Background to this inspection
Updated
26 July 2022
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
Inspection team
Three Inspectors and an Expert by Experience carried out the inspection. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
Heatherley - Care Home with Nursing Physical Disabilities is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service did not have a manager registered with the Care Quality Commission. This means the Provider is legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was unannounced.
What we did before inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
We spoke with five people who used the service and seven relatives about their experience of the care provided. We spoke with six members of staff including the manager, deputy managers, a nurse and care staff. We reviewed a range of records. This included six people’s care records and multiple medication records. We looked at four staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at further care records, training data and quality assurance records.
Updated
26 July 2022
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
About the service
Heatherley - Care Home with Nursing Physical Disabilities is a residential care home that provide personal and nursing care for a maximum of 42 people. At the time of our inspection there were 33 people living there. People live either in the main building or in one of eight self-contained bungalows located within the grounds. People who lived in the bungalows used the facilities in the main building at any time of day or night. People living at Heatherley had physical disabilities and some people also had a learning disability or acquired brain injury.
People’s experience of using this service and what we found
Based on our review of safe, effective and well-led the service was not able to demonstrate how they were meeting some of the underpinning principles of Right Support, Right Care, Right Culture. However, the provider was working toward meeting the principles, and embedding the positive changes made into the running of the service.
Right Support
People were able to access meaningful activities more regularly than they had been able to previously. Changes were being made so people were supported to identify goals and outcomes and plan the support they needed to achieve these. These improvements were just beginning at the time of inspection and time was needed for this to be embedded and for everyone with a learning disability to benefit from the changes.
Right Care
Care was becoming more person centred and flexible to meet people’s needs. People were supported by a kind and caring staff team who treated them with respect. People's rights were promoted, and they were protected from discrimination. Staff understood their responsibilities to protect people from abuse and knew how to report concerns should they need to.
Right Culture
There was a positive ethos at the service and people were involved in planning their own care and were encouraged to give their views about the support they received. People were supported to develop their skills and to be as independent as possible. People's relatives were able to give their feedback about the support their family members received and their views were listened to.
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; the policies and systems in the service supported this practice.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Why we inspected
This inspection was carried out to follow up on action we told the provider to take at the last inspection. For those key questions not inspected, we used the ratings awarded at the last inspection of these to calculate the overall rating.
Rating at last inspection and update
The last rating for this service was inadequate (published 18 February 2022) and there were breaches of regulations. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
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.