Archived: Herries Lodge

Herries Lodge is a ‘care home’. 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.

Herries Lodge provides accommodation and personal care for up to 47 older people with a range of support needs, including people living with dementia. The home is an adapted building over three floors, with access to a garden. At the time of our inspection there were 45 people using the service.

Our last inspection of Herries Lodge took place on 7 September 2016. We rated the service good overall, but requires improvement in the key question of well-led. We found there was a breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014; good governance. This was because the maintenance certificates for the fire alarm system, emergency lighting system and the emergency call bell system had expired in March or April 2016 and this had not been identified by the service’s health and safety audits.

Following the last inspection, we asked the provider to complete an action plan to show what they would do, and by when, to improve the key question of well-led to at least good. At this inspection we found sufficient improvements had been made to meet the requirements of regulation 17. The necessary maintenance certificates for the premises and for equipment used by the service were up to date. The provider had an effective system in place to monitor this.

At this inspection we found the evidence continued to support the overall rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

There was a registered manager employed at Herries Lodge. A registered manager is a person who has registered with the 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.

People told us they felt safe. There were enough staff available to meet people's needs in a timely way and to keep people safe. However, we have made a recommendation about the system the service uses to calculate staffing levels within the home.

Staff understood what it meant to protect people from abuse. They told us they were confident the management team would take any concerns they raised seriously. The registered manager made appropriate referrals to the local safeguarding authority when this was necessary.

Medicines were stored safely and securely, and procedures were in place to ensure people received their medicines as prescribed.

Procedures for recruiting new staff had recently been improved to help make sure the staff employed at the service were of suitable character.

Staff received a range of training which the provider considered to be mandatory. Staff told us they were happy with the training they received and felt it supported them to do their roles. People living at Herries Lodge told us the staff were well trained.

People told us the staff were kind and caring. During this inspection we observed the staff treat people with kindness, dignity and respect.

Staff were supervised regularly by the management team however we saw that supervisions did not always take place as frequently as the provider’s supervision policy required. We have made a recommendation about the service’s supervision procedures.

People were asked for consent before care was provided to them. Where people lacked capacity to make certain decisions for themselves, their care records contained evidence that decisions had been made in their best interests. People were supported to have maximum choice and control over their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice.

The service worked closely with community health professionals to support people with their health needs. People’s care records evidenced they received medical attention when they needed it, to promote their health.

People’s needs were assessed when they moved into Herries Lodge and detailed care plans were in place to guide staff in how to care for each person. Care plans were reviewed regularly to make sure people received the correct levels of care and support. Care plans contained details of people’s life histories and their likes and dislikes. This assisted staff to provide person centred care to people living at Herries Lodge.

There were activities taking place within Herries Lodge however some people told us they would like more to do. People told us they could not access the garden as much as they would like to.

People, their relatives and the staff all spoke highly of the registered manager. Staff told us they could always approach the registered manager if they needed support or if they had any concerns. The registered manager, the deputy managers and the provider completed regular audits of the service to make sure action was taken and lessons learned when things went wrong. This meant systems were in place to support the continuous improvement of the service.

Further information is in the detailed findings below.

The home is registered to provide accommodation and care for up to 47 older people, including people who are living with dementia. On the day of the inspection there were 46 people living at the home. The home is situated in Sheffield, in West Yorkshire. The premises had three floors and each floor had a large lounge / dining room and bedrooms. The ground floor accommodation had easy access to an enclosed garden. The first and second floors of the home were accessed by a passenger lift.

The registered provider is required to have a registered manager in post and on the day of the inspection there was a manager who was registered with the Care Quality Commission (CQC). 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.

Although some maintenance certificates were current, the maintenance certificates for the fire alarm system, emergency lighting and the emergency call bell expired in March or April 2016. This had not been identified when health and safety audits had been carried, and meant that there was a lack of assurance that people who lived and worked at the home were protected from the risk of fire, and that the emergency call bell system was fully operational.

This was a breach of Regulation 17 (2)(b) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

On the day of the inspection we saw that there were sufficient numbers of staff employed to meet people's individual needs. New staff had been employed following the home’s recruitment and selection policies and this ensured that only people considered suitable to work with vulnerable people worked at Herries Lodge.

People told us that they felt safe living at the home. People were protected from the risks of harm or abuse because there were effective systems in place to manage any safeguarding concerns. Staff were trained in safeguarding adults from abuse and understood their responsibilities in respect of protecting people from the risk of harm.

Staff told us that they were well supported by the registered manager and senior staff group. They confirmed that they received induction training when they were new in post and told us that they were happy with the training provided for them.

There was evidence that the registered provider was working within the principles of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS).

We checked medication systems and saw that medicines were stored, recorded and administered safely. Staff who had responsibility for the administration of medication had received appropriate training.

People who lived at the home and relatives told us that staff were very caring and that they respected people’s privacy and dignity. We saw that there were positive relationships between people who lived at the home, relatives and staff, and that staff had a good understanding of people’s individual care and support needs. A variety of activities were provided to meet people’s individual needs, and people were encouraged to take part. People’s family and friends were made welcome at the home.

People told us that they were very happy with the food provided. We observed that people’s nutritional needs had been assessed and individual food and drink requirements were met. However, some people told us that the food was, “Not as good as it used to be.”

There were systems in place to seek feedback from people who lived at the home, relatives and staff. People told us they were confident their complaints and concerns would be listened to. Any complaints made to the home had been investigated and appropriate action had been taken to make any required improvements.

Staff, people who lived at the home and a relative told us that the home was well managed. Quality audits undertaken by the registered manager and senior managers were designed to identify that systems at the home were protecting people’s safety and well-being. However, when quality audits had identified that improvements needed to be made, more care needed to be taken to record when actions had been completed.