Background to this inspection
Updated
31 March 2023
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 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 was carried out by 2 inspectors.
Service and service type
Healtherlea House Residential Care Home 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. Healtherlea House Residential Care Home 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 reviewed information we had received about the service since the last inspection. We sought feedback from the local authority who work with the service. 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. We used all this information to plan our inspection.
During the inspection
We spoke with 9 people who used the service about their experience of the care provided and observed the care people received. We spoke with 5 members of staff including the registered manager, a senior carer, 2 care workers and the registered provider.
We reviewed a range of records. This included 3 people’s care records and multiple medication records. We looked at 3 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
Following the site visit we continued to seek clarification from the provider and registered manager to validate evidence found.
Updated
31 March 2023
About the service
Heatherlea House Residential Care Home provides accommodation and care for up to 17 older people in one adapted building. On the day of our inspection 16 people were living at the service
People’s experience of using this service and what we found
Risks to people health, safety and welfare had not always been identified or assessed. When risks had been identified, actions had not always been taken to mitigate those risks. In addition, lessons had not been learned and appropriate actions taken following serious incidents.
Medicines were not always managed in a safe way. Recruitment procedures were not always robustly implemented.
Quality assurance systems did not always identify concerns with people’s care or the environment. In addition, they did not include a robust system for recording the actions required and taken to resolve issues or minimise risk.
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 felt safe and well cared for and staff felt supported in their work.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 9 August 2018).
Why we inspected
The inspection was prompted in part by notification of an incident in which a person was seriously injured and subsequently died. This incident is subject to further investigation by CQC as to whether any regulatory action should be taken. As a result, this inspection did not examine the circumstances of the incident. However, the information shared with CQC about the incident indicated potential concerns about the assessment and management of falls risks. This inspection examined those risks.
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.
We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.
For those key questions not inspected, we used the ratings awarded at the last comprehensive inspection to calculate the overall rating. The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Heatherlea House Residential Care Home on our website at www.cqc.org.uk.
Enforcement
We have identified breaches in relation to risk management, medicines management and governance 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.