The Care Quality Commission
  • Care Home
  • Care home

Archived: Heronswood Residential Care Home

51 Harestone Hill, Caterham, Surrey, CR3 6DX (01883) 344645

Provided and run by:
S.E.S Care Homes Ltd

All Inspections

16 September 2014

During an inspection looking at part of the service

During our inspection in June 2014, we found the provider had not met the regulations in relation to infection control and safety and suitability of premises.

We carried out this follow up inspection to check that the provider had taken the necessary action to make changes to some of their practices in relation to infection control. We also wished to check that repairs to the premises had been carried out as promised by the provider.

We saw staff stored mops correctly, kept collection bins locked and repairs had been made to people's living space to keep them safe from infection.

The provider had employed a maintenance person who had started to make repairs to the exterior and interior of the premises. We saw that people who used the service could now sit outside when they wished.

15 May 2014

During a routine inspection

We carried out an inspection at Heronswood Residential Care Home to look at the care and treatment that people who used the service received.

At the time of our inspection the service provided care and support to seven people. As part of our inspection we spoke with three people who used the service and three relatives. We also spoke with six staff which included the new manager and the operations manager.

We considered our inspection findings to answer questions we always ask:

Is the service safe?

Is the service effective?

Is the service caring?

Is the service responsive?

Is the service well-led?

Is the service safe?

We saw that, where appropriate, extra security had been installed which ensured the safety of the people who lived there. For example we saw that alarms had been installed on external doors to alert staff should a person wander out unaccompanied. This had followed an absconsion in 2013.

When we looked at a sample of care plans we found that risk assessments were in place to provide information to staff to help minimise any identified risks. We asked relatives if they felt their family member was safe, one relative told us, 'Yes, I really do.'

We saw that staff had received training in safeguarding vulnerable adults which showed us that staff would know what to do should they suspect any abuse was taking place.

Is the service effective?

We saw that people's care plans had been regularly reviewed which ensured they remained up to date in order to reflect a person's needs. Both the people who used the service and their relatives told us that staff had a good understanding of their needs. One relative said, 'They know their needs totally.' Another relative told us, 'I really can't fault them.'

Is the service caring?

We saw that people were supported by extremely kind and attentive staff. Staff were seen to interact with people well. We saw that staff spent time sitting chatting and laughing with people.

One person who used the service told us, 'The staff are kind. They help me.'

Is the service responsive?

We saw that where people's needs had changed, or their health deteriorated, staff responded by involving an appropriate health care professional. One relative whose family member's mobility had improved since they had lived at Heronswood said that they felt that this was down to the staff.

Is the service well-led?

The provider had systems in place for monitoring the quality of the service. We saw that the new manager was making changes in response to some comments and suggestions from relatives.

21 August 2013

During a routine inspection

People told us they had enjoyed their meal, liked the food and they got enough to eat.

People also told us their room was cool enough in summer, warm enough at night and in winter and that they liked their rooms.

Two people told us the staff were good but sometimes they had to wait for help.

We found there were not always enough skilled and qualified staff to meet people's needs, because the provider had not reassessed staffing needs and increased staffing accordingly, when the level of need and numbers of people living at the service had increased significantly.

People who used the service, staff and visitors were not protected against the risks of unsafe or unsuitable premises.

The provider did not have effective systems in place to monitor quality and assess and manage risks to health, safety and welfare.

We found that registered person was not notifying the Commission of incidents they are required to and particularly those referring to falls.

21 March 2013

During a routine inspection

We spoke to two people who used the service and they told us that they were "very happy at the home" whilst another told us that the staff were "very friendly and lovely people". People told us they liked living at Heronswood Residential Care Home although one person told us there were not always enough activities.

We saw that people's choices were included by involving them and/or their representatives in the process of care planning.

Medicines were being sourced, handled and managed appropriately.

Overall, we considered that Heronswood Residential Care Home was in an average state of repair and required remedial work to improve the living conditions for people who used the service.

