Heathgrove Lodge Care Home

Updated 8 July 2022

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 Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by one inspector, a specialist nurse and an Expert by Experience.

An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

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

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with eight members of staff including the registered manager, the clinical lead, a nurse, three carers, a housekeeping staff and a chef. We observed interactions between staff and people living at the service and spoke with nine people who use the service.

We reviewed a range of records relating to the management of the service, for example records of medicine management, risk assessments, accidents and incidents, quality assurance system, and maintenance records. We looked at seven people's care and support plans and associated records. We looked at three staff files in relation to recruitment. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection we continued to seek clarification from the registered manager to validate evidence found. We looked at further records and evidence including quality assurance records, training data, meeting minutes, and policies and procedures. We spoke with five relatives about their experience of the care provided to their family members. We contacted six professionals who worked with the service and received two responses.

Updated 8 July 2022

About the service

Heathgrove Lodge Care Home is a residential care home providing personal and nursing care to up to 33 people. The service provides support to older people some of whom are living with dementia. At the time of our inspection there were 16 people using the service.

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

There had been a change in provider and management changes since the last inspection, which affected the overall service management. The provider had been working to improve the quality and safety of the service. They had commissioned an external quality assurance team and continue to work with the local authority quality assurance team. The new registered manager was in the process of getting to know the service, introducing new systems and processes, and a clearer structure with more effective monitoring and accountability. However, these changes had yet to be fully established and embedded.

The décor and layout of the building was not adapted to meet people's needs. The service was not dementia friendly, was not easily accessible to people with mobility needs and did not encourage and promote independence and social interaction. People remained dependent on staff to take them to other parts of the service when needed.

People were at risk of social isolation because the provider did not ensure people who spent time in their rooms had opportunities for social engagement. We have made a recommendation about this.

People were safe living at the service and relatives felt their family members were kept safe. Staff understood their responsibilities to raise concerns and report incidents or allegations of abuse. They felt confident issues would be addressed appropriately.

People were supported by staff who had been checked to ensure they were safe to work at the service and there were sufficient staffing levels in place. People told us they did not have to wait long for staff support when using their call bells. Staff had received a range of training and development. Supervision to support and monitor practice was undertaken.

The staff team followed procedures and practices to control the spread of infection and keep the service clean. There was an emergency plan in place to respond to unexpected events. The premises were well maintained although some areas needed redecoration.

People were able to access healthcare professionals such as their GP. The service also worked with other health and social care professionals to provide effective care for people. People were supported to access appropriate food and fluids and meals were described as being good.

People told us they were happy with the care they received, and staff were kind and helpful. People's choices were considered when providing care and their views were taken on board. Staff had a good understanding of people as individuals and people were treated with dignity and respect.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Relatives felt the management of the service was improving and that they could approach the registered manager and staff with any concerns. Staff felt the management was open with them and communicated what was happening at the service and with the people living there. The management team appreciated staff contributions and efforts during the pandemic to ensure people received the right care and support.

Improvements to audits and management oversight of the service were being put in place by the new registered manager and these needed more time to have a positive impact on the service.

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 the service under the previous provider was requires improvement, published on 31 August 2019.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Heathgrove Lodge on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified a breach in relation to premises at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.