We carried out a review of the data available to us about West Heanton - Residential Home on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about West Heanton - Residential Home, you can give feedback on this service.
People’s experience of using this service and what we found
People gave consistently positive feedback about the care provided at West Heanton Residential Home. People commented: “Staff are all very compassionate. I get all het up and can’t seem to relax so I talk about it to the carers and they understand” and “All the carers here are very kind and helpful. In fact, it is a bit like being on holiday here as everyone is so kind. Whatever you need or want they make you feel it is okay to ask. I feel lucky to live here.”
Staff were highly motivated to ensure people received care which was compassionate and kind. The atmosphere in the home was warm and very friendly. People had developed strong relationships with staff, and it was evident that this was an important part of the ethos of the service.
Staff were exceptional at anticipating people's needs. We observed a staff member supporting a lady living with dementia who did not want to be seated. The staff member knew the person used to be a florist. Once the rain stopped they took the lady out to cut some roses in the garden. They then came in doors and on a table in the conservatory had laid out scissors and vases containing water. The lady sat down and filled each vase with a flower arrangement which was then taken and placed on the dining room tables. The lady was clearly so happy to be doing this and felt valued.
People received personalised care and support specific to their needs and preferences. There was an excellent understanding of seeing each person as an individual, with their own social and cultural diversity, values and beliefs.
People were encouraged to socialise, pursue their interests and hobbies and try new things. There was a focus on wellbeing and having a sense of purpose. The organisation, including all staff involved, ensured people had access to as many opportunities as possible to aid their physical and mental health well-being. Activities formed an extremely important part of people’s lives and had a positive impact on their wellbeing.
The home won a best practice award in 2017 run by North Devon Care Homes Team with regard to dementia awareness for staff. Staff dressed up in clothes from the 1940's and went to a local Fairground and Heritage centre to increase their awareness of what it would have been like for people earlier in their lives. As a result, staff are now able to engage more meaningfully with people with an increased understanding of their life experiences. A local celebrity, who champions dementia awareness, came in the evening to give awards to staff nominated by people. There was a Fete with vintage cars all in the 1940's style. This was open to people living in the local community, some of whom had known the people living in West Heanton for many years.
People were supported to have peaceful, comfortable and dignified end of life care in line with national best practice guidance.
The service provided safe care to people. One person commented: “Yes I feel safe, very much so. We have got lovely staff. I used to fall about a lot at home but not so much here.” Measures to manage risk were as least restrictive as possible to protect people’s freedom. People’s rights were protected because the service followed the appropriate legal processes. Medicines were safely managed on people’s behalf.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; policies and systems in the service supported this practice.
Care plans were personalised to reflect people’s personal preferences. People’s views and suggestions were taken into account to improve the service. People were supported to maintain a balanced diet. Health and social care professionals were regularly involved in people’s care to ensure they received the care and treatment which was right for them.
There were safe staff recruitment and selection processes in place. People received care and support from staff who were well trained and competent.
People, relatives and staff praised the service and the registered manager. Comments included: “The manager is a lovely bloke. A good manager with a lovely family”; “You can approach (registered manager) any time and I can’t fault the staff or think of anything he could improve on” and “(Registered manager) is a good leader.”
The registered manager had been nominated for the ‘Outstanding Care Awards for Devon and Cornwall 2019.’ As a result, they had successfully become a finalist. The winners were due to be announced on 28 June 2019. The registered manager successfully won a silver award for care home manager of the year.
A number of methods were used to assess the quality and safety of the service people received. For example, various audits and surveys. The service made continuous improvements in response to their findings.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection: The last rating for this service was Good (report published in September 2016).
Why we inspected: This was a planned inspection based on the previous rating.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for West Heanton Residential Home on our website at www.cqc.org.uk
Follow up: We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
West Heaton Residential Home is a family run care home which has operated for 25 years. It provides care and support for older people who may be living with dementia. The home is rurally located and can accommodate up to a maximum of 23 people. There were 22 people resident in the care home at the time of the inspection.
There are supported living units within the grounds and the premises and day care is provided. A domiciliary care agency operates from the premises. The provider therefore offers integrated care and support for older people in the local community. We do not regulate the day care service and this inspection was of the care home only.
The service is required to have 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. West Heanton Residential Home had a registered manager.
Our previous scheduled inspection of September 2014 found that proper steps were not always taken in a timely manner. This was in response to a change in people’s health care needs and systems in to identify, assess and manage risk, which were not always effective. This inspection found that most aspects of the service had been completed reviewed. People were safer and the staff team were completely engaged in continuous improvement to make people’s lives as good as possible.
Two community health care professionals described the care provided as “superb”.
Staff listened to people’s views and looked for ways to continually improve their lives. This included the introduction of snacks between meals. This had increased the amount of food and drink people who lacked appetite, were taking.
Where people had behaviours which challenged them and others, these were now reduced, through staff understanding the reality of the experience of people living with dementia. A very wide range of activities was provided, based on their background, and requests people made. Independence was fully promoted and restrictions were minimalized.
Staff were kind, caring and treated people with respect and dignity. Community nurses said the staff worked with “love and gentleness”.
The registered manager promoted a good ethos, putting people at the centre of how the home was run. The culture was one of kindness and caring.
Safety within the home environment was a high priority. People’s individual safety and comfort needs were well met, with risk understood and managed.
There was a high regard for ensuring people’s choice and liberty were not compromised. People’s legal rights were understood and the registered manager worked hard to promote them.
People were protected through robust staff recruitment and a wide range of staff training. The staffing arrangements were flexible and people’s needs were very well met. Staff had a very good understanding of how to protect people from abuse and harm.
Staff felt very supported and were working within an improved staffing structure, with key workers, to promote person centred care. Care plans were very detailed and provided staff with all the information they needed to meet people’s needs and wishes.