People who used the service told us that the staff were "lovely and simply wonderful". Both staff and people who used the service told us that they felt there were sufficient numbers of staff available on each shift to meet the needs of people.

The provider had systems in place to assess and monitor the quality and suitability of the service being provided. However, we considered the provider was not always responding in a timely manner to make improvements to the property.

7 June 2012

During an inspection looking at part of the service

Our inspection visit took place between 11.00 and 16.30 hours and was carried out on an 'unannounced' basis. This means that the service was aware beforehand that we would be visiting.

The majority of people who live at the service were involved in the review of the service through either their feedback or our observations of their interactions at service and with staff. We spoke with two carers (relatives) either on the day of our site visit or via telephone following our visit. We also consulted with three staff members. The site visit was facilitated by the operations manager. On the day of our site visit there were six people living at the service, including people who are older and who have a learning disability and people with physical and mental health needs.

A person who lives at the service told us how much they liked living there as the staff were very kind to them and that they always got the help they needed. A carer told us about the improvements in the standards of care that they have observed included 'staff having the time to spend just talking to my relative' . Another carer said 'still not convinced that much goes on in the way of things to do'.

We observed people who live at the service using none verbal forms of communication which staff were able to recognised and respond to. People who live at the service were observed showing relaxed body language and enjoyed interacting with staff.

4 February 2012

During an inspection looking at part of the service

We visited the service at a Saturday between 10.15am and 5.30pm. All people who live at the service were involved in this follow up review of the service through either their feedback or our observations of their interactions with the service and staff. We spoke with five carers (relatives) either on the day of our site visit or via telephone following our visit. We also consulted with six staff members. The deputy manger who was the person in charge on the day of our site visit facilitated most of the inspection until the arrival of the acting manager and operations manager. On the day of our site visit there were ten people living at the service including people who have dementia, mental health needs and behaviour which was described to us as challenging.

We noted significant improvements that have been made towards improving people's safety and wellbeing who live at the service. A new management team has been employed since our last review. They demonstrate the knowledge and skills to be able to continue to make the improvements they have told us they will undertake and to be able to sustain these improvements.

People who live at the service continue to tell us that they like living at Hersonswood due to the relaxed slow pace of life it provides. Carers consistently told us that they had noted improvements in the quality of care their relative had received. A carer noted 'They seem to be much better at the little things like ensuring everyone has some individual time'. A carer told us 'They are slowly getting better at providing activities and things to do'.

A carer spoke of how staff support their relative to maintain their personal appearance by helping them to put on their make-up each day. A person told us how they have recently received Holy Communion by visiting clergy.

Some people do not use verbal forms of communication. Observation showed that some people used single words or gestures and other people had their own style of communicating, for example, the use of body language, facial expressions or other forms of behaviour. We observed staff being able to interpreted these none verbal communications and provide the necessary support.

We observed a staff member explaining to a person what their medication was for, how and why they should take it. A carer told us how the acting manager had sought medical support promptly when their relative had become unwell.

A person living at the service told us that staff know what to do to help them. People described staff as 'Kind' and 'Lovely'. We observed that people clearly were at ease in the company of staff, showing relaxed body language, positive facial expressions and laughter.

Carers consistently told us the positive impact that increased staffing levels have had on their relative. A carer said 'I am here most days and what is noticeable is that there are more interactions between staff and residents'. Another carer told us that there is always someone around to help. However three carer's feedback their concerns about the number of agency staff currently being employed. A carer commented 'When I phoned up last night I did not know who I was talking to it's only really the acting manager that can tell you what is really going on'.

A person told us that they felt able to approach a particular staff member with any feedback or concerns they had. Several carers told us that their views about the quality of the services and facilities have been sought during the recent review of their relatives care plan.

