The Care Quality Commission
  • Care Home
  • Care home

Archived: Hevercourt

Overall: Good read more about inspection ratings

Goodwood Crescent, Singlewell, Gravesend, Kent, DA12 5EY (01474) 363690

Provided and run by:
Avante Care and Support Limited

Important: We are carrying out a review of quality at Hevercourt. We will publish a report when our review is complete. Find out more about our inspection reports.

All Inspections

7 and 8 April 2015

During a routine inspection

The inspection was carried out on 7 and 8 April 2015 and was unannounced.

At the previous inspection in April 2014 we identified two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. The breaches were in relation to the accuracy of records because not all risks associated with people’s care had sufficient guidance for staff to follow and staff were not always receiving supervision. The provider sent us an action plan telling us they would be meeting the regulations by 2 January 2015. At this inspection we found they were meeting the regulations and improvements had been made.

The service provided accommodation and personal care for older people some of whom may be living with dementia. The accommodation was adapted for people living with dementia and is arranged over three floors. There were 36 people living in the service when we inspected. A passenger lift is available to take people between floors.

There was a registered manager employed at the service. 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.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care services. Restrictions imposed on people were only considered after their ability to make individual decisions had been assessed as required under the Mental Capacity Act (2005) Code of Practice. The registered manager understood when an application should be made. Decisions people made about their care or medical treatment were dealt with lawfully and fully recorded.

Appropriately trained staff were not always deployed to deliver care in a timely way which meant people did not receive their medicines at the times it had been prescribed.

We have made a recommendation about this.

People felt safe. Staff had received training about protecting people from abuse and showed a good understanding of what their responsibilities were in preventing abuse. Staff were trained to spot the signs of abuse in people living with dementia. The management team had access to and understood the safeguarding policies of the local authority.

Risks were assessed and management plans implemented by staff to protect people from harm. The risk in the service was assessed and the steps to be taken to minimise them were understood by staff.

The registered manager and care staff assessed people’s needs and planned people’s care to maintain their safety, health and wellbeing. Assessments and care plans were reviewed as people’s needs changed or their dementia became more challenging.

There were policies and a procedure in place for the safe administration of medicines. Staff followed these policies and had been trained to administer medicines safely.

People had access to GPs and their health and wellbeing was supported by prompt referrals and access to medical care if they became unwell. There were good links with the district nursing team to promote people’s health and wellbeing. Additional training and skills development was provided to staff so that they understood how to manage people with behaviours that may challenge.

People and their relatives described a service that was welcoming and friendly. Staff provided friendly compassionate care and support. People were encouraged to get involved in how their care was planned and delivered.

Staff upheld people’s right to choose who was involved in their care and people’s right to do things for themselves was respected.

The registered manager involved people in planning their care by assessing their needs when they first moved in and then by asking people if they were happy with the care they received. Staff received training about dementia and knew people well. People had been asked about who they were and about their life experiences. This helped staff deliver care to people as individuals.

Incidents and accidents were recorded and checked by the registered manager to see what steps could be taken to prevent these happening again. However we found one incident that had not been checked by the registered manager.

The registered manager ensured that they had planned for foreseeable emergencies, so that should they happen people’s care needs would continue to be met. The premises and equipment in the service were well maintained.

Recruitment policies were in place. Safe recruitment practices had been followed before staff started working at the service. The registered manager ensured that they employed enough staff to meet people’s assessed needs. Staffing levels were kept under constant review as people’s needs changed.

Staff supported people to maintain their health by ensuring people had enough to eat and drink. All of the comments about the food were good.

If people complained they were listened to and the registered manager made changes or suggested solutions that people were happy with.

People felt that the service was well led. They told us that the management team were approachable and listened to their views. The registered manger and provider monitored health and safety within the service to prevent accidents. The care being delivered and the development of the service was focused on recognised best practice for people living with dementia.

We found a of breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have taken at the back of the full version of the report.

29 April 2014

During a routine inspection

Hevercourt is a care home for up to 46 older people and older people living with dementia. At the time of our inspection there were 36 people living at the home.

The service had a registered manager who was responsible for the day to day operation of the home. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service and has the legal responsibility for meeting the requirements of the law with the provider.

We were able to talk with some people using the service but not everyone was able to tell us about their lifestyle and how they preferred to be supported and cared for.  We used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us. We spent some time with people and observed their lifestyle and interactions with the staff.  Using SOFI we observed how people reacted and responded to see if people indicated they were receiving the care they needed.

