Background to this inspection
Updated
21 December 2023
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.
Inspection team
The inspection was carried out by 3 inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
Heatherstones is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Heatherstones is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
Registered Manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was a registered manager in post.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority, the local health and care partnership, Healthwatch and professionals who work with the service. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.
During the inspection
We spoke with 2 people who used the service, 3 relatives and 6 members of staff including the registered manager. We reviewed a range of records. This included 4 people's care records and multiple people's medicine records. We looked at 3 staff recruitment files and a variety of records relating to the management of the service.
Updated
21 December 2023
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
About the service
Heatherstones is a residential home providing personal and nursing care to people with learning and physical disabilities. The service can accommodate up to a maximum of 8 people. At the time of our inspection, there was 7 people using the service. The home accommodates people on one floor with communal areas and bathrooms.
People’s experience of using this service and what we found
Right Support: Medicines were not managed safely. We found concerns with medication administration records, controlled drugs, and use of thickeners. There was no call bell system in place. It was unclear how staff were alerted of any emergencies or upon request by people. It was unclear if and how people had been involved in making decisions about their care. There was no evidence in care plans of this. There was a lack of involvement from people around choosing their meals. The service cared for people in a clean and well-maintained environment that met their physical needs. Safety checks were taking place on the equipment. Personal emergency evacuation plans had been updated to include more information about how people should be supported. People were not always supported to have maximum choice and control of their lives. Staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
Right Care: People were safeguarded from the risk of abuse. People had care plans and risk assessments in place outlining how they should be supported. People were supported to routine health appointments. Health concerns were raised with professionals promptly. Staff supported people in a dignified way. Appropriate DoLs applications were in place for people.
Right Culture: There was no use of signs, pictures or aids to navigate people around the home. We made a recommendation that easy read signs are used around the home to orientate people. There was a lack of documents available in different formats for those who had communication needs. Attempts were made to gather feedback from people; however, this did not capture everyone’s views as the surveys were not adapted to those who were non-verbal. Staff were able to request additional training and support if needed. Staff felt supported by the registered manager and had received regular supervisions. People were supported to maintain relationships with their families and friends and take part in meaningful activities at the service and in the community.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 8 August 2018).
Why we inspected
We inspected due to the length of time since the last inspection.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
You can see what action we have asked the provider to take at the end of this full report.
Enforcement and Recommendations
We have identified breaches in relation to management of medicines, communication and audit systems at this inspection.
Please see the action we have told the provider to take at the end of this report.
Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.