Summary


Overall summary & rating

Requires improvement

Updated 24 October 2018

Heath Lodge is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Heath Lodge provides care and accommodation for up to eight adults with a learning disability and complex needs. At the time of the inspection there were seven people living there.

The inspection took place on 12, 13 and 18 September 2018 and was unannounced on day one. At the last inspection we identified significant breaches of the Health and Social Care Act Regulations regarding regulations 9,11,12,13,16,17 and 19 and the service was placed into special measures. During this inspection we found that improvements had been made and that the registered person was no longer in breach of regulations 9,11,12,13,16 and 19, although there was a continued breach of regulation 17 of the Health and Social Care Act Regulations. During this inspection the service demonstrated to us that improvements have been made and is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is now out of Special Measures. At this inspection the overall rating for the service is 'Requires Improvement'.

The process for regular evaluation of care plans was not sufficiently robust and quality assurance systems in place had not identified all of the concerns noted within this report. A new comprehensive quality assurance audit had been introduced however, this had not highlighted that some care plans had not been regularly evaluated and that significant information about safe transportation had not been updated.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.” Registering the Right Support CQC policy

At the time of this inspection there was no registered manager in post with day to day management provided by a manager from another of the registered provider’s services. 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. Following the last inspection, due to the seriousness of concerns identified, we used our enforcement powers and a decision was made to cancel the manager’s registration.

Registered persons are required by law to inform the Care Quality Commission (CQC) of certain events which occur within the service. During the last inspection we found that on several occasions they had failed to do so. This was an offence under Regulation 18 (1) (e) (f) of the Care Quality Commission (Registration) regulations 2009. Therefore, we used our enforcement powers to issue a Fixed Penalty Notice which resulted in the registered provider being fined £1,250. During this inspection we found that notifications had been submitted as required.

Improvements had been made regarding management and administration of medicines. The registered provider had liaised closely with a community pharmacist to raise standards and weekly audits were carried out.

Staff had received training and were knowledgeable about how to protect people from abuse and felt able to do so without fear of repercussion. They were also aware of whistleblowing procedures (reporting outside of the company). We saw that incidents had been reported to the local authority and notifications submitted appropriately.

There were procedures in place to record accidents and incidents and assess people’s associated risks. Although analysis of accidents

Inspection areas

Safe

Requires improvement

Updated 24 October 2018

The service had improved but was not consistently safe.

Some gaps were noted in the recording of accidents and incidents.

Risk management strategies were not always implemented in a timely manner, for example from the risk of smoking.

There had been a delay in addressing the requirements of an audit carried out by Cheshire Fire and Rescue Service.

Staff were aware of responsibilities regarding protecting people from abuse.

Effective

Requires improvement

Updated 24 October 2018

The service had improved but was not consistently effective.

There was a lack of documented evidence of people's consent to care plans.

The service was working within the principles of the Mental Capacity Act 2005 and decisions made on people's behalf were made in their best interest. However, additional clarity was needed regarding a person's support needs when accessing the community.

Staff had received the training they needed to carry out their roles and received regular supervision.

People had access to various professionals to maintain their health and well-being.

Caring

Good

Updated 24 October 2018

The service had improved and was Good.

People told us that staff were kind and caring.

We found that incidents between people living at Heath Lodge no longer escalated into physical altercations.

People had access to advocacy services and we saw that these had been used where necessary.

Responsive

Requires improvement

Updated 24 October 2018

The service had improved but was not consistently responsive.

Improvements implemented had not always been sustained.

Care plans had not always been regularly evaluated.

There was a policy and procedure to manage complaints. Complaints received had been handled in line with the policy and that people had been listened to.

Well-led

Requires improvement

Updated 24 October 2018

The service has improved but was not consistently well-led.

Quality assurance systems were not established and operated effectively.

There was no registered manager in post.

Staff told us that things had improved, that they were supported by management and that staff morale was good.