Heathcote

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

Caring – this means we looked for evidence that the provider involved people and treated them with compassion, kindness, dignity, and respect.

At our last assessment we rated this key question Outstanding. At this assessment, the rating has remained Outstanding.

This meant people were truly respected and valued as individuals; and empowered as partners in their care in an exceptional service.

This service scored 90 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider was exceptional at treating people with kindness, empathy and compassion and in how they respected people’s privacy and dignity. Staff always treated colleagues from other organisations with kindness and respect.

The provider had introduced an ambassador scheme across its homes which aimed to genuinely involve people in decision making and seek their active participation. People using the service were nominated by other people for the following: Activity ambassador, Recruitment ambassador and Resident ambassador. The latter had a role in welcoming new residents to the home and being a point of contact for them and relatives and to answer any questions or concerns they might have. People were treated like equal partners in care and staff recognised the role people had in helping other people new to the service settle in. The activity ambassador actively asked people what improvements they wanted and if they had enjoyed previously booked activities which helped to determine if an activity should be repeated. Minutes from these meetings demonstrated how suggestions were acted upon. For example, people said they had enjoyed the valentines 'celebrations, the Elvis impersonator and would like a regular coffee morning with senior management. In addition, there was a key worker system in the home and people knew who their key worker was. There was a poster in people’s room, with an explanation of the key worker role which included checking in on people every time they were on shift to see if they needed anything. People told us they had confidence in the key worker-system, and it helped them feel safe and listened too.

The culture of the service strongly promoted people’s dignity and emotional well-being by listening to their feedback and having a strong focus on human rights and equality. Staff went above and beyond to honour people’s wishes and life histories, supporting deeply personal outcomes such as enabling a person’s cat to remain with them at the end of their life and continuing to care for the pet afterwards in line with the person’s wishes. Staff were planning to scatter the persons ashes with the cat's 'ashes as per their wish. These acts reflected a highly compassionate approach where people were truly treated with dignity, empathy and humanity and the provider placed significant importance on continuity of care and trusted relationships. Another person had suffered from a debilitating illness prior to coming into the service and staff as part of their recovery had supported them to identify what was important to them which was them not wanting to lose their independence. They were supported by staff to choose and furnish their room and go out on a weekly basis with support from staff to continue to enjoy what they use to. When we spoke with this person they told us‘” They had everything they wished for and were having a good life.”‘

The use of agency staff was very rarely necessary as all staff we spoke with felt it important that people using the service should have continuity of care and they had built up warm, trusting relationships with people which was valued. Staff told us they spent more time with people at the service than their own families and they were all like 'extended family. 'The registered manager was well organised, planned and relied on regular bank staff or the good will of permanent staff to cover shifts if required.

On our arrival we found the home was inclusive and welcoming with staff being visible but not overbearing enabling people to move round freely and visitors were supported in line with the person being visited needs. Visitors could be supported to stay over should their relative become ill.

We observed a spacious environment where people enjoyed the company of others and were encouraged to socialise often in small groups. Some people chose not to socialise, but staff made every effort to be inclusive and share the activity programme with people and ask what they would participate in. For example, one person loved books and videos, and staff had supported them to build their collection and explore alternatives like an e-reader. Another person told their key-worker they felt isolated and their key-worker supported them in line with their wishes to have a phone installed so they could keep in touch with friends and as their needs changed staff supported them to keep email contact with relatives.

Staff all had a cheerful disposition and clearly enjoyed their job which they completed unhurried and effortlessly. The conversations we witnessed enhanced people’s care and people were involved in decisions about how they would like to spend their time .For example, where and when they would like to eat with appropriate choices being offered. Staff were respectful in their interactions taking time to listen to the person, provide reassurance, choice, and attention to detail. It was clear that people enjoyed the company of staff, and people spoken with said, how nice the staff were without exception. Whilst acknowledging they had their favourites, people said all staff, went ‘ Above and beyond. 'Examples included helping people to maintain contact with family, going out to do the things they enjoyed such as the park, the garden or a walk into the city. People had what they needed whether it be a blanket or other object of comfort, foot stalls, access to the television and their favourite programmes or music.

