Horfield Lodge

Updated 6 March 2020

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was carried out by one inspector.

Service and service type

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

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

Before the inspection we reviewed information we had received about the service since the last inspection. This information included the statutory notifications that the provider had sent to CQC. A notification is information about important events, which the service is required to send us by law. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used this information to plan our inspection.

During the inspection

We spoke with eight people who lived at the service and four visitors. We observed how people were spending their time and the interactions between them and the staff team. We spoke with twelve members of staff and volunteers, as well as the registered manager, deputy, area manager and quality lead.

We looked at five people's care records, together with other records relating to their care and the running of the service. This included staff employment records, policies and procedures, complaints, audits and quality assurance reports.

Updated 6 March 2020

About the service

Horfield Lodge is a care home that provides personal and nursing care for up to 75 people. The service is provided in accommodation over three floors. The top floor consists of care suites with a lounge, kitchen, bedroom and bathroom, the remaining accommodation consists of a bedroom and en-suite facilities. At the time of the inspection, 71 people were living at the home.

People’s experience of using this service and what we found

Those people who used the service expressed unreserved satisfaction and spoke highly of all staff and services provided. Comments included, “You have all been absolutely outstanding and I really appreciate all your hard work and the loving care you provide”, “The care mum received was exemplary”, “We found the standard of care and the commitment of staff to be first rate”, “All staff care deeply about their residents, and nothing is too much trouble for them”, “Mums health and emotional needs have always been met compassionately and with respect” and “Nothing is too much trouble and an atmosphere of calm, kindness is evident at all times. I can't praise it highly enough”.

People and their relatives agreed the service was safe. The registered manager and staff understood their role and responsibilities to keep people safe from harm. Risks were assessed and plans put in place to keep people safe. There was enough staff to safely provide care and support to people. Checks were carried out on staff before they started work to assess their suitability to support vulnerable people. Medicines were well managed and people received their medicines as prescribed. People were protected by the home’s infection control policy and procedures.

The service provided an effective service. Training and development was based on research and best practice guidelines to enhance quality and safety of the service provision. Staff felt constantly supported, valued and praised. They told us, “There is no shortage of praise and we get thanked for all we do”, “I feel valued by everyone I work with” and “Teamwork is essential and we have no problems there”. People continued to receive a nutritious, healthy diet that met individual preferences. The home was decorated and maintained to a very high standard whilst maintaining a homely feel. People were consulted about the adaptation and design of their home and choice and preferences were respected. There were various areas to enjoy activities, events and personal private time. The service had been creative in developing areas of the home that would enhance people’s wellbeing.

The service was exceptionally caring and put people at the heart of everything they did. One lady told us, “Nothing is too much trouble for the staff, it’s down to them that my wellbeing has improved both physically and emotionally, every day I wake up with a purpose”. We were introduced to people throughout our visit and they welcomed us. They were relaxed, comfortable and confident in their home. Staff had an excellent awareness of individuals' needs and treated people in a warm and respectful manner. They were knowledgeable about people's lives before they started using the service. Every effort was made to enhance this knowledge so that people’s life experiences remained meaningful. The commitment of the staff was excellent. They told us, “This is my second home”, “We are all so proud when we go home at the end of our shift, they all mean the world to us” and “I always feel happy coming back to work”.

The service was exceptionally responsive to people’s health and social needs. People received person centred care and support. One relative told us, “They know mum inside out, they have made every effort to get to know her, care is personalised, the staff know my mum as well as I do!”. Regular monitoring and reviews meant that referrals had been made to appropriate health and social care professionals. Where necessary care and support had been changed to accurately reflect people's needs and improve their health and wellbeing. People were offered a vast array of activities both at the service and in the local community. The whole team were proud and privileged to support people with end of life care. One relative wrote to the registered manager recently and stated, “I have seen a quote in your home, ‘You matter because you are you and you matter to the last moment of your life’. The staff of Horfield Lodge certainly lived up to that statement in their treatment of my mother”.

People benefitted from a service that was very well led. The provider, registered manager, deputy and staff team maintained a clear focus on continually seeking to improve the service people received. Staff told us the registered manager led by example and they had tremendous respect for her. Comments included, “She is extremely supportive and approachable”, “I look up to her and she inspires me” and “I cannot fault the manager, we are where we are because of her”. Everyone demonstrated strong values and, a desire to learn about and implement best practice throughout the service. Good quality assurance systems were in place and based upon regular, scheduled audits, which identified any action required to make improvements. This meant the quality of service people received was monitored on a regular basis and, where shortfalls were identified they were acted upon.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Good (published February 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.