Enter and view: Heathgrove Lodge (second visit)

Healthwatch Barnet carried out an announced Enter and View visit to Heathgrove Lodge on 18 July 2017. Heathgrove Lodge is a BUPA-operated nursing home providing care for up to 33 residents, with 31 residents living there at the time of the visit. The visit took place shortly after the appointment of a new permanent manager following a period of managerial instability. 

Healthwatch found that the home was clean, well maintained and generally provided a pleasant environment for residents. Bedrooms were ensuite, safety systems were in place, and communal areas were tidy. The garden was attractive and well maintained, although inspectors identified potential trip hazards around patio access and drainage covers that required attention.

Care planning procedures were comprehensive and followed BUPA’s standard assessment processes. Care plans were informed by discussions with residents, relatives and professionals, reviewed monthly and included arrangements for end-of-life care. The home worked closely with healthcare providers, including GPs, dietitians, tissue viability nurses and North London Hospice. The service was also participating in Barnet’s Care Homes Enhanced Support Services (CHESS) pilot to help reduce unnecessary hospital admissions. 

Inspectors found residents to be well cared for, appropriately dressed and generally satisfied with the home. However, they expressed concern that very few residents were observed in communal areas or using the garden during the visit. Management explained that many residents preferred to remain in their rooms until after lunch, but Healthwatch felt more could be done to encourage social interaction and participation in activities. 

Staffing levels were determined through BUPA’s care needs assessment system, with two nurses and six care staff usually on duty during the day. While managers explained that additional staff could be deployed when required, inspectors questioned whether staffing levels were always sufficient, particularly when residents appeared to be waiting for assistance with meals or when supporting one resident created delays for others. 

Staff generally spoke positively about training opportunities, which included e-learning, workbooks and face-to-face training. However, concerns were raised about staff morale and retention. Some staff reported dissatisfaction because newer employees were being recruited on more favourable pay and conditions than longer-serving staff, creating tensions within the workforce. Some staff also felt that their views were not always listened to by management. 

The home had a programme of activities supported by dedicated activity coordinators, including one-to-one support for residents who were unable to leave their rooms. Nevertheless, inspectors did not observe the scheduled morning activity taking place and found limited evidence of activity engagement during the visit. Healthwatch concluded that the activities programme should be reviewed to ensure it provided varied and stimulating opportunities for all residents. 

Food provision was viewed positively. Meals were prepared on site, menus included photographs and alternatives were available to accommodate individual preferences. Residents praised the quality of the food and inspectors observed efforts to provide personalised meal choices and special diets where required. 

Overall, Healthwatch concluded that residents were receiving satisfactory care in a clean and well-run home, but identified areas for improvement around staffing, activities, social engagement and environmental safety. Recommendations included reviewing staffing levels, addressing pay inequalities between staff, improving patio access and removing trip hazards, discussing routines and activity preferences with residents, and strengthening the activities programme. Healthwatch also asked Barnet Council to continue addressing delays in the processing and renewal of Deprivation of Liberty Safeguards (DoLS) applications.

In response, Heathgrove Lodge reported that pay structures had been reviewed, staffing levels continued to be monitored, property issues were being assessed, residents were being kept better informed about activities, and the activities programme had been expanded to provide a broader range of opportunities. Barnet Council acknowledged ongoing pressures on its DoLS service and stated that applications were being prioritised according to risk.