Highams Lodge

Updated 8 September 2023

Highams Lodge is run by Community Housing and Therapy, an independent health provider of housing and therapy to support people who experience severe mental health difficulties. The provider has 7 therapeutic communities across London, Surrey, and East Sussex. They also operate a crisis service in Surrey which offers an alternative to hospital admission for those experiencing crisis as well as planned respite and emergency admissions.

Highams Lodge is a therapeutic community. They provide trauma informed support based on a relational treatment model in a therapeutic community. They can accommodate up to 15 adults in one adapted building. The service provides support to people with complex mental health needs and substance misuse issues within a therapeutic environment.

This is a step-down service to prepare people with the necessary life skills before moving on to more independent living. A range of staff including support workers, therapeutic practitioners, community psychotherapists, support workers and social work support residents through a range of different interventions including group based activities, therapeutic keywork and individual therapy. The service also has access to a consultant psychiatrist who visits every six weeks.

At the time of the inspection visit there were 15 people using the service.

Highams Lodge was previously registered as a care home. The last inspection was conducted using that methodology in February 2021 and was rated as good overall at this time.

The service is registered to provide the following regulated activities:

treatment for disease, disorder, or injury

There was a registered manager in place at the time of the inspection visit.

Updated 8 September 2023

Overall summary

• The provider had clear systems to keep people safe and safeguarded from abuse which included a range of policies accessible to all staff, induction and appropriate training, working with other agencies and multidisciplinary forums where resident safety could be assessed, monitored and managed.

• There were reliable systems for the appropriate and safe handling of medicines. Staff administered medicines in line with legal requirements and national guidance. Regular medicines audits were carried out.

• There was a good safety track record. Incidents and complaints were investigated with resident involvement, thoroughly and transparently with lessons and themes identified and used to improve safety in the service.

• There was a range of staff who had the skills, knowledge and experience to carry out their roles. Resident care was coordinated, and person centred. This included coordinating care with other services where needed to support residents to move onto independent living when they were ready.

• Staff treated residents with kindness, respect and compassion. The service actively sought feedback on the quality of care provided and all carers we spoke to were positive about how they had been treated. Most residents we spoke to described staff as caring and comforting, that they were made to feel safe and treated with respect.

• Carers we spoke to were impressed with the care and support their relative received and described it as accessible, approachable and always took time to listen.

• The provider organised and delivered services to meet residents’ needs, taking account of their needs and preferences. For example, the service operated a therapeutic model which aimed to understand a resident’s behaviour and the treatment plan is formed around this.

• The provider took complaints and concerns seriously and responded to them quickly and appropriately to improve the quality of care.

• Managers had the capacity and skills to deliver high-quality, sustainable care. They were visible and approachable, and demonstrated compassionate and inclusive leadership.

• The provider had a clear vision and strategy to deliver high quality care and good outcomes for residents. Staff were aware of and understood the vision and their role in achieving it.

However:

• Although conversations around capacity and consent were held with residents, we found that these were not always clearly documented within the care records.
• Fridge temperature recordings for both the medicines fridge were not being completed correctly. Staff were only checking and recording the maximum and minimum temperatures and not the current temperature.
• The service did not have naloxone in their medicines stock even though some residents experienced substance misuse problems.

Updated 8 September 2023