Archived: Heathfield Gardens

Heathfield Gardens provides nursing accommodation and support for up to 10 people who have a learning disability. At the time of this inspection there were 10 people who lived at the home. There had been no new admissions since the last inspection.

The service had a registered manager in post. The home is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service.

There were enough staff to meet people’s needs. Staff provided people with support and assistance in an unhurried, kind and considerate manner.

Staff protected and promoted people’s dignity and privacy. All interactions between staff and people were caring and respectful. People’s independence was promoted and they were supported to maintain their interests and hobbies both inside and outside the home.

People were listened to. Where possible, people were included in developing and reviewing the service to ensure it was providing what people wanted. There was a clear complaints procedure which was available for people and their relatives.

The provider ensured that staff were suitable to work in the home, and they had the knowledge and skills to meet people’s needs. There were opportunities for additional training specific to the needs of the people, such as understanding behaviour and keeping people safe. Staff had one-to-one supervisions and appraisals.

Staff had received training in the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) to ensure they understood how to promote and protect people’s rights. People were asked for their consent before staff provided people with support. Staff were able to explain to us how they maintained people’s safety and protected their rights.

Medicines were managed safely and in line with current legislation and guidance. There were systems in place to ensure medicines were safely stored, administered and disposed of. Staff who administered medicines received training to ensure their practice was safe.

Referrals were made to the relevant health and social care professionals where risks and changes had been identified. People were given a choice of nutritious food and drink throughout the day.

People were safe and the provider had effective systems in place to safeguard people. Staff were trained to recognise and respond appropriately to signs that people may be subjected to abuse. Staff were aware of emergency procedures.

The service was managed in the best interests of people. There was an effective quality assurance in place. The was an easy to use complaints process in place. Staff were managed in a manner that ensured good care was provided to people. Staff knew people well and were motivated to provide good care and were proud of the service they provided.

Is the service safe?

The people who used the service told us that they felt safe living at the service and knew who to speak with if they were worried about anything. Staff had received training on keeping vulnerable people safe. People's personal files included a range of risk assessments and these included procedures to safely manage risks.

We found the service to be meeting the requirements of the Deprivation of Liberty Safeguards. People's human rights were therefore properly recognised, respected and promoted.

Staff recruitment practice was safe and thorough.

Is the service effective?

People told us that staff encouraged them to be as independent as possible. One person told us, 'I make a cup of coffee myself', and another said, 'I wash up every day.'

Staff encouraged, and supported, people to take risks that increased their independence. These risks had been thoroughly assessed and recorded.

People were fully involved in planning their lives. One person said, 'I've seen [my support plan]. I'm happy with it.' Staff also confirmed this and one staff member told us, 'Whatever [the people who use the service] like to do they do it.' Support plans guided staff to meet people's needs in a consistent and informed way.

Staff had positive views on the service. One member of staff told us, 'We all work well together. There's a good atmosphere.'

Is the service caring?

People's privacy and dignity were respected. One person told us, 'Staff knock on my door and wait [until I answer].'

People told us that staff respected their personal preferences and interests and thought that their needs were being met. Staff confirmed this and one member of staff told us, 'Cook will ask everyone, each day, what they want from three choices [of meal].'

Is the service responsive?

People's personal records showed that staff were encouraged to take an approach to people which was centred on their individual needs. People's personal preferences, and likes and dislikes, were recorded and support was provided that met people's wishes.

There were meetings for the people who use the service. People we spoke with said that trips out were discussed at these meetings. Minutes of these meetings showed the involvement of people who used the service and the service maintaining an overview of their needs.

The manager gave us several examples of actions taken to address changes in people's needs. These ranged from changing the service's vehicle to placing a pressure mat beside one person's bed to alert staff at night and reduce risk for the person.

Staff told us they felt listened to by management.

Is the service well-led?

The service had a quality assurance system which identified, assessed and managed risks to people's health, safety and welfare.

Staff described a sound set of values upon which the service was based. These included treating people who used the service with dignity, valuing their opinions and showing respect to people and to staff.

We asked the provider to send information to the Care Quality Commission (CQC) to show that the necessary improvements had been made. This information was sent to the CQC in February 2014.

Information sent to the CQC showed that consent was obtained in a way that met legal requirements. We saw improvements had been made to ensure the premises were safe and suitable for providing people's care. The provider sent evidence that showed staff received training and support to meet people's needs and a system of clinical supervision for nurses had been introduced.

We found the improvements made had ensured the provider was meeting the required standards of care at Heathfield Gardens.

We found that care was planned and delivered in a way that generally met people's needs. We also found the medicines were managed safely at the home.

Some arrangements were in place for obtaining consent to deliver people's care and treatment at the home. These were not fully in line with legal requirements, however, where people did not have the capacity to make their own decisions.

Although some courses had been attended by staff, training was not adequate to ensure they were able to deliver safe and appropriate care. Nursing staff were also not receiving adequate support from the provider to maintain and develop their clinical skills.

People's bedrooms were comfortable and personalised and the home was accessible. We found that people were not, however, fully protected from the risks associated with unsafe premises due to inadequate maintenance of some areas of the home.