Heanton Nursing Home

Updated 17 April 2021

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

As part of CQC’s response to the coronavirus pandemic we are looking at the preparedness of care homes in relation to infection prevention and control. This was a targeted inspection looking at the infection control and prevention measures the provider has in place.

This inspection took place on 21 December 2020 and was announced.

Updated 17 April 2021

This inspection was completed on the 18 and 23 July 2018 and was a planned comprehensive inspection looking at all five key questions. Prior to this, the last inspection was completed as a responsive focussed inspection which took place in March 2018. This was in response to a specific incident of someone swallowing a hazardous substance. The Care Quality Commission (CQC) wanted to ensure people were safe and systems were in place to prevent any further incident occurring. In March 2018 we only looked at the key questions of safe and well-led. We did not identify any areas of concern and the service improved to a rating of overall good.

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

Heanton accommodates up to 52 people in one adapted building. The service is divided into three separate units which the service calls ‘houses’ by the name of Watersmeet, Exmoor and Williamson. Williamson is on the ground floor and caters for people living in the earlier stages of dementia. Also on the ground floor is a smaller house - Exmoor. This caters for people with complex needs due to their dementia needs. Upstairs there is one house - Watersmeet for people living with dementia who were in a repetitive stage or advanced stage of their dementia. The provider has developed and implemented this care model based on the household model of care pioneered in the USA by LaVrene Norton, Action Pact and Steve Shields. At the time of the inspection there were 51 people living at the service.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Staff offered care and support which is exceptionally caring and compassionate. People mattered and staff had a detailed understanding of people’s likes, preferences and wishes. People were asked to think of a wish and staff went out of their way to achieve this. Some staff came in on their day off to take people out for trips and meals out. Staff visited people in hospital in the own time, to keep in contact and show they cared. Staff knew people and their families well and worked in a person centred way.

The visions and values were imaginative and people were at the heart of the service. The registered manager and senior leaders led by example. The service was really well led and creative in the way they developed the service. They had developed bespoke training which gave staff the enthusiasm to embrace their vision and values to provide a family and home like environment where people felt safe and loved. This was evident in our observations, in records and in the way staff spoke passionately about people. There were strong links with the local community. The management team looked for ways to ensure people, their family and staff were involved in the running and improvement of the service.

The service was exceptional at helping people to express their views so that all staff understood their views, preferences, wishes and choices. They did this by ensuring staff had the skills to understand and interpret people’s complex ways of communicating.

There were sufficient staff with the right skills and understanding of people’s needs and wishes. Some concerns had been expressed following the inspection about insufficient staff on duty. The provider was open and honest in identifying there had been times when they had been short on their preferred numbers in the last month or so. However, the provider, registered manager and staff team all agreed that people’s needs and safety were not compromised due to staff shortages because of sickness. People and their relatives said staff were exceptionally kind and helpful. Our observations showed staff respected people’s dignity and privacy and worked in a way which showed kindness and compassion. This indeed where people were nearing the end of their life.

Care and support was person centred and really well planned. Staff had good training and support to do their job safely and effectively. Activities were tailored to meet individual’s needs.

People were supported to have maximum choice and control of their lives and staff supported

them in the least restrictive way possible; the policies and systems in the service supported this

practice. People's consent to care and treatment was sought. Staff used the Mental Capacity Act (2005) (MCA) and Deprivation of Liberty Safeguards (DoLS) and understood how these applied to their practice.

Risk assessments were in place for each person. These identified the correct action to take to

reduce the risk as much as possible in the least restrictive way. People received their medicines

safely and on time most of the time.

Staff understood about abuse and who and when they should report any concerns to. Recruitment practices were robust and ensured only staff who were suitable to work with vulnerable people were employed.

People enjoyed a wide and varied choice of meals. Mealtimes were relaxed and enjoyable for people.

Quality assurance processes and audits helped to ensure that the quality of care and support as

well as the environment was closely monitored. This included seeking the views of people and

their relatives.