Background to this inspection
Updated
30 November 2018
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This was a re-inspection of this service to check whether the provider was 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 an updated rating for the service under the Care Act 2014.
Before the inspection, we reviewed records held by CQC which included notifications, complaints and safeguarding concerns. A notification is information about important events which the registered person is required to send us by law. This enabled us to ensure we were addressing potential areas of concern at the inspection.
We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to This enabled us to ensure we were addressing potential areas of concern at our inspection.
We announced this inspection to the registered manager, giving them 48 hours’ notice. This is because this is the methodology we follow when inspecting community based services.
This inspection took place on 1 November 2018. The inspection was carried out by two inspectors and an expert by experience. An expert by experience is a person who has experience of caring for a person living in this type of environment. The expert by experience telephoned 15 people and one relative to receive their views of the agency and the care received.
During our inspection at the office, we spoke with the registered manager, operations manager, the registered providers senior management and six frontline staff. We reviewed a variety of documents which included the care records for six people, four staff files, medicines records and other documentation relevant to the management of the agency.
Updated
30 November 2018
Heath Lodge Care Services is a domiciliary care agency which provides personal care to people who live in their own homes. It provides a service to people living with dementia, learning disability of autistic spectrum disorder, mental health condition, physical disability or sensory impairment and younger adults. At the time of our inspection the service was providing care to 69 people.
This announced inspection took place on 1 November 2018.
The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (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. There was a registered in post who assisted us with our inspection.
We last carried out a comprehensive inspection of this service on 13 and 14 February 2018 when we rated the service as Inadequate overall. We also took some enforcement action, in the form of warning notices, against the registered provider as we had found continued breaches of regulations from the previous inspection. Following this inspection, the registered provider submitted an action plan telling us how they planned to address our concerns. We carried out this inspection to see if the registered provider had acted in line with their action plan. As such we checked to see if there were sufficient staff, people were receiving safe care and kept free from abuse, people received person-centred care, their consent was sought and good governance was in place. We found overall the service people received had improved, however the registered manager and provider needed to ensure sustainability of those improvements.
Staffing levels at the agency were sufficient, however we found that staff were leaving people early to get to the next person. This was because no travel time was allowed in between calls. People confirmed with us that staff did not stay the full time. The registered manager and senior management took immediate action to address this.
The registered manager was aware of their statutory requirements to notify us any safeguarding concerns or serious injury. Care records for people were very detailed and demonstrated a person-centred approach. People’s consent was sought in line with the Mental Capacity Act 2005.
Risks to people were identified and managed and people received the medicines they required. Accidents and incidents were recorded and lessons learnt. Pre-assessments were completed to ensure the agency could provide appropriate care. Where people required food provided to them or input from health care professionals this was done.
People told us staff were kind and caring. They said they had seen staff following good infection control processes. People were cared for by staff who had been recruited through appropriate channels. Staff were sufficiently trained and supported to manage people’s needs. Staff had regular supervisions with their line manager.
The registered manager worked with other professionals to ensure people’s needs were met. Complaints and comments received by the registered manager were responded to in an appropriate manner.
The provider’s senior management and the registered manager were open and transparent about the shortfalls within the service and committed to continuing to take action to improve. Feedback at our inspection resulted in them taking prompt action to address the lack of travelling time for staff. Quality assurance processes were more robust and despite the short time the registered manager had been in post improvements had already taken place. People, relatives and staff felt the service had improved since the registered manager had taken up post. Staff felt supported and told us the culture within the team had got better.
This service has been in Special Measures. Services that are in Special Measures are kept under review and inspected again within six months. We expect services to make significant improvements within this timeframe. 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.
During our inspection we found one continued breach of regulation. You can read the action we have asked the provider to take at the end of this report.