Archived: Heathercroft Care Home

Updated 7 May 2021

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 Care Act 2014.

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

This inspection was carried by two inspectors, an inspection manager and an Expert by Experience. 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

Heathercroft Care Home 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 meant the provider was 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 the 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.

During the inspection

We spoke with four people who used the service and 14 family members about their experience of the care provided. We spoke with 12 members of care staff, the deputy manager, Director and Chief Operating Officer and Quality and Compliance Director.

We reviewed a range of records which included six people's care records, multiple medication administration records from across the different units, and five staff personnel files in relation to recruitment. We also reviewed a variety of records relating to the management and governance of the service, including policies and procedures.

After the inspection

We continued to review evidence that was sent remotely as well as seeking clarification from the provider to validate evidence found. We looked at audit and governance data, as well as infection prevention and control policies and procedures.

Updated 7 May 2021

About the service

Heathercroft Care Home is a 'care home.' The service is registered to provide nursing and personal care for up to 88 older people across two purpose-built units; Heathercroft unit is for people with nursing and personal care needs and the Ashberry unit is for people living with dementia. Following our last inspection, we imposed conditions to remove the nursing element of the location's registration. At the time of our inspection there were 41 people being provided with accommodation and personal care.

People's experience of using this service and what we found

People's health, safety and wellbeing were sometimes put at risk due to a number of concerns identified during this inspection. Risk management was not always consistent, and people and family members did not always feel assured about their safety. Staff did not always have the right skills, knowledge or experience to carry out their role safely and effectively.

There were not enough assurances that the service consistently met current national guidance and standards in relation to infection prevention and control (IPC). Staff had limited knowledge about some IPC procedures, including the removal and disposal of PPE. There was limited assurance that staff were taking part in regular COVID-19 testing. The provider did not always make sure that adequate measures were in place to prevent the spread of infection; particularly in relation to COVID-19.

The service had experienced a long history of inconsistent management and poor compliance with regulations. This had lead to low staff moral and poor team cohesion. Family members told us communication from managers was poor, and people spoke negatively about the constant change in management. Staff felt the service was disorganised due to lack of consistent management and provider support.

There were widespread, significant shortfalls in the way the service was led which had resulted in multiple and continued breaches of regulations. Governance systems were not robust enough to identify issues and drive improvement. Staff did not feel involved, appreciated or engaged with.

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

Rating at last inspection and update

The last rating for this service was inadequate (report published 29 October 2020) and there were multiple breaches of regulations.

Why we inspected

This inspection was prompted in part due to concerns received about staffing, lack of staff training and inconsistent management. A decision was made for us to inspect and examine those risks and to follow-up on concerns identified at the previous inspection and to check whether any improvements had been made.

This report only covers our findings in relation to the Key Questions Safe and Well-led. The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has remained inadequate. This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvements. Please see the Safe and Well-led sections of this full report.

The provider took some actions following the inspection to mitigate some risk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified repeated breaches in relation to Regulation 12 (Safe care and treatment), Regulation 17 (Good governance) and Regulation 18 (Staffing). We have also identified a new breach of Regulation 13 (Safeguarding people from abuse).

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

The service remains in special measures'. We will keep the service under review and, if we do not propose to cancel the provider's registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe, and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it, and it is no longer rated as inadequate for any of the five key questions, it will no longer be in special measures.