Harefield Lodge

Updated 16 April 2021

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

As part of CQC’s response to the coronavirus pandemic we are looking at the preparedness of care homes in relation to infection prevention and control. This was a targeted inspection looking at the infection control and prevention measures the provider has in place.

This inspection took place on 19 March 2021 with a site visit and was announced. We completed a virtual follow up review of information with the provider’s operations manager on 31 March 2021.

Updated 16 April 2021

Harefield Lodge is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Harefield Lodge is registered to accommodate up to seven adults, who have a learning disability or an autistic spectrum disorder. At the time of our inspection there were five people there. The home consisted of a main building with bedrooms, offices, a kitchen, a dining area and lounges. There were sensory areas and quieter places for people to spend time in if they wished. To the rear of the property there were self-contained flats where people could live and be supported by staff to live as independently as they could.

The service had been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At this inspection we found the service remained good overall and had become outstanding in response to the question, “Is the Service Responsive?”

Harefield Lodge had a registered manager. A registered manager is a person who has registered with the Care Quality Commission 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.

The service had an open, supportive and person-centred culture with good relationships amongst people and staff.

Most of the people who lived at Harefield Lodge communicated with nonverbal gestures, sounds and by touch. We spoke to one person who told us they enjoyed living at Harefield Lodge and liked everyone who lived and worked there. We received positive feedback from relatives and health professionals who visited the home regularly.

People were supported by appropriate numbers of trained, experienced, skilled staff who knew the people who lived at Harefield Lodge very well. Staff supported people to ensure they lived their lives the way they chose. Communication styles and methods were tailored to individual people and staff supported people to understand the choices available to them.

The service had carefully considered people's individual needs through the adaptation, design and decoration of the premises, indoors and outdoors. The garden was in the process of being adapted to reflect people’s preferences with plans to include sensory areas, quiet reflective areas and containers and vegetable growing sections where people could take part in growing and tending to their own vegetables and plants.

There were elements of outstanding practice in relation to providing person centred care that met people's individual needs. People received outstanding person-centred care from a staff team that showed innovation and tenacity to ensure people received care and support tailored to their specific needs to enable them to live fulfilled lives. People were encouraged and supported to take part in a wide range of activities, music therapy, sensory sessions and visits to places that gave them enjoyment. Activities were adapted according to people’s individual needs to ensure they got the most benefit and enjoyment from the activities. People and staff told us they really enjoyed their activities which promoted their independence and maintained their sense of wellbeing.

Staff understood how to identify and report abuse and were well supported in their roles. Staff received up to date training on all core subjects as well as ad hoc training for subjects that interested them such as autism and specialist medicine training.

People were supported to take their medicines safely by staff who had received the appropriate levels of training.

People were supported by staff to make their own choices about how they spent their day. Staff had a good knowledge and understanding of the Mental Capacity Act 2005 (MCA) and promoted people's independence and choice in their day to day living. Where people might lack capacity to make a specific decision staff acted in accordance with the MCA.

People were enabled to have choice and control of their lives and staff supported them in the least restrictive way possible, the systems in the service supported this practice.

People's health care needs were met and staff supported people to see healthcare professionals when appropriate. Staff were proactive in recognising people’s changing health needs and acted quickly to ensure people received specialist health care when they needed it.

People were treated with kindness, dignity and respect by a staff team who knew them very well. People’s privacy was respected at all times.

There was a clear complaints policy and relatives told us they knew how to make a complaint if the needed to and felt any concerns would be taken seriously and action straight away.

There were quality assurance systems in place to drive continuous improvement and ensure the home offered a safe, effective, caring and responsive service.

Further information is in the detailed findings below.