Background to this inspection
Updated
2 June 2015
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 is 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.
The inspection took place on 9 April 2015 and was announced. The provider was given 48 hours’ notice because we needed to be sure that the office was open and that staff would be available to talk with us.
An inspector and an expert by experience with an understanding of older people undertook this inspection. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of service.
We checked the information that we held about the service and the service provider. This included statutory notifications sent to us 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 used all this information to decide which areas to focus on during our inspection.
We spoke with people, relatives and staff. We also spent time looking at records including nine care records, four staff records, medication administration record (MAR) sheet, staff training plans, complaints and other records relating to the management of the service.
On the day of our inspection we spoke with a representative of the provider, the office manager and a care co-ordinator. Following the inspection we spoke with a care assistant and contacted social care professionals for their feedback. Telephone interviews were conducted with 19 people and two relatives.
The service was last inspected on 21 November 2013 and no concerns were identified.
Updated
2 June 2015
The inspection took place on 9 April 2015 and was announced.
Heath Lodge Care Services is a domiciliary care agency that provides care and support to people with a range of needs such as people living with dementia, older people, people with a physical or learning disability or sensory impairment. Care is provided to people in their own homes or who live in sheltered accommodation.
The service has not had a registered manager in post since May 2013. 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.
People said they felt safe and were cared for by care staff who were honest and trustworthy. Staff knew how to recognise the signs of abuse and what action to take if they suspected abuse was taking place. They had been trained in safeguarding adults at risk. Risks to people were assessed and reviewed on a regular basis, with three monthly checks. There was information and guidance for staff on how to manage people’s assessed risks. Staff knew what action to take in the event of a person sustaining a fall or needing medical assistance. Staffing levels were sufficient to keep people safe and people received copies of staff rotas so they knew when and at what time care staff would visit. The service followed safe recruitment practices and necessary checks were in place before new staff commenced employment. People’s medicines were managed and administered by staff who had received training in medicine administration.
Staff had the knowledge and skills to meet people’s needs effectively and had received training in a range of areas such as health and safety, food hygiene, moving and handling and first aid. All new staff were offered the opportunity to take a level 2 qualification in health and social care. New staff shadowed experienced staff before they worked independently with people. Consent to care and treatment was sought in line with the requirements of the Mental Capacity Act (MCA) 2005 and staff had been trained in this area. People were supported to have sufficient to eat and drink and were supported by care staff as much as they needed. Food and fluid monitoring charts were completed to ensure people ate and drink sufficient to their needs. People had access to healthcare support when this was needed and care staff liaised with health and social care professionals about people’s health needs.
People felt well looked after by caring and friendly staff. Staff knew people well, including their likes and dislikes and personal preferences. People were involved in all aspects of their care and were encouraged to express their views. Their privacy and dignity were maintained by staff who were sensitive to people’s needs. People were supported to be as independent as possible.
Care plans provided comprehensive information and guidance to staff about people’s needs and what duties needed to be undertaken at each visit. Staff arrived at the allotted times to deliver care and would call the office if they were going to be late. A member of office staff would then ring the person to inform them. Concerns or complaints were dealt with promptly and action taken to prevent similar events from reoccurring. People and their relatives were encouraged to provide feedback about the quality of care they received and other aspects of the service.
People thought that staff were polite and helpful and that communication was good. Staff were asked for their feedback about the service. The provider had systems in place to audit the quality of the care delivered and other aspects of the service and took action where needed. They completed quarterly monitoring forms for the local authority. Compliments were recorded and there were several compliments from relatives recorded on file.