Relatives spoke favourably about their family members care with one saying, "When I go to visit [relative], I watch what they are doing with other people. They are really kind and gentle with everyone.” Another said, "They are incredible. They know what is going on with them. They are absolutely kind and caring. They keep us updated on what is going on. "Another relative Said, “We have been overwhelmed by the kindness of the care staff. They are confident and very good.”

The provider treated people as individuals and was exceptional in how they made sure people’s care, support and treatment met people’s needs and preferences. The provider took account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

The service valued people’s individuality and the care we observed was one of mutual respect, interdependence, and emotional connections where the staff and people being supported got on well, enjoyed each other's company and trusted one another. There was alot of spontaneous laughter and the whole staff team worked as one to improve the quality of a person’s day through a smile, a hug, a positive interaction.

The role of the key worker could not be underestimated and strengthened bonds between people using the service and staff. All staff spoken with knew people well and care plans were very detailed. People told us they were confident staff supported them in the way they wanted to be supported and although staff knew people's preferences they still asked and offered people choices. We asked for examples of how people were supported to maintain their individuality and have their preferences recognised. One person had always dreamt of publishing their own book and their wartime experiences. Their key-worker supported them to purchase a handheld computer and then spent hours with them researching the information they needed, often in their own time. The person was able to achieve their dreams and their book was published.

One person broke their leg prior to moving to the service. This had a significant impact on their independence. They told their key-worker they wished to walk on the beach and dip their toes in the sea. Through a programme of exercise and rehabilitation, the person got their wish and was able to walk on the beach and paddle in the sea.This example showed how staff enhanced people’s experiences and enabled them to continue to live life as they wanted to.

One person told us staff organised a taxi and took them out for lunch and shopping as this was something they had always enjoyed. Another person was supported to go to a hospital appointment as they had no family support. Another person had a befriender they met with regularly and they took them out. This helped to reduce the risk of social isolation and promoted their well-being. Another person’s passion for chess was recognized and valued by staff, who supported them to maintain an ongoing connection with a former student associated with the home who visited regularly to play chess with them.This personalized approach showed how staff went beyond meeting people’s basic needs to ensure they could continue activities and relationships important to their identity and happiness.

Care plans were up to date, and accessible to people should they want to access them, and staff regularly discussed people's care needs with them. Key worker meetings, monthly reviews, and resident meetings were just a few examples of how people were included and consulted about their care needs. People were asked about their views of staff, activities, menus etc. and typical comments included: “I'm really happy here, ‘they do a great', and ‘I can’t fault them.”

We observed staff practices and could clearly see they knew people well and noticed their needs and any changes to them. Staff could tell us whether people preferred a bath or shower and if they were late risers. One person told us they got anxious at night but said the carers knew their preferences and attended to them early in the morning and always brought them snacks and drinks throughout the night as they got hungry and they felt reassured by familiar staff. Rota's showed staffing could be flexible to consider an increase in need and support required.

Care plans Included a social history, any significant routines, rituals, personal values, cultural,spiritual and/or religious beliefs which were respected and upheld for example through different church services for different nominations of faith and upholding individual dietary requirements. Staff discussed with people and their families about their wishes should they become unwell or need lifesaving treatments. Palliative care was provided in line with people's needs, and staff recognized that it was important to support the person and family in a familiar environment wherever possible. One person had recently experienced a bereavement and staff supported them to attend their relative's funeral and wake, which demonstrated that staff cared for people and supported them to have the opportunity to say goodbye.

The relationship between people and staff was mutually respectful and staff commented on being a family who were there for each other. The relationship between staff was one of harmony and respect with all staff pulling together and working as a team. This created a lovely atmosphere for everyone.

We saw people were well groomed with a regular hairdresser and pamper sessions and people commented they could get their hair done weekly. People’s care plans stated if they liked to wear jewellery or have items of importance with them such as a handbag. We spoke with a person who enjoyed knitting squares for charity and another watching their favourite television programme. People had their preferred areas to sit in the home, and we observed people socialising and asking after each other. Whilst some preferred their own company staff were seen encouraging people to join in and ensuring they had everything they needed.

