Heron Hill Care Home

Updated 18 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 3 inspectors, a member of the medicines team, a nurse specialist advisor and 2 Experts 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.

Service and service type

Heron Hill 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. Heron Hill Care Home is a care home with 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.

Inspection activity started on 24 February 2023 and ended on 1 March 2023. We visited the service on 24 February 2023 and returned on 01 March 2023 to look at medicines management and records relating to the management of the service.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We used information gathered as part of monitoring activity that took place on 13 February 2023 to help plan the inspection and inform our judgements. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 19 people who lived in the home and 29 relatives and visitors about their experience of the care provided. We observed how staff interacted with people. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We spoke with the registered manager and 13 members of the care team and 3 ancillary staff. We spoke with the provider’s nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We looked around the home and reviewed a range of records. This included 14 people’s care records. We reviewed 10 medicine administration records. We observed medicines administration, spoke with staff and looked at the governance arrangements for the safe handling of medicines. We looked at records related to the recruitment and training for 5 staff. We also looked at a variety of records relating to the management of the service.

Updated 18 March 2023

About the service

Heron Hill Care Home is a care home providing personal and nursing care to up to 86 people. The service provides support to older people and people who are living with dementia. The home is on three floors and arranged into three units. Nightingale is a general nursing unit on the ground floor. Cavell on the first floor is for people living with dementia and nursing needs. There is a small male only unit, Wheawall unit, accommodating up to 20 men on the second floor. All units have separate dining and communal areas. All bedrooms are single occupancy and have ensuite facilities. At the time of our inspection there were 72 people using the service.

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

People were safe and protected from abuse. There were enough staff, with the right skills, to support people. The provider used safe systems when new staff were employed. Risks to people were identified and managed. Staff followed systems and processes to safely administer, record and store medicines. Regular checks were completed to ensure that should any shortfalls be identified they could be promptly addressed. The registered manager had systems to learn and share lessons from incidents. People were protected against the risk of infection.

People received the support they needed because staff were trained in how to provide their care. Most people were positive about the meals provided. Some people raised concerns about the choice and variety of meals. The registered manager addressed this during the inspection. People’s rights were protected. 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.

Staff planned and provided care to meet people’s needs. People were provided with a variety of activities they enjoyed. One person said, “There is lots to do if you want.” The provider had a procedure for receiving and managing complaints about the service. People received support, as they needed, as they reached the end of life.

People told us the service was well managed and said they would recommend it. The registered manager was committed to providing people with person-centred care. People were asked for their views and their feedback was used to further improve the service. Staff felt well supported and able to provide good care to people. The registered manager and staff worked in partnership with other services to ensure people received the care they needed.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and/or who are autistic.

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 requires improvement (published 4 April 2019).

At our last inspection we recommended the provider made improvements to medicines management, capacity assessments, activities and managing records. At this inspection we found the provider had made the required improvements.

Why we inspected

This inspection was prompted by a review of the information we held about this service. We identified the service may have improved since the last inspection. We carried out a focused inspection to review the key questions of safe, effective, responsive and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.

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 read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Heron Hill Care Home on our website at www.cqc.org.uk.

Follow up

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