9 November 2011

During an inspection looking at part of the service

Some carers and people continue to talk about how the quiet pace of live at the service suited their needs. However one person told us that there was 'nothing to do other than stare at the four walls'. A carer told us how their relative 'normally looks very nice the staff are good with the laundry'. Another carer spoke of being actively engaged in decisions regarding their relative's sudden ill health and decisions around their treatment and care.

A carer told us that the service is 'great as it is quiet and small and that she doesn't want a lot of things to do'. Another carer told us how welcomed they are made to feel when they visit. A person told us that they can go to bed and rise when they wanted. A carer told us about their concerns that the service has not recognised the religious needs of their relative and some other people living at the service by not celebration key Christian festivals

A person who lives at the service said 'I don't know what has happened to this place but it is not what it used to be. Staff don't seem to care anymore or don't have the time. We have very dangerous people here, I just stay out of the way and stay in my bedroom'.

A carer told us that they visited the service along with their relative to see if the service was suitable prior to making any decision about moving there. They spoke about how the manager at the time had given them all the information they needed to make an informed choice. They also noted that they were 'really impressed that perspective residents are invited to contact carers of people living at the service in order to gain a real understanding of what it is like living at the home'.

We observed the lunch and evening meal, which was very relaxed and people were given time to eat their meal where they wanted to. Two people chose to eat their meals not in the dining room, which was respected. A carer told us that the service has managed and accommodated their relative's restricted diet in a sensitive way. A carer said ' the food did improve for a while but sometimes my mum still says that she can't eat the food as it is inedible'. The views of people about the meal provided during our site visit was mixed and varied. Some felt the portion was too big, not too good, but okay. Others felt it was not the sort of meal they will eat at home, but it was bearable. Another person said they eat it because they were hungry and one person just eats what they are given.

Several carers feedback that they felt confident to raise any concerns they had about practices with the operations manager and that they had been very helpful in addressing their concerns. Another carer said that when they have raised concerns action was taken to try and address the concern, but that improvements have not been sustained.

A person told us that they did not always feel safe due to the behaviour of some other people who live at the service. A carer told us that they were 'happy to provide feedback if asked but have never been asked'.

We observed a person repeatedly say to staff that they were in pain for several hours. They only received their prescribed pain relief after a visitor told staff..

A person who lives at the service told us 'staff could not care less at the moment' . Carers consistently spoke of the kindness of some staff with a carer commenting 'staff are wonderful'. A carer told us that they thought the staff were doing the best job they could under very difficult circumstances. Another carer said ' I have only ever seen kindness from staff even under very difficult circumstances'. Carers and people consistently told us about the continuous turnover of staff. Their comments included ' It was all pretty good up until about 18 months ago when they started to have staffing problems and cover shifts' and 'there always seems to be a lot of turnover of staff and new faces which has been very unsettling for my mother'.

One carer said 'I visit weekends and I am not sure who is in charge as no staff seemed to want to take responsibility'. Carers and people consistent told us of their worries and concerns about staffing levels and the quality of staff now that the manager had left and that there appeared to be no one in charge.

A person who lives at the service told us that the management of the home seems disorganised.

22 July 2011

During a routine inspection

A person who lives at the service told us that 'I like living here as I can do what I want'. Several carers told us that their relative enjoyed and benefited from the quiet relaxed pace of life provided at the service. Carers noted the limited opportunities for mental stimulation. One carer said 'not a lot of activities going on a bit boring really I don't think I would like to live here'.

A carer told us that they been involved in the assessment of their relatives support needs when they first moved to the service.

A person told us how nice it was to live at the service, as people were friendly. We observed that people who live at the service were clearly at ease in the company of staff. They showed relaxed body language and smiled consistently in response to staff. Carers described staff as caring and gentle. They said that there was always staff around to help.

A carer expressed their concerns that their relative had not received the appropriate medical care.

We observed the lunch meal time, which was very relaxed and people were given time and support to eat their meal. A carer said of the meal their relative was given during a recent visit: 'it didn't look brilliant'.

Carers told us that they are frequently asked if everything is ok and if there is anything that could be improved.