Heaton House Residential Care Home

We found the following examples of good practice.

People were well supported by staff to have telephone and internet contact with their family and friends. The staff facilitated in person visits in a manner which minimised the risk of infection spread, including outside visits, and visits using patio doors in ground floor rooms.

The registered manager had plans in place to isolate people with COVID-19 to minimise transmission. The service had good supplies of personal protective equipment (PPE) that were readily available in stations throughout the service.

Visitors were asked health screening questions regarding COVID-19 and were expected to wash their hands with soap and water when they arrived.

Staff had received training on how to keep people safe during the COVID-19 pandemic and staff and residents were regularly tested for COVID-19. The building was clean and free from clutter.

Staff ensured people’s welfare had been maintained and they had sufficient stimulation, such as crafting and music activities.

People’s experience of using this service:

People benefitted from living in a well organised, forward thinking home where their needs were always put first. The culture of the home was open, and people felt confident to express their views and opinions. The management team championed people’s rights and worked collaboratively with staff and external partners to constantly improve the service and develop links with the local community.

The registered manager promoted intergenerational work which had a dramatic and positive effect on people’s wellbeing. Some people also visited the nursery school to watch the children perform school plays which staff, people and children enjoyed enormously. People were enthusiastic about the regular weekly visits from children at a local nursery school and it was apparent how this interaction enriched peoples and the children’s lives.

We observed people became animated and sparkled during musical activities at the service. There was an extensive activity timetable and the registered manager was always keen to add new items to it, including people’s past hobbies and new aspirations. People had planned activities twice a day to keep them as active as possible both mentally and physically.

The registered manager was extremely responsive to new ideas for enhancing people's wellbeing at the home. Staff assisted people to use technology to keep in touch with relatives, this had given relatives the courage to travel as they were sure they could speak face to face via the internet with their relatives. Message apps were also in use to excellent effect, ensuring family groups were included in the news regardless of time zones.

The registered manager, and staff were extraordinarily passionate about providing excellent care for people. This showed in the cheerful moods of people and staff when we visited.

Staff were well trained and supported and people felt safe in their hands. There was enough staff, so that people received care when they needed it. Staff were efficient and well trained, including in dementia care and safeguarding. Messaging apps, phone and emails were used to alert staff to new training and shift changes which supported the effective running of the service. Staff were clear about their roles and were happy and proud to work at the home. The registered manager led by example and fostered a culture of constant learning, keeping themselves and the team up to date with new ideas in dementia care.

People had their choices respected. People were supported to eat and drink at mealtimes by staff who took time to assist them. Staff accompanied people to healthcare appointments outside of the home and the home had good relationships with local GPs and dental surgeries.

Staff worked in partnership with health professionals and therapists to maximise people's wellbeing and wherever possible, improve their health. People enjoyed a wide range of nutritionally balanced meals and specialist diets and preferences were catered for.

The provider had designed the home with people living with dementia in mind, it was bright with dementia friendly signs and decoration. The home was clean and tidy so that people could move around safely. Rooms were effectively themed, décor used contrasting colours to ensure people could see furniture and floor changes clearly, but also inspired conversation around the room’s main topic, for example the seaside.

People were extremely relaxed and happy around the staff. Staff spoke kindly to people and took time with them in their interactions. Staff spoke to people by their preferred name and took time to talk to them and ensure people were always included and comfortable. Staff spoke to people in ways they understood and calmed distressed people by talking about their lives and history. People living with dementia could not always say what they liked, but staff were able to recognise signs around what people wanted based on their knowledge of the person.

Rating at last inspection: The last rating for this service was Good (published 10 May 2017 ).

Why we inspected: This was a planned inspection based on the previous rating.

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.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Heaton House is registered to provide accommodation and personal care for up to 14 people. At the time of the inspection 12 people were living at the home. People had various needs including dementia and physical disabilities.

Heaton House is a small residential home situated in a residential part of Worthing, West Sussex in close proximity to local shops. The home has 13 bedrooms which are spread over two floors. All bedrooms were of single occupancy and had en-suite facilities, 10 bedrooms had showers. Communal areas included a dining area which led into a lounge. The lounge windows overlooked a south facing garden; bird feeders were positioned in view of those using the lounge. In addition a separate open television lounge was available for people.

A registered manager had been in post since 2010. The provider manager was also a registered manager at Heaton House Residential Care Home. 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. Both registered managers were present throughout the inspection.

People and their relatives felt Heaton House was a safe environment. There was sufficient staff who had been trained in how to recognise signs of potential abuse and protected people from harm. Risks to people had been identified and assessed and information was provided to staff on how to care for people safely and mitigate any risks. People’s medicines were managed safely and administered by trained staff. The service followed safe staff recruitment practices and provided a thorough induction process to prepare new staff for their new role.

We found the home to be clean and tidy and maintained to a high standard. Home furnishings such as pictures and photographs decorated communal areas and hallways attractively. The ambience of the home was warm and inviting.

Staff implemented the training they received in core subject areas by providing care that met the needs of the people they supported. Staff received regular supervisions and spoke positively about the guidance they received from the managers.

Staff understood the requirements under the Mental Capacity Act 2005 and about people’s capacity to make decisions. They also understood the associated legislation under Deprivation of Liberty Safeguards and restrictions to people’s freedom.

Additional drinks and snacks were observed being offered in between meals and staff knew people’s preferences and choices of where and what they liked to eat.

Staff spoke kindly to people and respected their privacy and dignity. Staff encouraged people to be as independent as possible. Staff knew people well and had a caring approach.

People were supported to express their views and were actively involved in decisions about their care and treatment as much as they were able.

People received personalised care. Care plans reflected information relevant to each individual and provided clear guidance to staff on how to meet people’s needs. Staff were vigilant to changes in people’s health needs and their support was reviewed when required. If people required input from other health and social care professionals, this was arranged.

People, relatives and staff told us they were happy with the activities that had been organised. The home organised a variety of entertainers to engage with people. People and their relatives were listened to by the registered manager and the staff team.

There was a complaints policy in place. People and their relatives knew who to go to with any concerns they had.

People and their relatives felt the home was well led. The registered manager was open and approachable. A range of quality audit processes overseen by the registered manager were in place to measure the overall quality of the service provided and to make any necessary improvements.

During our inspection we observed that staff treated people with warmth and genuineness. One person said about the staff, "They are so kind."

We looked at the care records of three people. We saw evidence that care had been planned and delivered in line their individual needs. We also saw evidence that arrangements were in place to obtain valid consent from people to the care they received.

We spoke with three members of staff. They said they worked as a team and that they felt there was enough staff on duty to meet people's needs.

We saw that the home had arrangements in place for controlling the risk of infection. When we looked around the home we saw that it was kept clean and free from odour.

The home had a complaints policy and procedure in place. The people we spoke with said they knew who to contact if they had any concerns. They were all satisfied that any concerns were dealt with.

Staff received appropriate professional training, development and supervision. There were effective recruitment and selection processes in place and appropriate checks were undertaken before staff began work.

We observed staff in their interventions with service users and we also looked at records of care and support for three people in detail. We found that people's privacy, dignity and independence were respected. People told us they were very satisfied with the quality of service provided at Heaton House.

People who use the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

People who use the service and/or their representatives were asked for their views about their care and treatment and they were acted on. The manager was able to demonstrate a good understanding of the needs and wishes of the service users.