Heathcote

We found the following examples of good practice.

Staff were observed to be wearing Personal Protective Equipment (PPE) in line with current government guidance at the time of the inspection.

Furniture within communal areas had been spaced effectively to encourage and promote social distancing to maintain the safety of the people supported.

Visiting professionals were required to evidence their vaccination status and produce a lateral flow test completed that day prior to entering the building. Once inside their temperature was also recorded to minimise risk to those residing within the service.

People's vaccination was recorded within their care plan to ensure appropriate steps were taken to plan and arrange for booster injections as may be required.

Since our last inspection in 3 September 2015, there has been a change of registered manager, however, the people who lived in the service told us that they continued to feel safe and very well cared for. There were systems in place which provided guidance for care staff on how to safeguard the people who used the service from the potential risk of abuse. Staff understood their roles and responsibilities in keeping people safe. Risk assessments were still in place to identify how the risks to people were minimised. There continued to be sufficient numbers of trained and well supported staff to keep people safe and to meet their needs. Where people required assistance to take their medicines there were arrangements in place to provide this support.

Both the registered manager and the staff understood their obligations under the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). People living in the home were still being supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

People’s needs were assessed and the service continued to support people to eat and drink enough to maintain a balanced diet. They were also supported to maintain good health and to have access to healthcare services.

We saw many examples of outstanding and positive caring interactions between the staff and people living in the service. People were able to express their views and staff listened to what they said and took action to ensure their decisions were acted on. Staff continued to strongly protect people’s privacy and dignity.

People received care that was personalised and responsive to their needs. The service still listened to people’s experiences, concerns and complaints. Staff took steps to investigate complaints and to make any changes needed. People were supported at the end of their lives to have a comfortable, dignified and pain free death.

The registered manager told us that they were well supported by the organisation. The people using the service and the staff they managed told us that the registered manager was open, supportive and had good management skills. There were still good systems in place to monitor the quality of service the organisation offered people to ensure it continued to meet their needs.

Further information is in the detailed findings below

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well led?

This is a summary of what we found.

Is the service safe?

We found that people were treated with dignity and respect. They told us they felt safe and would not wish to live anywhere else.

We found that the service had procedures in place to monitor the safety and quality of the service provided. Each person had received an assessment on their mental capacity and each person had been judged to have capacity. Records in care plans showed individual care and support needs were assessed so that they could be met safely. Risks had also been assessed and acted upon to minimise these are far as possible.

People were supported safely and correctly with their dietary needs. Meals and drinks were monitored and special diets listed for staff to follow.

All staff had received training in safeguarding and were aware of how to ensure people were safe and protected from possible abuse.

The monitoring and audit systems in place ensured that the service provided was offered safely and correctly.

One area of the home was a concern due to wheelchairs obstructing a fire exit. However, this was dealt with immediately and the obstruction removed to ensure people's safety was not compromised in the event of a fire.

Is the service effective?

Relatives told us that this was the right home for their family member. They told us their views were listened to about all aspects of the care and support provided.

People living in the home were spoken with in meetings or on a one to one basis to gain their views. They told us they voiced their opinions and action was taken when requests or concerns were raised.

We found a supportive line management structure in this home that monitored the quality of the service to measure the effectiveness of the quality of the service provided.

People who did not have close family support were assisted with an advocacy service provided by 'Age Concern'.

Is this service caring?

Throughout the day we overheard or observed interactions between staff and people living in the home. We heard choices offered, respect given, time given for people to do the task themselves, assistance when needed and encouragement to promote independence.

People we spoke with praised the staff team saying they were all good. Relatives and the GP praised the manager and the staff team for their caring approach to all aspects of the care and support provided.

Is the service responsive?

Where people were assessed as requiring more support than could be offered by the home further professional support was sought. Professionals were involved quickly to support people with their health needs. The GP told us that the home was effective. They said, 'The staff know the people well and act and communicate with the surgery quickly.'

Meetings had been held and areas for improvement that were highlighted were acted upon. Improvements had also been introduced since the last inspection where ideas had been discussed and acted upon. Staff told us the manager had an open door policy and that they could and would voice any issues and that they would be acted on.

Although no-one had made a complaint the people we spoke with told us they knew how to complain and that the complaint would be acted on. We were told by the people living in the home and relatives how responsive the manager was and how any issues they may have were addressed quickly.

Is the service well led?

Heathcote had a registered manager in post who knew all the people in the home. They told us how they varied their time of arrival to ensure they would meet all staff to gain their views and monitor the service at different times of the day.

A quality monitoring system was in place comprising of audits, meetings, questionnaires and spot checks.

The home manager had registered with the care Quality Commission in March 2014. People using the service and the staff spoken with told us the management was good. They told us they were listened to and action was taken when appropriate.

Care plans were completed and reflected the needs of people living in the home. They included any risks identified and action taken to reduce or remove the risks. Specialist advice was sought when required and staff had the skills required to offer appropriate care. This told us people's care and welfare was protected.

Meals were offered with choice and various nutritional needs were catered for. Drinks were encouraged and staff were aware of those not drinking enough. People who were at risk of a poor diet would be referred to a specialist. This would ensure people were supported with suitable and nourishing meals.

Medication procedures were followed and administration, storage and audit processes for medication were carried out safely.

Previously some concerns had been raised about the staff support, training and supervision arrangements. The home had now improved upon these concerns. Staff told us about the changes and record evidence showed that improvements had been made and that staff were now supported, skilled and better able to do their job.

The home had a number of systems in place that enabled them to measure and improve on the quality of the care that was provided.

We found that there was inconsistent support for staff to carry out their roles effectively. Some training was slightly overdue, some staff received regular supervision but others did not. Appraisal did not always take place regularly but staff did have opportunities to gain qualifications to support them in their work.

People told us they felt that they were kept informed about what was going on in the home. People were aware of the problems with the home's lift and although one person was not happy that they were unable to go downstairs when they wished, they understood why this had happened and that the lift was going to be repaired soon after our visit. They told us that they knew how to complain if they needed to and they or their relatives would complain if it was needed.