This inspection took place on 8, 9, 11 and 25 October 2018 and was unannounced on the first day.
Our last comprehensive inspection took place on 18, 19, 28 January and 1 February 2016. We found no breaches in the Regulations at that inspection.
The Heathlands Village is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided and both were looked at during this inspection.
The Heathlands Village provides a wide range of care services for up to 214 older people from both the Jewish and Non–Jewish community. The Heathlands Village is divided into six units. Beach House, residential dementia, Wolfson, residential, Unit 2 residential, First Floor residential, the Simon Jenkins nursing unit and Oakwood nursing dementia unit. The Heathlands Village is situated in extensive well-maintained grounds. At the time of our inspection visit the service was undergoing extensive restructure and design and only 121 people were using the service.
The service had a registered manager in place. A registered manager is a person who has registered with CQC 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.
At our last inspection in January 2016 we rated the service as ‘good’, with an ‘outstanding’ rating for the key question, ‘is the service responsive?’. At this inspection we found the evidence continued to support the rating of good and the service could demonstrate continuous improvement.
We found concerns about the safe control of substances hazardous to health (COSHH) on the new dementia unit, Beach House. The registered provider acknowledged that this was a result of people moving around the service. The registered provider’s maintenance team acted to rectify this issue immediately.
Overall, people’s medicines were safely managed. However, we raised some concerns about the storage of non-medicated creams and thickeners as well as the recording of thickeners that were not on the computerised medicines system. We were aware that the service was in the process of changing their supplying pharmacist and computerised medicines systems. The registered manager assured us that they would address the shortfalls we found with the new pharmacist and additional medicines cabinets would be provided. Minor issues were addressed immediately by the provider.
Recruitment procedures were sufficiently robust to protect people from the risk of unsuitable staff. However, improvements were needed to the registered providers application form to ensure a full employment history was maintained. This was addressed immediately by the provider during our inspection.
Staff had received training in safeguarding adults and knew the correct action to take should they witness or suspect abuse taking place. Improvements had been made to the security systems of The Heathlands Village.
We saw further improvements had been made to strengthen moving and handling procedures and health and safety training for staff in line with Health and Safety Executive (HSE) guidance.
The service was clean and tidy throughout and no malodours were detected.
We saw that the service had made changes to the site to make it more dementia friendly and provide a quieter area for people to live who were receiving end of life care. The registered provider had completed refurbishment of an existing area to create a new smaller dementia unit which was to a very high standard. This was to be the blue print for other areas of the home. It was recognised that these changes did not suit everyone. However, action had been taken by the registered provider to help minimise the impact.
There were adequate numbers of staff to support people safely and effectively. Staff had received or had access to training to help them support and care for people safely and effectively. Improvements had been made in staff training and more support was being offered to staff from human resources to improve staff retention.
People had access to health care professionals both on and offsite.
People enjoyed the food that was offered which was overseen by the Manchester Beth Din.
People’s religious needs were able to be met on site. Following requests from relatives we saw that Yiddishkeit (Jewish customs and way of life practices) had been further promoted with more work planned. Non Jewish people were also welcome to live at The Heathlands Village and their needs would be catered for and adapted to. For example, the provision of Asian meals.
We saw frequent and friendly exchanges between staff and people who used the service and the atmosphere was calm and relaxed.
There were a wide range of facilities to access and arrangements for social activities were wide ranging with additional support provided by volunteers if needed. The new exercise bikes had proved to be a hit with people who use the service.
The service had recently received the highest level of the gold standard framework to support people nearing the end of their life to receive compassionate and supportive care that met their cultural needs.
People were actively encouraged to give their views and raise concerns or complaints. The service saw concerns and complaints to help drive improvement and were discussed at a high level.
People told us and we saw that managers at all levels were visible, approachable and supportive. We saw that the service had recently appointed a care quality assurance manager. Part of this role was to maintain quality assurance in line with CQC regulations and Key Lines of Enquiry.
There was a strong emphasis on continually striving to improve and working in partnership with others. The service actively sought and acted on the views and opinions of people who used the service, relatives and staff. The service had developed a clear and visible code of practice that supported a positive culture and value base, which was expected to be followed by all people connected with The Heathlands Village.