Heatherfield Care Home

Updated 12 July 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 team consisted of 2 inspectors, a medicines inspector, an operations manager and an Expert 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

Heatherfield 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. Heatherfield 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.

What we did before the inspection

We reviewed information we had received about the service. We contacted the local authority commissioning and safeguarding teams for their feedback about 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 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 3 people who lived at Heatherfield Care Home and 11 relatives about their experience of the care provided. We observed interactions between staff and people in communal areas. We spoke with 9 members of staff including the registered manager, deputy manager, nurses, care staff, kitchen staff, and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We spoke with 2 visiting healthcare professionals.

We reviewed a range of records. This included 10 people's care records and 6 people's medication records. We looked at 4 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.

Updated 12 July 2023

About the service

Heatherfield Care Home provides accommodation, nursing and personal care to a maximum of 74 people. At the time of the inspection 67 people were receiving support in a purpose built building across 3 separate units; specialising in nursing care, younger people and dementia care.

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

Most aspects of medicines were managed safely. The management of covert medicines and some documentation was not in line with the provider’s policy. We have made a recommendation about this.

People were safe from the risk of abuse. Risks to people were assessed and regularly reviewed when people's needs changed. Some staff were not fully aware of people’s individual risk assessment details. We have made a recommendation about this. The building was well maintained, and health and safety risks were assessed.

The provider employed sufficient staff, staff were trained appropriately and recruited safely. Staff worked effectively with visiting professionals. Infection control measures were in place, and visiting was managed in line with current guidance.

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.

Care records were person centred. People were supported to eat and drink a balanced diet. Menu choices were not always presented to people living with dementia in line with best practice guidance. We have made a recommendation about this.

The management team worked in partnership with healthcare professionals to ensure people received appropriate support in a timely manner.

There was a positive culture in the service. Staff said the management team were supportive. Most relatives thought the service was managed well. Quality assurance checks were taking place, lessons had been learnt and improvements were made continuously.

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 good (published 25 January 2023).

Why we inspected

We received concerns in relation to end of life care and skin integrity. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

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

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

Recommendations

We have made recommendations in relation to menu choices, risk assessments and medicines management.

Follow up

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