Archived: Heatherlea House Residential Care Home

This inspection took place on 31 August 2016 and was unannounced. Heatherlea House provides care for older people who have mental and physical health needs including people living with dementia. It provides accommodation for up to 17 people who require personal and nursing care. At the time of our inspection there were 15 people living at the home.

There was a registered manager in post. 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.

On the day of our inspection staff interacted well with people and people were cared for safely. People and their relatives told us that they felt safe and well cared for. Staff knew how to keep people safe. The provider had systems and processes in place to keep people safe. Medicines were administered and stored safely.

We saw that staff obtained people’s consent before providing care to them. The provider acted in accordance with the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). The MCA provides the legal framework to assess people’s capacity to make certain decisions, at a certain time. If the location is a care home the Care Quality Commission is required by law to monitor the operation of the DoLS, and to report on what we find.

We found that people’s health care needs were assessed and care planned and delivered to meet those needs. People had access to healthcare professionals such as the district nurse and GP and also specialist professionals. People had their nutritional needs assessed and were supported with their meals to keep them healthy. People had access to drinks and snacks during the day and had choices at mealtimes. Where people had special dietary requirements we saw that these were provided for.

There were sufficient staff to meet people’s needs and staff responded in a timely and appropriate manner to people. Staff were kind and sensitive to people when they were providing support and people had their privacy and dignity considered. Staff had a good understanding of people’s needs and were provided with training on a variety of subjects to ensure that they had the skills to meet people’s needs. The provider had a training plan in place and staff had received regular supervision. People were encouraged to enjoy a range of hobbies and social activities. They were supported to maintain relationships that were important to them.

Staff felt able to raise concerns and issues with management. Relatives were aware of the process for raising concerns and were confident that they would be listened to. Regular audits were carried out and action plans put in place to address any issues which were identified. Accidents and incidents were recorded. The provider had informed us of notifications as required by law. Notifications are events which have happened in the service that the provider is required to tell us about.

A single inspector carried out this inspection. The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well-led?

Below is a summary of what we found. The summary describes what we observed, the records we looked at and what people using the service and staff told us.

If you want to see the evidence supporting the summary please read the full report.

Is the service safe?

Staff demonstrated a good understanding of how to support people to make decisions and how the Mental Capacity Act (2005) should be used to protect people's rights. Records showed they had received training about this subject.

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. There were no applications needed or made by the home under this legalisation since our last inspection visit.

We saw people were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines. These arrangements included safe storage of medication, staff training about how to give medications in a safe way

The provider had a plan in place to deal with emergencies such as the failure of essential services such as gas or electricity and fire or flooding so that people were assured their accommodation and care needs would be met.

Is the service effective?

People had individual care plans which set out their care needs. Records showed people and their representatives were involved in developing and reviewing care plans.

People told us that staff helped them to make their own decisions and listened to their views about their care. They told us staff always asked for their consent before they carried out any care tasks. There was an advocacy service available if people needed it.

Records showed that people were able to see their GP or other healthcare professionals whenever they needed to. One person told us about a recent health issue they had and we saw their personal records reflected this.

Is the service caring?

Throughout our visit we saw staff approached people in a kind and friendly manner. They made sure people had privacy when they wanted it. They spoke with people in a respectful tone and manner.

People said things like, 'I couldn't wish for anywhere better', 'Coming into a care home is not what I'd choose but because I had to this is the best place' and 'They look after me really well.' A relative told us, 'If it wasn't for the good care xxx wouldn't still be here.'

Is the service responsive?

People we spoke with told us they were able to express their views about the home and be involved in decisions about how the home was run. They told us staff always listened to their views and opinions and acted upon them.

As a result of the care review process a general increase in people's bathing needs had been highlighted. The provider, staff and people who lived in the home told us about the plans to install a ground floor shower room to better meet people's needs.

Is the service well-led?

The manager was on extended leave during our visit. The provider had made arrangements for the deputy manager to carry out the managers role until they returned. The deputy manager told us the provider was very supportive. Staff told us they were well supported by the provider and the deputy manager and their views were listened to.

The provider had an effective system to regularly assess and monitor the quality of service that people receive.

We saw people who lived in the home were consulted about how they liked their care to be delivered and were asked for their views about how the home was run.

People had been given accurate information about the fees they would have to pay. Records showed that people had been correctly charged for the facilities and services they had received.

Some of the systems used for planning, delivering and recording the provision of care were not robust. This increased the risk that people would not receive safe and consistent care.

Arrangements for giving people medication were not wholly reliable. This had resulted in a medication error that had not been identified and corrected.

There were enough staff on duty to meet people's needs for assistance.

Some of the quality assurance systems were not well organised. This increased the risk that people would not reliably receive all of the facilities and services they needed.

People told us they felt safe living at the home and they could make choices and decisions about the care they received. They also told us they knew how to make a complaint if they needed to.

We saw people received individualised care and support, from staff that were knowledgeable about their needs, wishes and preferences.

People made comments such as, 'I can choose what I want to do, they [staff] help me with anything I want' and 'Nothing is too much trouble for them [staff], if I want them they're here within minutes. They stop by for a chat which I really enjoy.'