Heathland Court Care Home

Updated 17 August 2023

The inspection

We conducted 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 conducted by 2 inspectors.

Service and service type

Heathland Court 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. 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 CQC 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 not a registered manager in post, although a new acting manager was recently appointed, and they have submitted an application to be registered with us.

Notice of inspection

This inspection was unannounced.

What we did before inspection

We reviewed information we had received about the service since their last inspection. We received telephone feedback from a relative and email comments from 6 community health and social care professionals including, a GP, 2 nurses, an occupational therapist, a local authority contract manager and a clinical educator/trainer. 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 12 people who lived at the care home and 6 visiting relatives and/or friends. We also talked to various managers and staff who worked at the care home including, the regional director, the new acting home manager, the deputy manager/clinical lead nurse, the care workers manager, a unit/floor manager, 2 nurses, 7 care workers, an activities coordinator, and the maintenance person.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not verbally communicate with us.

Records looked at as part of this inspection included 8 people’s care plans and 8 staff files in relation to their recruitment, training, and supervision. A variety of other records relating to the overall management and governance of the service, including policies and procedures, were also looked at, including multiple medicines records and internal audits.

We continued to seek clarification from the provider to validate evidence found. We requested additional evidence to be sent to us after our inspection. This included a risk management plan for 1 person who lived at the care home, the staff training matrix, and staff fire drill participation records. We received the information which was used as part of our inspection.

Updated 17 August 2023

About the service

Heathland Court Care Home is a residential ‘care home’ providing personal and/or nursing care to up to 58 older people. At the time of our inspection 55 people were living at the care home. They accommodate people across 4 separate floors, each of which has their own adapted facilities. The units located on the top and bottom floors support people with nursing needs and the first floor specialises in supporting people living with dementia.

People’s experience of using this service and what we found.

The care home was able to demonstrate they had improved in the last 9 months since their last inspection and were no longer in breach of regulations, although further improvements are still required.

At our last inspection we found the provider had failed to ensure staff did not work excessive hours without sufficient time off between shifts; risks people might face were not always safely managed; and their governance systems were not effectively operated.

At this inspection we found enough improvements had been made to address these outstanding breaches. People now received personal care and support from staff who had been given sufficient time off between shifts to recuperate and therefore did not work excessive hours. Staff knew how to prevent and manage risks people might face and had access to newly reviewed, detailed, risk management plans. The providers established oversight and scrutiny systems were now operated effectively.

We received negative comments from a few community health and social care professionals about the standard of care provided at the service. However, most external professionals, people living at the care home, their relatives, and staff working there, told us the service was beginning to improve under the leadership of the new management team and was moving in the right direction.

However, we identified a number of new issues at this inspection which needed to be addressed. This included improving how the provider conducted checks and kept records of the daily room temperature of their clinical rooms where medicines were stored. The service was not meeting their legal requirement to have a registered manager in post to oversee the delivery of regulated activities at this location.

The service was adequately staffed by people whose suitability and fitness to work at the care home had been thoroughly assessed. People were kept safe and were confident any concerns they raised would be listened to and acted upon. Staff understood how to safeguard people. The premises were kept hygienically clean and staff followed current best practice guidelines regarding the prevention and control of infection including, those associated with COVID-19. Medicines systems were well-organised. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People living at the care home, their relatives and staff working there were complimentary about how approachable and accessible the current management team were. The provider promoted an open and inclusive culture which sought the views of people living at the care home, their relatives, and staff working there. Complaints, concerns, accidents, incidents, and safeguarding issues were appropriately reported, investigated, and recorded. The provider worked in partnership with various community health and social care professionals and agencies to plan and deliver people's packages of care and support.

For more details, please see the full report which is on the Care Quality Commission (CQC) website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 26 October 2022) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We conducted an announced comprehensive inspection of this service on 22 September 2022. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve how they ensured staff would not work excessive hours without sufficient time off between shifts; prevented and managed identified risks safely; and operated their oversight and scrutiny systems.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the key questions safe and well-led which contained those requirements.

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.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from requires improvement to good, although the well-led key question remains requires improvement.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Heathland Court Care Home on our website at www.cqc.org.uk.

Recommendations

We have made a recommendation about the management of some medicines.

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.