Heaton House Care Home

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• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

During our assessment of this key question, we found limited improvements had been made regarding staff training, support, and supervision. The provider could not demonstrate staff were up to date with their training and it was not clear from documents in place, which training sessions the provider considered to be mandatory or should be prioritised. This has resulted in a breach of regulation relating to staffing. You can find more details of our concerns in the evidence category findings below. Staff did not always work effectively with other relevant health professionals to meet people's changing needs. Support had not always been sought, for example, regarding diet types and people had not always been effectively assessed for any difficulties with eating and drinking, which placed people at risk. The systems and processes in place did not always ensure people’s care plans were up to date which increased the risks to people of receiving inconsistent support. Changes in people’s health and wellbeing were not always identified in a timely manner. Care plans and related documentation either contained a lack of detail or were contradictory; staff had not always followed required processes. Where people required or received a modified diet, the correct terminology was not always used within care documents. One relative told us they were aware staff had referred [person] to other health professionals, such as doctors and opticians, however, another relative told us no-one ever visited to cut [person's] finger nails.

This service scored 50 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Assessing needs during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Delivering evidence-based care and treatment during this assessment. The score for this quality statement is based on the previous rating for Effective.

The provider had not done all that was reasonably practicable to ensure they worked alongside other health and social care professionals to meet people's needs, for example referrals were not always made to speech and language therapists when the need was indicated, or the correct terminology was not used within care documentation. The provider did not have a routine structure of audits in place to ensure people were safe and staff were providing effective care which met people's needs. We noted one person's room was extremely untidy and disorganised. The deputy manager told us this was normal, however, after staff supported the person to tidy it, within a short space of time the room was back to being untidy. We found no reference to this in the care plan or any evidence to identify if the issue had been escalated to the person's social worker or other professionals for assessment. There was no evidence of the provider or deputy manager providing regular staff supervision; the deputy manager told us there was no staff supervision matrix for 2023. The deputy manager told us the 'resident of the day process' was due to start in November 2023; they said, "There is a form which the seniors have been completing, it has not been done consistently." Neither the provider, deputy manager, senior staff or care staff had identified the issues we found during this on-site assessment visit.

The local authority told us they had a number of concerns about the provider in relation to staff support and supervision, staff recruitment and staff training. The local authority also identified policies hadn’t been reviewed and there were no logs in place to support management in the monitoring and reviewing of DoLS, accidents and incidents, complaints and safeguarding. The local authority safeguarding team had been providing extensive support on safeguarding and safety to staff at Heaton House and raised concerns that improvements had not taken place. The local authority noted that although hands-on care by the care staff was considered good, the provider systems in place were significantly lacking.

We did not look at Supporting people to live healthier lives during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Monitoring and improving outcomes during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Consent to care and treatment during this assessment. The score for this quality statement is based on the previous rating for Effective.