The provider promoted people’s independence, so people knew their rights and had choice and control over their own care, treatment and well-being.

People’s care was seamless due to regular staff working effectively as a team and prioritising people’s needs. Care plans focused on people's strengths to ensure staff only supported people in line with their needs and preferences. For example, one person made their bed every morning but needed weekly support to change their sheets. Some people were checked regularly whilst others preferred not to be checked but had a call bell if they needed assistance. This supported people's autonomy and choice.

We asked the registered manager for clear examples of how they ensured there was a strong, embedded culture of person-centred care, which supported individuals to make choices, maintain their independence, and live fulfilling lives aligned with their preferences and interests. They told us how they kept people connected with their family and their community using assistive technology where appropriate. They gave an example of a person living with dementia who had always prepared vegetables at home before retiring to bed and staff have continued to support them to do this when they moved to Heathcote. The person also liked to hoover but had limited mobility but staff supported them to maintain this familiar routine.

Another person uses to attend a regular exercise class whilst living at home and has been supported to continue with this class at Heathcote. The persons relative or the registered manager took them to the class and the person said they were “so thankful” to still attend each week, adding that it helps them “keep supple and lithe.” This reflects how the service actively respects and promotes people’s choices and supported positive well-being through familiar, meaningful activity.

Another person had a keen interest in jigsaw puzzles and previously enjoyed visiting charity shops to find new ones. The service recognised the importance of this activity to them and, their key-worker took them to local charity shops whenever they wished to find a new puzzle. This ensures they remained active in choosing their own leisure activities and retains control over how they spend their time.

One person told us their key worker followed things up. They said maintenance regularly checked their room and domestic staff ensured the room was kept clean. They told us they did not attend residents’ meetings but were kept well informed and received the minutes. They said they tended to be in their room but were encouraged and supported with activities.

We spoke with another person who received a newspaper along with other people; However, they wished to take on a meaningful role within the home. They took responsibility collecting the newspapers directly from the paper delivery and distributing them to other people. They independently wrote the daily menu choices on the dining room whiteboard, contributing to the smooth running of the home and supporting people to make informed choices. These opportunities empowered them to remain active, valued, and involved in daily life, reinforcing their identity and independence. They were also supported to access an electronic device so they could make their own purchases rather than relying on staff to do it. With staff support they were now able to independently browse and purchase items of their choosing, at a time that suits them.

Following an ambassador meeting involving people using the service and management, two people stated they missed shopping at the local supermarket. The next day, staff supported people to go to the shops on to purchase their own items.

This provided response reflects a commitment to promoting independence, choice, and control rather than limiting opportunities. Staff actively removed barriers and created meaningful experiences that reflected people’s preferences and past lifestyles. People were supported to make their own decisions, maintain community connections, and engage in a familiar, valued activity that supports their sense of identity.

Appropriate risk assessments were completed but were completed in a way that did not diminish their independence or affect their ability to have control over their own life.

The provider listened to and understood people’s needs, views, and wishes. Staff responded to people’s needs in the moment and acted to minimise any discomfort, concern, or distress.

Staff treated everyone as individuals and knew their preferences but still gave every opportunity for people to express a choice. This was most obvious when we reviewed activities which were decided by people and involved one to one interactions and outings, as well as small group activities. Lunch preferences included a range of soft or alcoholics drinks, and varying food portion sizes and individual jugs of gravy and, or sauces. Unintentional weight loss was closely monitored, and we saw most people were a healthy weight and weight loss was quickly identified and reversed or stabilised.

The provider had established quality assurance processes which improved the lives of people using the service from value-based recruitment where the manager was skilled in identifying and ensuring staff had the right beliefs and behaviours. They supported staff through internal promotion and promoting their skills and knowledge within the workplace. We observed competent staff, gaining people’s consent before offering care or treatment such as medicine administration and clearly explaining to people what their medicines were for and if they required pain relief. Staff were observant and noticed if people were uncomfortable or sitting without interaction and staff would frequently enquire how people were and supported people safely with their mobility and safe transfers if required. Teamwork was observed throughout out the day and into the evening with staff working seamlessly to support people across the day.

