15 October 2021
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 Care Act 2014.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
The inspection was completed by three inspectors. One of the inspectors focused on medicines as they were a medicine inspector.
Service and service type
Care home name is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. We spoke with the local authority and reviewed information we held about the service. We used all of this information to plan our inspection.
During the inspection
We spoke with three people who used the service and two relatives about their experience of the care provided. We spoke with six members of staff including the housekeeper, maintenance person, deputy and registered manager. We spoke with a health care professional whilst on site.
We observed the care people received and reviewed a range of records. This included four people’s care records and multiple medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records.
15 October 2021
About the service
Heather Vale is a residential care home providing personal and nursing care to 37 people aged 65 and over at the time of the inspection. The service can support up to 39 people.
Accommodation is provided over two floors, in one adapted building. Each floor has two separate wings, each providing individual bedroom and communal living facilities, such as dining rooms, kitchenette areas and specialist bathing facilities.
People’s experience of using this service and what we found
Auditing systems were not always effective or used to drive improvement in the quality and safety of the service provided. Medicine errors had not been identified or consistently addressed. Care plans did not always contain all the required information or risk assessments in line with people’s long-term conditions. This meant we could not be assured people would receive the care they required for their current needs.
The registered manager and deputy offered support to staff and had an open approach with relatives. However, overarching governance was not in place to ensure ongoing improvements were coordinated and maintained.
Infection, prevention and control was managed well, and guidance followed in line with COVID 19. Point of care hand washing facilities were not always accessible and this was addressed immediately after the inspection.
There were sufficient staff who had been recruited safely. Staff showed kindness and compassion in meeting people’s needs. Consideration was given to people’s daily choices and the decoration of their own space.
People were protected from the risk of harm and when concerns had been raised, these were investigated. Lessons had been learnt from these events. Surveys had been used to obtain people’s views and these showed positive outcomes.
The staff worked well with health and social care professionals in meeting peoples ongoing health needs.
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 21 November 2019)
Why we inspected
We received concerns in relation to people’s care, medicine and management. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
The overall rating for the service has changed from Good to Requires Improvement. This is based on the findings at this 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.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Heather Vale on our website at www.cqc.org.uk.
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.
We have identified breaches in relation to Regulation 12 (safe care and treatment) and Regulation 17 (Good Governance).
Please see the action we have told the provider to take at the end of this report.
We will request an action plan for 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.