We could not be sure that safe care was being delivered as we found that risk assessments did not have sufficient guidance for staff to follow to manage the risks. We also found that risk assessments were not written in enough detail to ensure people were protected from the risk of harm. Improvements were needed in this area. We have told the provider to take action about these concerns.

The level of detail in care plans about people’s choice, preferences and independence skills in relation to their personal care routine varied. Therefore records did not ensure people received a consistent approach to their care and support. The registered manager was aware of these shortfalls and the service was in the process of taking action to improve the care plans.  We found improvements were needed in this area. We have told the provider to take action about these concerns.

Relatives told us they were satisfied with the service received and said that staff were kind and caring and respected people’s rights and dignity. We found that people using the service were treated with kindness and respect. We saw that people’s preferred name was recorded in their care plan and we heard this being used by staff. 

Staff had received training in the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). Where people were unable to make more complex decisions, such as agreeing to medical treatment, there were systems in place to manage this in line with legal requirements.

There were sufficient staff on duty at the time of the inspection with the skills and knowledge to ensure that people’s needs were met. However the system to make sure that staff were receiving individual meetings with their manager to discuss their training needs and development were not being effectively managed.  Improvements were needed in this area. We have told the provider to take action about these concerns.

There was a management structure in the home, which gave clear lines of responsibility and accountability.  The management in the service carried out quality monitoring to assess the quality of care provided and plan on-going improvements. These included audits of practice, however we found the home’s systems were not always effective in highlighting and addressing shortfalls in practice.

10 July 2013

During a routine inspection

Assessments were undertaken on admission to the home and the care plans had been developed and drawn up with the individual, where possible, and their families had been consulted on every aspect of the care plan. We saw staff interacting with people in a positive and encouraging way.

We saw there were pre assessments carried out before people came to live at the service. This was to ensure that the service could meet the individual needs of the person. We observed staff using a range of manual handling aids such as slings and handling belts. We saw that where manual handling took place there were two staff providing support.

We noted that windows restrictors appeared to be integrated into the hinging system of the windows. We asked the manager about this and they told us that they would check to ensure this type of window restrictor meets guidance from the Health and Safety Executive for care homes. We saw that the service and grounds were clean and well maintained. We saw that the home made good use of signage to remind people about good hygiene practices.

Staff told us that they felt supported by the new management team. They told us the service had improved since the management team had stabilised. One member of staff said, 'The atmosphere is so much better, things have changed for the better' another said 'People are treated with respect; you can see its getting better'.

During our last inspection on the 21st March 2013 we found that there were not enough staff on duty to meet the needs of people who used the service. At this inspection we found the provider had taken steps to ensure that staff were deployed effectively.

The provider had a quality assurance system in place that covered all the main aspects of the service. We saw that the service benefited from audits that were undertaken by a Quality Manager. (Quality managers are employed by this provider carry out audits of its services and make recommendations for the manager to follow)

21 March 2013

During a routine inspection

There were 25 people living at the service at the time of our inspection. We were unable to speak with people at length as many had dementia. We used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us. We examined the care records of five people who used the service. We also spoke with six staff working at the time of our inspection.

We found that people's dignity and independence were not always respected. We observed instances where people's independence was not promoted during meal times. There was scope to better conserve people's dignity when they were moved using a hoist.

We saw evidence that care provided to people met their individual needs, their care plans were well formulated and were person centred and specific to the individual. We witnessed incidents of people being moved in an incorrect sized sling when being assissted with a hoist. This placed them at risk of harm and/or injury.

We found there were insufficient staff on duty at the time of our inspection to support the needs of people using the service. We viewed the staff roster, spoke with six members of staff and undertook observations as part of our judgement.

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

5 January 2012

During a routine inspection

During the course of the day we met or talked with some of the people who were living in the home. Not all of the people were able to tell us their views due to their individual needs and difficulties with communication. We used a formal way to observe these people. This is called the 'Short Observational Framework for Inspection' (SOFI). This involved observing up to five people for up to one and a half hours in the main lounge area of the home. This included looking at people's state of well being, the interaction from care staff and how they were occupied. The findings of our observations are included in this report.

We were able to speak with relatives who were visiting and they all spoke positively about the support provided from staff. They told us that they felt the staff were kind and caring and patient with the people who lived in the home. One family member told us about their experience when their relative moved into the home. They said "Everyone was very helpful, we were able to look around first and the care provided was very good".

Two relatives told us that they thought there was not much for people to do and they found that the activities were lacking.

Our observations during the SOFI and throughout the day showed us that staff were kind and caring. There were times, however, when staff were too busy to be able to spend time with the people in the home. We saw that this was particularly widespread in the morning, when we observed many people spending time isolated in the communal areas without any interaction.