There were good systems in place for ensuring the service was well monitored.
These inspections visits took place on 3 and 30 December 2014 and were unannounced.
West Heaton Residential Home is a rurally located care home which provides care and support for older people who may be living with dementia. The home can accommodate up to a maximum of 23 people. West Heanton Limited is a family based business. The home does not provide nursing care. People's healthcare needs are met through the local community services, such as the district nurses and GPs. There were 23 people residing in the care home at the time of our inspection.
The service has 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 and associated Regulations about how the service is run.
At the last inspection, on 2 May 2014, we asked the provider to take action because the standard of record keeping did not ensure people were protected from the risks of unsafe or inappropriate care. We found during this inspection that record keeping continued to put people at risk of unsafe or inappropriate care because the home did not have an effective system for records management.
People’s need’s were monitored but this did not always lead to a timely response to concerns, such as weight loss. The home relied on community services to act once problems had developed. Systems, such as risk assessment tools, were not used so the home could identify where risk was increased, and take steps to prevent problems from occurring.
The service had inadequate systems to ensure health and safety were promoted at all times. However, there were arrangements for listening to people’s views and there were reviews of how the home was run which had led to changes, such as the staff training arrangements.
Staff did not adequately understand the Mental Capacity Act (2005) (MCA) and Deprivation of Liberty Safeguards (DoLS) and how they applied this in practice. They understood the importance of providing people with choices and listening and responding to their preferences, where expressed. They were clear they would not act against people’s wishes. No person was being deprived of their liberty and decisions were made in their best interest.
People felt safe but arrangements relating to reporting abuse were not robust, although they were under review.
People’s needs were generally met by sufficient numbers of staff who considered their training to be effective and who were encouraged to take qualifications in care. Staff received supervision and support for their work and felt able to take any concern or enquiry to the registered manager. The arrangements for recruitment of staff protected people from staff who might be unsuitable to care for them.
Medicines management protected people using the service. It was well organised and ensured people received the medicines they required at the time they required them. People had a nutritious diet available to them although some requested more variety and people did not have the choice of whether they received sugar supplements or not.
People felt valued and were cared for. Time was set aside for additional one to one time with staff, called “TLC”. There was a variety of activities and engagement with the local community, where people had friends and neighbours.
We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. Changes in care needs were not responded to in a timely manner to promote people’s health and welfare. The home lacked systems to ensure risk was reduced and managed.
You can see what action we told the provider to take at the back of the full version of this report.
We also spoke with the manager, senior care staff, care staff, housekeeping and kitchen staff.
We found, where people did not have the capacity to consent the provider acted in accordance with legal requirements.
Care and treatment was planned and delivered in a way to ensure people's safety and welfare.
People were protected from the risk of infection because appropriate guidance had been followed.
There were enough qualified, skilled and experienced staff to meet people's needs.
There was an effective complaints system available.
People were not always protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were not maintained.
We found that people's care was being well planned. People were involved in making decisions about their care and treatment. People we spoke with said that they were happy with their care and support. Comments included 'Staff are very good, they try to accommodate us as best they can, and they know all our likes and dislikes.' 'We are looked after extremely well here.'
We saw that the service ensured that any new staff had the right checks in place to ensure they were fit to work with vulnerable people, before they commenced employment.
The home had developed systems and checks to ensure that they reviewed and monitored the quality of care provided. This included involving and listening to people who lived at the home as well as staff.
We visited this service on the 24 January 2012 and spent approximately six hours speaking to people who lived at the care home as well as to people who received a service from their domiciliary care service. In total we spoke with nine people, six people who currently live at the care home and three people who have support from the domiciliary care service.
We also spent time talking to staff members including care staff in the home, one care staff from the domiciliary care agency. We looked at some key records including, care plans, risk assessments, staff training and recruitment records. We looked at all communal areas of the home and at six of the individual bedrooms. We also spent time observing how staff provided care and support throughout different times of the day. We had lunch with some of the people who used the service and spoke with nine people about their experiences of living at the home or of receiving domiciliary care from the agency.
We heard very positive comments from people we spoke with about the care and support they received. People told us
'The carers are all first rate, they make sure everything is well organised for me and make life so much easier.'
'We have a lovely bunch of staff caring for us, they are all very nice.'
'We are well catered for here, no complaints.'
We spoke with three care staff from the home and one from the agency that provides support to people in their own homes. They had a good understanding of the needs, wishes and preferences of the people they provide care and support to. We heard from the care staff that in their opinion they were given good training opportunities and have regular support and supervision to ensure that have done their job properly.
We observed care staff provided care in a positive, kind and respectful way. We saw that peoples' diverse needs were considered. For example we saw that tracking hoist equipment had been fitted in some bedrooms to allow less mobile people to be moved safely. One person in the home smoked and they had been given access to a small conservatory so that they had somewhere indoors to smoke. The registered manager told us, this area was not previously used by any other people in the home, so had not restricted the use of this area and there were still three other communal areas for people.
We saw that care was well planned for those living in the home and for people who received care in their own homes. The service had an electronic system for recording care needs, risk assessments and daily records.
We noted during our tour of the premises that in communal toilets there were material hand towels, and not paper disposable towels. We pointed out that this could present as a possible risk to infection control. The registered manager said he would address this. Since our visit to the service the manager has sent in photographic proof that they have installed paper towels in all communal toilets.
We checked the water temperature in two communal toilets and found the water was very hot. We were told that these were due to be decommissioned within the next month due to an extension and use of more spacious toilet facilities. As an interim measure the manager put up a sign to warn people that the water was very hot. We were also assured that those people who had dementia were unlikely to use these toilets without assistance.
We checked the staff training and recruitment files and found that the service had robust recruitment processes in place that helped to protect people.