Examples have been given throughout this report on how key-workers supported people to identify objectives and help people live fulfilling lives.People had daily contact with their key member of staff and told us they could raise issues freely and these were addressed. People were involved in their plans of care and meeting minutes showed how feedback was acted upon. For example, the purchase of new chairs, hanging baskets to improve the garden and clear evidence of regular trips as people wanted to go out more.

Technology was used appropriately to help promote people's safety without stifling their independent. This was clearly very important to people and enabled people them to move freely around the home with walking aids if required and fall pendants.For example, one person who had recently fallen had been referred to the physiotherapist and chose to continue walking in the garden. Positive risk assessments were dynamic and enabled people to take measured risks.

We reviewed incidents and accidents which were kept to a minimum due to the responsiveness of staff in identifying any changes in people’s well-being or cognition.We noted in people’s care plans that amendments were made frequently to show adaptations or adjustments in people care based on their changing or unmet needs. For example, staff offered fortified foods,snacks and milkshakes as part of a healthy diet. There were no issues with poor skin integrity and oral health care was promoted with people being supported to stay healthy.

People with cognitive changes were reviewed and underlying health conditions ruled out such as offering people regular hearing checks or referring them to the GP so underlying infections could be ruled out. The home was clear about the limitations of the service given the physical environment and proximity to main roads etc. Pre-admission assessments were thorough and kept under review to ensure staff could continue to provide safe care without compromise whilst ensuring the compatibility and welfare of everyone was considered.

Daily checks helped to ensure high standards were maintained at all times and any issue resolved straight away. People told us they could approach any of the staff to feedback their care and experiences and bar codes enabled visitors to provide instant feedback they wished when visiting.This was reviewed as part of the overarching quality assurance.

One person told us, “You heard things about care homes, and I was nervous about coming but I'm happy here and there's nothing I would change.” Consistently people were positive about their experiences of living at the home with another person telling us,“It's not perfect, nothing is but staff are so kind.”

We observed staff listening to people and responding to any request with nothing being too much trouble.A relative told us,“They are familiar with a few carers. They are very helpful, and they even do shopping fort hem.The care staff are very good and patient.”A carer told us,”We are a family we look out for each other, we cry together, we get to know each other well.”A person told us,“The staff are fantastic can’t fault them do anything for you.”

People told us call bells were responded to quickly and if staff were busy at that moment they would tell the person that and reassure them that they would not belong.

Staff noticed changes quickly and checked how people felt before offering support. Staff offered appropriate choices and asked people about their families and showed a clear appreciation of the person and their circumstances. For example, we heard staff asking people if they were hungry, thirsty, wanted support to join in activities, asking them how their family members were and if they were in pain, ( required pain relief) or if they wanted an alternative to the set menu. They encouraged people to go out and supported them to do so. People embraced the simple things we all enjoy such as a coffee out, shopping,or going out for an ice-cream etc. We heard staff asking people what they wanted to do with some people going out independently and others being supported by staff, and or family. An example of staff responding to people’s needs was a recent ‘Heathcote bake off’ which people wanted to do and meant people could revisit the culinary skills and bake their favourite dishes which were then judged and the winner rewarded.

People were confident in staff to meet their needs and keep them safe, and everyone told us they did feel safe and that staff were respectful and fun.

The provider always cared about and promoted the well-being of their staff and was exceptional at supporting and enabling staff to always deliver person-centred care.;

The service demonstrated a strong person-centred culture, with people experiencing care that was reassuring, engaging, and supportive of their well-being. Systems were in place to support safety and governance. Safeguarding was firmly embedded and staff felt supported by all layers of management. Staff turnover was low and had been for many years creating a stable and predictable environment for people using the service. Staff told us they felt connected and proud of the care they provided. This created a positive atmosphere. A staff member told us: “The registered manager is well respected, grounded and doesn't show favouritism and shows professionalism at all time teaching staff to be the best they can be.”

