CQC report explained · a residential care home
What the CQC found at Heath Lodge
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People told inspectors they felt safe. Risk assessments, medicines arrangements, recruitment checks, health and safety checks, and incident reviews were in place.
- Effective?
- Good
- People received individualised support from trained staff. They were supported with food, healthcare, independence and decision-making.
- Caring?
- Good
- People said staff were friendly and respectful. Inspectors found that staff supported privacy, dignity, independence and involvement in care decisions.
- Responsive?
- Good
- Support plans reflected people's needs, choices and aims and were regularly reviewed. Some records did not clearly show that people had been consulted, and some people wanted more help to access the community.
- Well-led?
- Requires improvement
- There were detailed quality checks and the manager understood their responsibilities. However, some rotas, dates, signatures, support plan records and action plans from meetings needed improvement.
What inspectors found, January 2020
Rated Good overall; inspectors found safe, kind and responsive care, but the home Requires Improvement for being well-led.
This was an unannounced planned inspection on 31 October 2019. One inspector and an expert by experience spoke with four people living there, the manager and three staff. They also reviewed care records, staff recruitment files, medicines records and management documents.
The overall rating was Good. Safe, effective, caring and responsive care were all rated Good. People described staff as kind and supportive. Inspectors found that medicines, risks, staffing, training and care planning were generally managed well.
Well-led was rated Requires Improvement, as some rotas and records were not clear or complete. The home had improved from an overall Requires Improvement rating at the previous inspection, published on 23 October 2018. The provider was no longer in breach of Regulation 17.
People felt safe
People told inspectors they felt safe, and staff knew how to respond to safeguarding concerns.
“People told us they felt safe living at Heath Lodge.” from the report
Safe medicines support
Staff were trained to support people with medicines, had regular competency checks and were subject to medicines audits.
“Safe medication practices and procedures were in place; people were supported with their medicines by trained members of staff who regularly had their competency levels checked.” from the report
Kind and respectful staff
Inspectors found staff were familiar with the people they supported and provided compassionate care that respected privacy and dignity.
“Staff provided kind, compassionate and considerate support.” from the report
Personalised support
Care and support were tailored to people's needs, choices and goals. People were encouraged to make decisions and live independently.
“People received care and support that was tailored around their individual needs and choices.” from the report
Improved care planning
The previous breach about care plans not being regularly reviewed had been addressed by this inspection.
“During this inspection we found that the registered provider was no longer in breach of this regulation.” from the report
Incomplete records
needs fixingSome documents were not always accurately dated and signed. Records did not always show that people had been involved in developing their support plans.
“some documents needing some staff to accurately date and sign records” from the report
One-to-one support rotas
needs fixingThe rotas did not always clearly show when funded one-to-one support hours had been provided. The manager had started reviewing this during the inspection.
“Their support was not always clearly defined on the staff rotas and hard to see where these hours had been provided.” from the report
Limited action plans from meetings
minorPeople could give feedback, but meeting records did not clearly show how suggestions and comments had been acted on.
“However, there was limited information regarding action plans to show how people's feedback had been managed.” from the report
Community access
minorMost people were happy, but some people wanted more support to take part in activities and access the community.
“Some people wanted more support to access the community.” from the report
- 01How will you make sure one-to-one funded support hours are clearly recorded on staff rotas?
- 02What checks are now in place to ensure records are accurately dated and signed?
- 03How will you record that my relative has been involved in developing and reviewing their support plan?
- 04How do you record and follow up suggestions made at resident meetings?
- 05What changes have you made after reviewing the best practice guidance on Registering the Right Support?
This was an unannounced planned inspection covering all five CQC questions, with the care home premises and care provided both looked at. This explanation was written from the published report of 10 January 2020 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, October 2018
Heath Lodge was rated Requires Improvement and is out of special measures; inspectors found kinder care and progress, but important records and management checks were still not reliable.
This was an unannounced comprehensive inspection over 12, 13 and 18 September 2018. Inspectors spoke with people living there and staff, reviewed care and medicine records, checked recruitment and other documents, and looked around the home.
The home had improved significantly since the previous inspection. Medicines, safeguarding, staffing, food, complaints and support for people's choices had improved. Inspectors rated caring as Good and saw kind relationships, less conflict and effective de-escalation.
However, the home was not consistently safe, effective, responsive or well-led. Care plans were not always reviewed or updated, risk information was sometimes incomplete, and quality checks had failed to identify some problems. There was also no registered manager in post.
The home had previously been rated Inadequate and placed in special measures. It was no longer rated Inadequate and had left special measures, but the provider still had to improve governance and record keeping.
Kind relationships
Staff knew people well and treated them with kindness and respect. Inspectors saw staff successfully calming someone who was becoming upset.
“We observed staff interactions to be kind, considerate and caring.” from the report
Improved medicines
Medicine procedures had improved through work with a community pharmacist. Staff were trained and their competence was checked.
“We looked at medication records and observed staff practice when administering medicines and found that safe procedures were followed.” from the report
More choice and independence
People were more involved in menus, shopping, meals and managing personal budgets. They could choose when to get up and go to bed and were supported with activities.
“People were supported to take part in various activities which included bowling, wrestling, snooker, meals out, visiting the garden centre, shopping, the Friday Club and going to the local pub.” from the report
Quality checks missed problems
seriousThe new audit system did not identify inaccurate statements about care plan reviews or other shortfalls. It also lacked clear deadlines and named responsibility for corrective actions.
“Systems in place had not identified all of the issues noted within this report.” from the report
Some safety risks needed faster action
needs fixingRecords and analysis of accidents and incidents were not always robust. Smoking-related risks, fire audit actions and some risk assessments needed further work.
“Risk management strategies were not always implemented in a timely manner, for example from the risk of smoking.” from the report
No registered manager
needs fixingThere was no registered manager at the time of inspection. Day-to-day management was being covered by an interim manager from another service.
“At the time of this inspection the service did not have a registered manager.” from the report
Financial investigation still ongoing
needs fixingEarlier concerns about people's money had led to an investigation. The provider was still agreeing final reimbursement figures for inappropriate purchases or differences in records.
“The registered provider is currently in the process of agreeing final reimbursement figures where purchases have been made inappropriately or where there is a discrepancy in amounts credited to Heath Lodge records.” from the report
- 01Who is currently responsible for the day-to-day management of the home, and when will a registered manager be in post?
- 02How do you check that every person's care plan and risk assessment is reviewed and updated when their needs change?
- 03What action has been completed in response to the concerns about smoking risks, fire safety keys and emergency evacuation routes?
- 04What is the current position on the investigation into people's finances, and when will any outstanding reimbursements be completed?
- 05How do you make sure that improved practices, such as recording conflict triggers and allowing people to choose staff for personal care, continue consistently?
This was a comprehensive inspection of all five key questions, carried out to review progress after the previous inspection placed the home in special measures. This explanation was written from the published report of 24 October 2018 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Heath Lodge
4 rated inspections over 5 years: the service has held its Good rating throughout.
- January 2020Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- October 2018Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- October 2018Inadequatedown from GoodSafe: InadequateEffective: InadequateCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- June 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2014
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- December 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 28 January 2011.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
Weigh the report against the rest
Fees, photos and reviews from families
How to read CQC ratings and reports
What to check when you visit
At least 100 live-in carers within about an hour of Warrington
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £980 to £1,260 a week. 90 can care for a couple. 10 years' experience on average.
“He developed a close affinity with Terence, spending time talking with him before he retired to bed and looking after his needs during the night.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.