Heatherlea House Residential Care Home

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.

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 15 people were living at the service

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

This was a targeted inspection that considered how the service managed the risks associated with people’s level of mobility and the potential for falls to occur.

Risks were identified, assessed and regularly reviewed to minimise the risk of people experiencing falls. However, risk management plans did not always reflect essential details of the support people received. In addition, analysis of any falls trends was not always clearly recorded.

People were supported to move around in a safe way, whilst maintaining as much independence as possible. People told us they were happy and felt safe with the support they received.

Staff were trained to support people with their mobility. Appropriate equipment was in place to enable staff to assist people to mobilise in a safe way.

Lessons were learned when falls had occurred and actions were taken to minimise the risk of reoccurrence.

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 a specific incident where a person using the service died. This inspection did not examine the circumstances of the incident.

The information CQC received about the incident indicated concerns about the management of falls. This inspection examined those risks.

We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe section of this full report.

We also 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 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.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

There was a registered manager in post who was available throughout the inspection. 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.

People living at the service were protected from harm as the provider had robust processes in place to ensure their safety. Staff supporting people were aware of their responsibilities in relation to protecting people from abuse. They had received appropriate training to support their understanding of any safeguarding issues. The registered manager reported any issues of concern to both the CQC and the local safeguarding teams and worked in an open and transparent manner. There were clear processes in place to ensure lessons were learnt following any incidents or events.

The risks to people’s safety were clearly identified with measures in place to reduce these risks. The environment and essential equipment were well maintained.

People were supported by well-trained and competent staff in sufficient numbers to keep them safe. Their medicines were managed safely and people were protected from the risk of infection through good hygiene practices and staff knowledge of reducing the risks of cross infection.

People’s needs were assessed using effective evidenced based assessment tools. These were then used to provide clear guidance for staff to assist them gain a good understanding of an individual’s needs and offer the most effective support to people. Staff were supported with appropriate training for their roles.

People were supported to maintain a healthy diet, with staff showing good knowledge of people’s nutritional and health needs. They received support to manage their health needs through well-developed links with local health professionals. The environment people lived in was a well maintained safe environment which met their needs.

Staff sought consent from people before caring for them and they understood and followed the principles of the Mental Capacity Act, 2005 (MCA). 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 at the service, and relatives were treated with kindness and care by staff who supported people with respect and dignity, and developed positive relationships with people in their care.

People were able to maintain relationships with people who were important to them and relatives felt their views and opinions about their loved one’s care were listened to.

The care people received was person centred and met their individual needs, they were supported to take part in a range of social activities to prevent isolation. People’s wishes in relation to their end of life care were discussed with them so their wishes were known. There was a complaints procedure in place and people knew who to complain to should they have any issues.

The service was well led, the registered manager was visible and supportive towards people, their relatives and the staff who worked at the service. The quality assurance systems in place were used effectively to monitor performance and quality of care. The registered manager responded positively to changes and used information to improve the service and care people received.