Heathlands Residential Care Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people were safe and protected from avoidable harm.

This service scored 69 (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 had a proactive and positive culture of safety, based on openness and honesty. They listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice. Accidents and incidents were reported, recorded and analysed to identify any patterns or trends so actions could be taken to reduce the risk of reoccurrence.

The provider had systems in place to ensure adverse incidents were reported to external stakeholders, including the local authority and to the CQC. Regular staff meetings were held. We reviewed minutes of meetings which showed incidents were discussed with staff so learning could be shared.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

Staff completed pre-admission assessments prior to people moving in to obtain key information to enable a positive transition into the service. One person told us staff visited them in hospital to complete a pre-admission assessment. Staff worked collaboratively with health care professionals to ensure referrals to other services were made.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. The service shared concerns quickly and appropriately.
People told us they felt safe. One person said, “I feel safe, and have no issues, I would speak to the manager if there were”. Staff confirmed they had received safeguarding training and had access to safeguarding and whistleblowing policies. A safeguarding log was maintained, with details of incidents reported to the local authority.
 

The provider assessed, monitored and reviewed the risks to people’s safety and wellbeing. Risk assessments were clear and detailed; for example, where people took anticoagulant medicines (blood thinners), they contained clear guidance if the person was to fall. However, people’s risks were not always monitored in line with their risk assessment, this placed people at risk of their health deteriorating.

We found care records did not always reflect where people or their relatives had been involved in discussions about their care. Some people told us they were involved in decisions around their care. One person said, “Me and [relatives name] are involved in discussions about my care”. A relative told us, “They [staff] ring up to inform us of any incidents. The other week [Person’s name] had a fall. They [staff] rang me up”. Staff told us they had access to care records; however, some staff told us they sometimes found it difficult to find the time to read them. Despite this we found staff knew people well.

One person was supported to take positive risks. Their care records evidenced risks had been considered and mitigated to promote their independence and well-being.

The provider had systems in place to monitor the safety and upkeep of the premises. Regular checks were undertaken on the safety of the environment and equipment was routinely serviced and maintained. However, during our visit we observed some safety concerns which had not been addressed or identified through the provider’s internal audits. For example, cleaning products were not safely secured away when not in use. This placed people at risk of harm if accidently ingested. A hot water boiler, used in 1 communal dining room to make hot drinks had an isolation code which had been disabled. This placed people at risk of accidently scalding themselves. We discussed the concerns with the provider who assured us the temperature was set at 39 degrees so people could not burn themselves and ensured the isolation code was activated.

There were sufficient numbers of staff available during our visit. However, some people and relatives felt there were not always enough staff at weekends, as they had to wait longer than usual to get in and leave the building as there were no reception staff on duty. One person told us, “They are always a bit pushed for staff, especially at weekends.” A staff member said, “Staffing levels are normally fine. If someone calls in sick, then the manager or deputy manager will step in and support”. The registered manager told us they monitored the response times to call bells and took action to address when waiting times exceeded the accepted standard.

The provider had identified domestic staff had been setting the alarms off when cleaning people’s rooms and calls had not been cancelled, staff were reminded in meetings they were required to still check and cancel the call if assistance was not needed.

The provider had systems in place to ensure safe recruitment practices were followed. Staff told us they felt supported in their roles and they had completed an induction and shadowed experienced staff before they were able to work independently. We saw staff had received regular one to one meetings and annual appraisals with their line manager.

The provider did not always assess or manage the risk of infection. They did not always detect and control the risk of it spreading or share concerns with appropriate agencies promptly.

We identified some areas of concern regarding cleanliness and food hygiene. For example, some chairs and carpets were soiled, and food items were not correctly labelled or stored. We discussed our findings with the provider who took prompt action to address the concerns we identified. The provider informed us they had identified areas that required replacing and updating and plans were in place for this work to be undertaken. Despite our findings, people we spoke with did not raise any issues regarding the cleanliness of the service.

Medicines and treatments were generally managed safely. However, we did find some medicinal creams were not always correctly labelled or stored safely. The provider had also identified this through their internal audits and was addressing this. Staff completed topical medication administration charts to confirm medicinal creams had been applied. However, these did not always reflect creams had been applied to the part of the body as directed by the prescriber. However, other aspects of medicines were well managed. Staff received relevant training and their competency to continue managing medicines safely was routinely assessed. Regular audits were carried out on medicines, and the findings added to an action plan with updates on progress and monitored by the registered manager and provider. Medicine stock balances and records showed people consistently received the medicines prescribed to them.

People we spoke with told us, “I don’t have a lot of medication. Staff bring it automatically morning and night”. Another person said, “Staff bring my medication its usually on time”.