Heightside House Nursing Home

Updated 3 November 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 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

The inspection was carried out by an inspector, a medicines inspector and an Exert 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

The service is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

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 Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used all of this information to plan our inspection.

The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.

During the inspection

We spoke with 9 people who lived at the home and 1 visiting relative to gain their feedback about the support provided. We also spoke with the registered manager, 4 nurses, 3 care staff, the head chef, 2 kitchen staff and the maintenance person. We reviewed a range of records, including 2 staff recruitment files, 5 people’s care records, 7 people’s medicines records and other medicines-related documentation.

After the inspection

We spoke with 3 people’s relatives on the telephone. We reviewed a variety of records related to the management of the service, including policies and audits. We contacted 4 community health and social care professionals who visited the service regularly for their feedback about the support provided.

Updated 3 November 2022

About the service

Heightside House Nursing Home is a residential care home providing personal and nursing care to up to 78 people. The service provides support to older people and younger adults with mental health support needs. Accommodation is provided in 4 units; The House, The Mews, Close Care and The Gate House. The House is an adapted building, over 4 floors and incorporates the High Dependency Unit, The Mews is purpose built and consists of one 6 bedded unit, shared bungalows and flats, Close Care is purpose-built and includes a 7 bedded unit and a bungalow and The Gate House is an adapted building and can accommodate up to 3 people. No-one was living in The Gate House at the time of our inspection. There is also a separate activities centre. At the time of the inspection 47 people were living at the service.

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

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.

People’s medicines were not always managed safely or in line with national guidance. People told us they felt safe living at the home, and we found that risks to their health, safety and wellbeing were managed well. Staff were recruited safely and knew how to protect people from abuse and avoidable harm. Staffing levels were appropriate to meet people’s needs and people told us they did not wait long for support. Staff did not always wear appropriate personal protective equipment (PPE) to protect people from COVID-19 and the risk of cross infection. We have made a recommendation about this. Appropriate action was taken to manage accidents and incidents, and the safety of the home environment was checked regularly.

The audits completed by staff and management did not identify many of the shortfalls in medicines processes and practices that we found during our inspection. Where audits had identified that improvements were needed, action had not always been taken. The registered manager and staff understood their roles and responsibilities. They worked in partnership with community health and social care professionals to ensure people received any specialist support they needed. Management sought people’s views about the service and acted upon them. People and staff were happy with the management of the service and felt it had improved under the new registered manager.

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

Rating at last inspection and update

The last rating for the service was requires improvement (published 22 July 2021).

For those key questions not inspected, we used the ratings awarded at the last inspection where those key question were reviewed, to calculate the overall rating.

Why we inspected

We carried out an unannounced focused inspection of this service on 21 June 2021. Breaches of legal requirements were found. We issued the provider with Warning Notices and requested they be compliant by 5 August 2021.

We undertook this focused inspection to check whether the Warning Notices we previously served in relation to Regulation 12 (Safe care and treatment) and Regulation 17 (Good governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been met. The overall rating for the service has not changed following this focused inspection and remains requires improvement.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

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 and will take further action if needed.

We have identified breaches in relation to the management of people’s medicines and the provider’s oversight of medicines processes and practices at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.