We set out to answer our five questions during our inspection; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?At the time of our inspection there were 12 people living permanently in the home and two people were staying for a short stay. We observed the care being provided to people in the communal areas of the home and examined the care documentation and supporting records. We spoke with six people that used the service who were able to tell us of their experiences and we spoke with four members of staff to gain their understanding of how they met the needs of people living in the home.
Below is a summary of what we found. The summary is based on our observations during the inspection, discussions with people using the service, their relatives, the staff supporting them and looking at records.
If you wish to see the evidence supporting our summary please read the full report.
Is it safe?
Staffing was maintained at safe levels. During our inspection people's needs were responded to in a timely manner. Staff received training which included dementia training. This was because some people living in Hengrove Lodge were living with a form of dementia. This meant staff were trained to support people through their dementia journey.
Safeguarding procedures were in place and staff understood their role in safeguarding the people they supported. Staff had a good understanding of who they needed to contact should they have any concerns around people's welfare. Two people that lived in the home told us they felt safe and told us if they had any concerns they would tell the manager. People who used the service were cared for by staff who knew how to protect them from the risk of abuse.
We spoke with staff who explained what whistle blowing at work was and knew the procedures that were in place. They told us it meant to report to someone in authority if they suspected malpractice and or abuse at work that could compromise people's safety. We saw a copy of the whistle blowing procedure was up to date with the contact information of who staff could report concerns to.
The home had policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards (Dols). The registered manager confirmed no one currently living in the home was subject to such an application. However relevant staff had been trained to understand when an application may be required and the registered manager told us about times when they had sought advice in the past from the Dols team. This meant that people were safeguarded from abuse.
Systems were in place to make sure that managers and staff learnt from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. We saw that incidents and accidents were regularly audited by the manager. This reduced the risks to people and helped the service to continually improve people's safety.
Is it caring?
People were supported by sensitive and attentive staff. We saw that care staff showed patience and gave encouragement when supporting people. We spent time in the communal lounges observing interactions between staff and people that used the service. The observations we made demonstrated staff supported people in a calm unhurried manner, using communication methods conducive with their individual assessed needs. Staff sat with people playing dominoes and doing puzzles. People were consulted before staff undertook their care routines. This was confirmed by people that we spoke with.
People who lived in Hengrove Lodge that we spoke with told us they felt safe and happy living in the home. People's comments included: 'I have never been happier; we have a game of dominoes often'. 'I do lots with my day, I enjoy sewing and knitting'. 'Staff are nice'. 'We do what we want to do to be honest'. 'I get up and go to bed when I like'.
People's preferences, interests, likes and dislikes had been recorded that supported their individual needs.
Is it effective?
We found people's health and care needs were assessed with them and reviewed regularly. Care plans provided guidance for staff to follow to ensure people's individual specific needs were met. Care plans were reflective of people's current level of need.
Specialist dietary, mobility and equipment needs had been identified in care plans where required. People told us their keyworker met with them on a monthly basis.
It was clear from our observations and from speaking with staff that they had a good understanding of people's care and support needs and that they knew them well.
There was an independent counselling service provided regularly within the home. This was provided by the provider on a six weekly basis. This meant that when required, people could access additional confidential support.
Is it responsive?
People's needs had been assessed before they moved into the service. The registered manager told us people met with their key workers monthly to discuss their care plans and relatives were involved as people required and agreed.
People received co-ordinated care. We saw evidence in people's care plans that demonstrated people had been visited by their GP and other health care professionals. For example people's files held information and advice sought from the district nurse team in relation to their wound management care. Records demonstrated they visited on a regular basis.
Is it well-led?
People that used the service, their relatives and external professionals completed a satisfaction survey once a year. The registered manager told us if any concerns were raised these would be addressed promptly. Comments included: 'The home is wonderful'. 'Home is led by a brilliant manager and all staff'. 'I am well looked after here'. Comments from externals professionals included: 'Staff are always knowledgeable about people' and 'Privacy is always respected'.
Some people we spoke with were able to tell us their experience. They confirmed they felt listened to by staff and knew how to raise a complaint if they needed to.