The service was good because it placed genuine, person-centred value not only on the people using the service but also on the staff who support them. The management had created a supportive, inclusive culture where staff well-being was prioritised through tailored initiatives, emotional support, and practical benefits. There were firmly embedded systems of support including mental health first aiders who could provide emotional support and signposting to other resources. Where staff had mental health concerns, the service introduced ‘the Mind Wellness action plan’ which managers completed with staff and discussed what support they needed, what support they would like, and any potential triggers which would help the manager to adequately support staff to do the very best job whilst managing their own health. Evidence was provided that senior management were well trained to support staffs' well-being and mental health and staff plans helped staff to feel supported and continue working. A confidential example was provided.

Additional measures of support included: Employee Assistance Programme – a free confidential phone line which was anonymous and could be accessed by any staff member for advice and counselling advise. Black Swan has a menopause champion whose role is to support staff who maybe currently living with the symptoms of menopause. The support ranges from face to face and telephone support, to the completion of risk assessments to support them in the workplace and where necessary, staff are able to access specific “menopause friendly” uniforms which helps maintain their temperatures. Benefits were well advertised and staff received regular updates and newsletters.

Staff had extensive employment benefits and the support of a well-established provider who offered development opportunities to staff and internal and external training opportunities Reward benefits included being able to reclaim money for certain items such as glasses, physiotherapy and benefits this is further extended to the employees and their children. Staff retention and staff satisfaction from staff surveys was high which indicated this was a good organisation to work for. A staff member told us: “We all gel together, people are well cared for, and staff look forwards to coming to work.”

Another told us, "Working here it’s a real privilege it's about the relationships you form with people she said I don’t have grandparents and here it's like having 24 grandparents and I look forwards to coming to work every day.”

Staff were empowered to develop, and be recognised for their achievements, and supported through personal challenges, enabling them to feel valued and supported. Staff received regular training, opportunities to talk and share good practice, annual appraisals, and team meetings. Night staff were seen very much as part of an inclusive team and staff meetings were held at different times to enable night staff to fully participate. All the staff we spoke with felt the registered manager was, 'one of them ’and truly understood each role within the service and helped to ensure teams pulled together and worked as one team. The registered manager had been promoted from within the service and had been long standing with positive comments and respect from her staff who said, ‘she always went the extra mile.’ and had ‘dedicated her working professional life to care. Equally the registered manager told us the support they received was ‘amazing.” The service was inspiring their own staff to progress within care and encourage students to gain insightful experience. All the staff we spoke with told us they loved coming to work and all helped cover vacant shifts as they felt it was better for the people they supported to see a familiar face, who they trusted.

Staff were encouraged to undertake additional roles and, or areas of study. Champion roles were well developed within the service with staff having a job description and training to help them fulfil their role. A champion role was based on staff experience or areas of care they were passionate about. For example, dignity champions which were important in helping to promote the right culture of respect and dignity which was important in ensuring people using the service and staff felt valued in their home and in the workplace. Apprentice of the month recognised the achievements of learners. Staff were supported to apply for national vocational awards, (NVQ) and their hard work acknowledged and celebrated.

The provider had a well-established staff reward system where nominations were made for amongst other things: Good leadership, team worker, best newcomers. Staffs' well-being was promoted through this and the recognition of when staff were going 'above and beyond.’ The provider promoted good staff retention and career progression, and staff turnover was very low. The provider entered its homes into the Norfolk care awards as a way of recognising staff talents and commitments to care. This included ‘best team award.’ Staff going the extra mile or delivering exceptional care was rewarded. This encouraged high standards of care and innovative practices.

Feedback from people using the service and relatives was all very positive with everyone telling us about seamless care and staff all delivering to a high standard. Care nominations included positive examples of staff delivering excellent person-centred care. For example, one nomination described a member of staff as, 'reliable, compassionate and patient.’