Heathlands Care Centre

Updated 13 December 2023

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

The inspection team consisted of 3 inspectors, 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. They contacted people's relatives for feedback about the service.

Heathlands Care Centre is a 'care home'. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Heathlands Care Centre is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

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 looked at all the information we had collected since the last inspection of the service including information from the local authority and notifications sent to CQC. A notification is information about important events which the service is required to tell us about by law. We reviewed the Provider Information Return (PIR). 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. We used all this information to plan our inspection.

During the inspection

We spoke with the registered manager, the deputy manager, one registered nurse, the administrator, a consultant employed by the provider, a maintenance officer and the chef. We also spoke with 2 members of care staff. As people were not able to speak with us we observed staff supporting people in communal areas. We spoke with 13 relatives about people’s care and support. We reviewed a range of records. This included 6 people's care records, 6 staff personnel files and 6 medicines administration records. A variety of records relating to the management of the service, including audits, policies and procedures were also reviewed.

Updated 13 December 2023

Heathlands Care Centre is a residential care home providing personal and nursing care to up to 46 people. The service provides support to older people including people with dementia and other mental health needs. The service is provided over two floors. At the time of our inspection there were 15 people using the service.

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

Changes had been made to improve the quality and safety of care delivered. However, insufficient time had passed to demonstrate sustained improvements.

Staff were not always provided with clear guidance about how to manage risks for people. Care plans contained inaccurate and contradictory information.

People were not always protected from the risk of abuse. We observed a staff member forcefully put a spoon in someone's mouth whilst supporting them to eat.

People were not always given person-centred care. The provider had not ensured people’s care plans contained sufficiently detailed or accurate information to support staff to meet people’s needs and preferences.

Improvements to people’s dining experience had been made by staff. People were supported to maintain a healthy diet. The food was varied and appealing and alternatives were offered at mealtimes. Snacks and drinks were available at all times.

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 consent to receiving care and support was sought by staff.

Staff reported safeguarding concerns to the relevant authorities. Enough staff were deployed to support people. Medicines were managed safely. People were protected from the risk of acquiring an infection. Staff reflected on incidents and accidents to prevent recurrences.

People's needs, choices and preferences were assessed using evidence based methods. Staff training in relevant and specific areas was up to date. Staff worked with external professionals to meet people's needs and help them access healthcare services. Improvements to the environment had been made to ensure it met the needs of people living with dementia.

Some improvements to systems and processes were in place to ensure the delivery of safe, compassionate, well-led care. The provider was no longer in breach of some regulations, but some breaches have continued at this inspection. The registered manager used the action plan to track progress. There was a programme of audits, completed at different intervals, however more time is required to embed the new system of audits and checks. There is evidence of meetings with, relatives and staff, however there was a lack of evidence to demonstrate people’s views were recorded and acted upon. The registered manager and clinical lead work collaboratively to implement and review service improvements. Staff reported an improved workplace culture.

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

This service has been in Special Measures since 23 February 2023. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

The last rating for this service was inadequate (report published 23 February 2023) and there were 9 breaches of regulations.

We served a warning notice against the provider and issued 8 requirement notices. For the requirements notices, 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 the provider had complied with some regulations but remained in breach of other regulations.

At our last inspection we recommended that staff receive training in legionella management. At this inspection we found the service made progress towards this recommendation.

Why we inspected

This inspection was prompted due to the previous rating and to follow up on a warning notice.

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.

You can see what action we have asked the provider to take at the end of this full report by selecting the 'all reports' link for Heathlands Care Centre on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to person centred care, safe care and treatment and good governance. We have made a recommendation to the provider regarding investigating and responding to concerns raised. Please see the action we have told the provider to take at the end of this report.

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 continue to monitor information we receive about the service, which will help inform when we next inspect.

The overall rating for this service is ‘Requires improvement’. However, we are placing the service in 'special measures'. We do this when services have been rated as 'Inadequate' in any Key Question over two consecutive comprehensive inspections. The ‘Inadequate’ rating does not need to be in the same question at each of these inspections for us to place services in special measures. This means 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, 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.